Policies and Procedures
Participation in Counseling
As a client of Christal Jallorina Christian Counseling (CJCC), you are not required to accept treatment from CJCC at any time and you have the right to decline part or all of your treatment, including withdrawal from services should you not be willing to participate.
Informed Consent for Medical Records
I understand and consent to CJCC having one medical record for me, which is stored electronically. CJCC may also keep personal notes regarding my treatment, which will not have any of my identifying information on them, and are for the counselor's professional use only. These are filed separately from my electronic medical record.
All information obtained/derived during the course of treatment is fully confidential; disclosures you share with your therapist are confidential unless you have SIGNED a consent form to release part or all of the information. If you desire CJCC to either release or obtain information from a specific individual or agency, a Release of Information Form must be obtained. A fee may be associated with providing information to a specific individual or agency. Exceptions to this guideline include instances when 1) the client is a clear danger to (a) themselves or (b) others and, 2) instances when the client is a minor (under the age of 18) and reports that he or she is or has been a victim of physical or sexual abuse, and 3) there is any suspected abuse to a child or adult. Please sign and date all Release of Information documents.
You may contact me by phone, via the Client Portal through Jituzu or via email, at email@example.com. I typically return phone calls every Friday afternoon. I am not available 24/7. If you have an emergency, including thoughts of suicide/homicide or other danger, please call 911. Please do not use email to discuss your mental health concerns, as this is not secure.
Your first appointment, or assessment, will be 90 minutes long. Each session thereafter lasts for 50 minutes. Please be aware that if you arrive late for an appointment, it will still end at the scheduled time. A reminder alarm will be set for 10 minutes prior to the end of session, so that you will not need to be concerned about time keeping.
Fees and Payment
Please refer to www.cjccounseling.com ("Services" tab) for a list of current fees and services. You may request an invoice for services provided. After you have selected a service, you will be given a customized fee sheet, which will describe your fee schedule in detail. If fees change for CJCC, you will have 30 days before you will owe the increased fee. This only applies to those paying out of pocket; insurance fees and copays may change without notice.
Payment for all video services are due PRIOR to or during your appointment. They are payable via Jituzu over the phone or through your personal confidential Jituzu portal.
If balances are not paid in a timely manner, CJCC reserves the right to terminate services and to charge monthly interest of 3% until the balance is paid in full. Once a session has been completed, there are no refunds.
If you elect to bill insurance for services, keep in mind that insurance co-pays can change without notice. Any unpaid balance will be the responsibility of the client and will be due prior to further services being rendered. If a claim is denied for any reason, the client will be responsible for payment of services associated with this claim. Please check with your
insurance to see if they will reimburse for video counseling prior to your first video appointment.
Also, if you plan to use insurance, please upload a scanned copy of your insurance card and a photo ID onto your Jituzu portal prior to your first appointment. Please check with your insurance provider to find out what your current copay is.
Unpaid balances on accounts will be collected from clients 90 days after insurance has been billed. This means that CJCC is giving your insurance company 90 days to pay the claim. The law states that it must be processed within 30 days of receipt. After 90 days, you are responsible to pay CJCC directly. I will give you a receipt to submit to your insurance to pursue reimbursement on your own.
If your insurance changes or terminates, please call CJCC as soon as possible to provide updated information. If the insurance changes or terminates and you fail to notify me, this will result in the claim being denied from the insurance company and you will be held responsible for the entire fee. If I am not "in-network" for your insurance, you may call your insurance company and follow the process to submit a claim and get reimbursed. Please call them ahead of time so that you will know how much they will reimburse you.
Cancellations and Missed Appointments
When an appointment is scheduled, that time is reserved for you. It is your responsibility to give at least 24 hours' notice if you must miss or cancel an appointment. Therefore, a cancellation fee of $60 will be assigned every time an appointment is missed or cancelled with less than 24 hours' notice. This fee is assessed regardless of the reason for missing or cancelling the originally scheduled appointment. Repeated missed appointments or cancellations may affect the retention of your allotted time slot. In addition, if you frequently miss sessions or come late, this can negatively impact the benefits you receive from counseling.
I trust that your counseling experience with CJCC will be helpful. If you have any questions regarding these arrangements or other aspects of your relationship with me, please discuss them with me at any time.
You will be provided with a copy of these policies and procedures for your records, should you sign on to do services through CJCC.