This section is intended to provide you with information about fees, appointments, insurance and telephone calls. Please read it carefully to ensure that you understand all of the policies mentioned.

Fees:

For work outside of our offices, such as seeing clients in the hospital or house calls, we charge our regular rate "portal to portal" -- that is for the time that we are out of the office on your behalf.

Payment:

Full Payment is due at the beginning of each session. Please make out your cheque before the session begins. This will ensure that sessional time is not spent on bookkeeping.

Outstanding Balances:

We run a "cash practice" and prefer not to have to deal with the extra overhead of billing. For this reason we expect outstanding balances, i.e. "I forgot my chequebook," or "I forgot we had an appointment," to be made up at the next session.

Insurance:

We will be pleased to provide you with a receipt with a copy for your insurance company. Please specify that you intend to submit a claim due to the extra information required for insurance reimbursement and let us have a copy of the policy. We will make every effort to assist you in obtaining full or partial reimbursment. Additionally, your insurance may require that we provide them with an assessment and detailed progress reports. You may understandably elect not to use your insurance to protect your confidentiality or to avoid the "mental disorder" label.

Your health insurance policy is a contract between you and your insurance company. We are not a party to that contract. We do not contract directly with insurance companies as a network provider, so we are responsible and accountable only to you. Thus our loyalties are not divided, and there is no conflict of interest.

Usual and Customary Fees:

Our practice is committed to providing the best treatment possible at a reasonable
rate. For the Toronto area our fees are on par with what others charge, given comparable levels of experience and expertise. You are responsible for payment regardless of any insurance company's arbitrary determination of usual and customary rates.

Etiquette:

You do not need to knock on the front door when you arrive for your appointment. Come in and sit down in the waiting area. We will come and get you promptly at the start of the hour. Our time will end at ten minutes to the hour. We use this time to review our clinical notes, return phone calls, and prepare for our next appointment.

Please help us stay on time by having your cheque written prior to the beginning of the
session.

Confidentiality:

In all matters having to do with your therapy, confidentiality will be maintained unless you have signed a written release of information to a specific individual or agency. If your insurance uses managed health care we may be required to write reports or discuss your case with a case manager.

There are three exceptions to the confidentiality policy:

1. In some circumstances (i.e., child abuse) we are legally obligated to report matters to the authorities;
2. When we believe that a client is of imminent danger to himself or others; or
3. When we decide that consultation with a colleague will help in your treatment. In the latter situation, your name will not be used.

Appointments:

At the end of our first session we will make arrangements for further appointments. You can either have the same time and day each week, or if your own schedule does not allow for this we can vary the time and day. Due to our caseloads, there are usually limited possibilities as far as open times. Evening and Saturday appointments tend to be booked up quickly.

If you are unable to keep an appointment please provide us with 48 hours
notice so that the time may be made available to others who need our help.

If you miss an appointment without notifying us or cancel with less than 48 hours notice, we will need to charge you our full fee for the missed time.

^*Insurance companies do not reimburse for missed appointments.

Phone Calls & Messages:

We strive to promptly return all calls, but there can be unavoidable delays. If we are unavailable for a period of several days (such as vacation, etc.) we will leave instructions on our telephone message about back-up arrangements.

You may call James Vickers on his cell phone, (416) 721-3841 in the event of an emergency. Should James not be available, he will return your call as soon as possible.

However, if for any reason you are unable to reach us, please contact the nearest hospital emergency room.

Notice of Termination:

You are not obligated to see us for any specified number of sessions^*.  It is important, however, to give us one session's notice.  What we want to avoid is a situation where you cancel and then don't reschedule without explanation. A clean ending will be important to both of us.

^* This policy differs from that involving a commitment to group therapy. If you become
a group member please make sure that you review the "Group Ground Rules" before
starting.