Insurance:I accept all Blue Cross Blue Shield products including HMO, PPO and POS plans. If
you do not have BCBS I may be able to work with your insurance if you have what is referred to as an "out of network
benefit". This benefit allows the policy holder to see any provider they choose, with the agreement that your will be
reimbursed for your out of pocket expenses. Prior to meeting with me, I ask that you contact your insurance company to clarify
the type of plan that you have as well the extent of coverage your insurance company provides. Length
and frequency of treatment:
Psychotherapy involves regular sessions, usually 50 minutes in length, at least once weekly. Duration and
frequency of psychotherapy varies depending on the issues that are presented and your individual needs. In beginning with
new clients, I schedule 4 consecutive sessions for the purpose of assessment. At the end of this assessment period, I will
discuss with you my recommendations for therapy. At that time we will begin to create a treatment plan that will become the
focus of your therapy. However, if prior to the end of these four sessions, I feel that that there are issues beyond my areas
of expertise or the presenting issue would be more appropriately addressed in a modality other than that which the client
requested, I reserve the right to refer you to a more appropriate practitioner.
that you share with me will be kept strictly confidential, and will not be disclosed without your written consent. However,
by law, there are some circumstances that will require me to break that confidentiality. These circumstances include any or
all of the following;
Fee policies (Self pay clients):
Please contact me directly to discuss my fees.
Payment is expected at the end of each session. If you need to cancel an appointment, please provide me with at least 24 hours
notice; otherwise, you will be charged my full fee for the missed session. Rescheduling sessions also requires at least 24
hours notice. Bounced checks will result in a $35 processing fee. I also provide a reasonable sliding scale.
Third Party Billing (using insurance to
pay for therapy): My psychotherapist may disclose any
and all records pertaining to my treatment to my insurance company, or agreed upon other third party payer, and/or primary
care physician as necessary for coordination of treatment, submission and validation of claims, or case management. I may
revoke this consent in writing at any time
I have been informed of the costs of services. While Joseph Winn MSW, LICSW will submit my claim to my insurance
company, or agreed upon other third party payer, I understand that I am responsible for the costs of services should my insurance
company not cover services. I have been encouraged to contact my insurance company to determine the scope of mental health
services covered by my policy. No Show Policy:
I will be unable to schedule another appointment with you after two consecutive and unexplained absences
until the fees for these sessions have been paid in full.
Phone and emergency contact:
If you need to contact me by phone, DO NOT HESITATE to contact me. You can reach me at (617) 461-8479.
I am usually able to return phone calls the day they are made. You will not be charged for phone calls unless we have a scheduled
conversation of an information - exchanging or problem solving nature that lasts more than 10 minutes, at which point the
charges will be rounded to the quarter hour. Phone messages will be indicated on receipts, and these fees are expected at
the end of the next therapy session. If you cannot reach me in an emergency, and need immediate attention, please get to the
nearest emergency room. Physician contact:
Physical and psychological symptoms
often interact. I encourage you to obtain a physical examination, or seek medical consultation if warranted, within 30 days
of our initial meeting. The purpose of this recommendation is to rule out the possibility of medical conditions which may
manifest as emotional or psychological issues. I will ask that you allow me to obtain copies of your most recent physical
exam or relevant medical records. If you do not have access to a primary care provider, I can assist you in locating a practitioner
based on your needs, and preferences. Medication may sometimes be helpful for psychological issues. If I feel that a medication
evaluation is indicated, I will discuss this option with you. If you feel that this is an appropriate addition to your therapy,
I will arrange a referral for such an evaluation. I will ask that you sign a release of information allowing me to discuss your situation with
the evaluating practitioner and obtaining a copy of said providers assessment and recommendations.
Collateral contact / meetings:
In the event that I need to discuss your treatment with other professionals, or others that you feel are
important to your treatment, you will not be charged. I do, however, charge full fee and travel expenses per hour for in-person
meetings with outside providers. I will not attend these meetings unless you ask me to do so. Charges for these meetings will
be indicated on receipts, and these fees are expected to be paid at the end of the next therapy session.
I will provide you with at least 2 weeks notice prior to any scheduled vacation
I am planning. During my absence I will provide the name and contact information of a clinician who will be available to you
if needed. If you are in crisis at the time of my vacation, I may ask that you sign a consent to release information, so I
may discuss with the covering clinician how best to assist you in my absence.
Freedom to terminate therapy:
If at any time you feel that the treatment is not progressing as you wished,
please do not hesitate to inform me of this. I will do my best to accommodate your needs, and resolve any issues that you
feel need to be addressed. You have the right to end therapy at any time. If you wish, I will give you the names of other
qualified psychotherapists. Informed consent:
I understand that some of the information discussed in the course of psychotherapy may be distressing to
me, but may be necessary to help me resolve my concerns. I understand that alternatives to psychotherapy include alternative
therapies, medication treatments or no treatment. I have read and understand the preceding statements. I have had an opportunity
to ask questions about them, and I agree to enter a professional psychotherapy relationship with Joseph Winn MSW, LICSW, CST.
- Disclosure of intent to harm yourself;
- Disclosure of intent to harm another;
that minor children are being placed at risk e.g., sexual or physical abuse and / or neglect.
- Disclosure that elderly and / or handicapped people are being placed at risk e.g., sexual,
physical or economic abuse and / or neglect.
I need to discuss your treatment with a colleague, I will disguise all identifying information, including the use
of a pseudonym.
- If a patient files a complaint
or lawsuit against me, I may disclose relevant information regarding said client in order to defend myself against such