You don’t have to figure this out all on your own.

You’re ready to take that courageous first step:

Contact Kim to schedule your free 15 min consult. You and Kim will decide together if this is a good counseling match and if appropriate, schedule your intake session.

At your intake session, Kim will get to know you better by learning about your struggles, strengths and goals. You will then decide together when to schedule your next sessions and how often you will meet. Please feel free to ask any questions as this is your time to use to meet your needs.

Your journey to you is not a straight path, there will be both distress and celebrations of victories. You are a full range of emotions and practicing that awareness is what being you is all about.

Generally speaking, the information provided by and to a client during therapy sessions is legally confidential. If the information is legally confidential, the clinician cannot disclose the information without the client's consent or as provided for in HIPAA. Respecting this right, Finucan Consulting will not inform others that you are in therapy and the content of sessions will remain confidential. The only time this confidentiality may be broken is if one or more of the following exceptions/conditions apply:

• If you pose physical danger to yourself or others

• If you disclose that you or another person has physically or sexually abused a child, an incompetent or a disabled person, or an elderly person.

• If you disclose that a child, an incompetent or a disabled person, or an elderly person is suffering due to neglect.

• A court order signed by a judge

• You have signed a Release of Information

Information about your health is private. And it should remain private. That is why Finucan Consulting is required by federal and state law to protect and maintain the privacy of your health information. We call it “Protected Health Information” (PHI). The basis for federal privacy protection is the Health Insurance Portability and Accountability Act (HIPAA) and its regulations, known as the “Privacy Rule” and “Security Rule” and other federal and state privacy laws.

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment, or health care operations, and for other purposes that are permitted or required by law. It also describes your rights to control your protected health information. “Protected Health Information’ (PHI) is information about you, including demographic information that may identify you and that relates to your past, present or future physical or mental health condition and related health care services. We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice at any time. The new notice will be effective for all (PHI) that we maintain at the time. Upon your request, we will provide you with any revised copy that can be sent to you in the mail or ask for one at the time of your next appointment.

Uses and Disclosures of Protected Health Information:

Your (PHI) may be used and disclosed by your provider, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you. Your (PHI) may also be used and disclosed to pay your health care bills, and to support the operation of your provider’s office. Following are examples of the type of uses and disclosures of your (PHI) that the provider is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be used by this office.

Treatment: We will use and disclose your (PHI) to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party that has already obtained your permission to have access to your (PHI). For example, we would disclose your (PHI), as necessary, to a hospital that may provide care to you. In addition, we may disclose your (PHI) to another physician, pharmacy or medical laboratory when they become involved in your care.

Payment: Your (PHI) will be used, as necessary, to obtain payment for your health care services. Finucan Consulting may use and disclose a patient’s medical information to obtain payment for treatment and services rendered. In general, payment includes verification of eligibility and pre-certification with a health plan, submission of billing information either directly or through a third-party clearinghouse for reimbursement, utilization reviews and collections.

Healthcare Operations:

We may call you by name in the waiting room when your provider is ready to see you. We may use or disclose your (PHI), as necessary, in order to contact you to remind you of appointments. (For instance, we may leave a message on your voice mail, send mail to your address, or leave a reminder with another person at the telephone number you provide). We may provide your PHI to a family member, friend, or other individual who you indicate is involved in your care or responsible for the payment for your health care, unless you object in whole or in part. Retroactive consent may be obtained in emergency situations.

Other Required Uses and Disclosures That May Be Made Without Your Consent, Authorization or Opportunity To Object: We may use or disclose your (PHI) in the following situations without your consent or authorization. These situations include:

Required By Law: We may use or disclose your (PHI) to the extent that the use or disclosure is required by law. This will only be done in compliance with the law and will be limited to the relevant requirements of the law.

Abuse or Neglect: We may disclose your (PHI) to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your (PHI) if we believe that you or a venerable adult have been a victim of abuse, neglect, or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure would be made consistent with requirements of applicable federal and state laws.

Legal Proceedings: We may disclose (PHI) in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized). We may also disclose this information in response to a subpoena, discovery request, or other lawful process. We will at all times, attempt to avoid releasing your records without your consent.

Criminal Activity: Consistent with applicable federal and state laws, we may disclose your (PHI) if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose (PHI) if it is necessary for law enforcement authorities to identify or apprehend and individual.

Worker’s Compensation: We may disclose your (PHI) as authorized, to comply with worker’s compensation laws and other similar legally established programs.

Disclosure is required or permitted to a health oversight agency for oversight activities authorized by law. Example: When compelled by U.S. Secretary of Health and Human Services to investigate or assess my compliance with HIPAA regulations.

YOUR RIGHTS

The following is a statement of your rights, with respect to your PHI and a brief description of how you may exercise these rights.

You Have the Right To Request A Restriction Of Your Protected Health Information: This means you may ask us not to use or disclose any part of your (PHI) for the purposes of treatment, payment, or healthcare operations. Your request must be a written statement with the restriction requested and to whom you want the restriction to apply. If you choose to release any protected health information, you will be required to sign a Release of Information form detailing exactly to whom and what information you wish disclosed.

You Have The Right To Receive Confidential Communications From Us By Alternative Means Or At Any Alternative Location: We will accommodate reasonable requests. We will not require an explanation from you as the basis for this request. Please make this request in writing.

You Have the Right to Obtain a Paper Copy of This Notice from us, at any time upon request.

You have the right to inspect and copy your PHI if requested in writing. We may refuse to give you access to your PHI if we think it may cause you harm, but we must explain why. As a client, you have the right to receive a copy of your counseling/therapy file. This file copy will consist of only documents generated by us and will be completed within 30 days’ notice of your request. You will be charged copying fees as stated in the Disclosure Statement. Psychotherapy notes are afforded special privacy protection under the HIPAA regulations and are excluded from this right.

You have the Right to Amend Your PHI. If you believe that there is some error in your PHI or that important information has been omitted, it is your right to request that we correct the existing information or add the missing information. Your request and the reason for the request must be made in writing. You will receive a response within 60 days of our receipt of your request. We may deny your request, in writing, if we find that: the PHI is (a) correct and complete, (b) forbidden to be disclosed, (c) not part of our records, or (d) written by someone other than Finucan Consulting staff. Our denial must be in writing and must state the reasons for the denial. It must also explain your right to file a written statement objecting to the denial. If you do not file a written objection, you still have the right to ask that your request and my denial be attached to any future disclosures of your PHI. If we approve your request, We will make the change(s) to your PHI. Additionally, we will tell you that the changes have been made, and we will advise all others who need to know about the change(s) to your PHI.

You Have The Right to Get a List of the Disclosures. You are entitled to a list of disclosures of your PHI that Finucan Consulting has made. The list will not include uses or disclosures to which you have already consented, i.e., those for treatment, payment, or health care operations, sent directly to you, or to your family; neither will the list include disclosures made for national security purposes, to corrections or law enforcement personnel, or disclosures made before April 15, 2003. After April 15, 2003, disclosure records will be held for six years. We will complete the accounting of disclosures within 60 days of receiving your request. The list I give you will include disclosures made in the previous six years unless you indicate a shorter period. The list will include the date of the disclosure, to whom PHI was disclosed, a description of the information disclosed, and the reason for the disclosure. We will provide the list to you at no cost, unless you make more than one request in the same year, in which case there will be a reasonable charge based on a set fee for each additional request.

WHAT IF I HAVE A QUESTION OR COMPLAINT?

Should you have a question regarding our Notice of Privacy Practices, please contact our Security Officer at 843-619-7989. If you believe that your privacy has been violated, you may file a complaint with us or with the Secretary of Health and Human Services in Washington, D.C. We will not retaliate or penalize you for filing a complaint with us or the Secretary. To file a complaint with us, please contact our Security Officer at 843-619-7989. Your complaint should provide specific details to help us in investigating a potential problem. To file a complaint with the Secretary of Health and Human Services, write to: 200 Independence Ave., S.E., Washington, D.C.20201 or call 1-877-696-6775.

Notice effective 1/1/24

IA Good Faith Estimate protects clients from unexpected medical bills. This act was passed by Congress in 2022, is for those who do not have insurance or are not using insurance to pay for their counseling. You have the right to a “good faith estimate” to ensure you are aware of your costs. Kim will send you, your individual good faith estimate via the client portal. You are the decision maker of what works for you.

A Good Faith Estimate is not intended to serve as a recommendation for treatment or a suggestion that you may need to attend a certain number of counseling sessions. Counseling is a personal process that changes as we work together. The number of sessions or the estimated cost of services may change over time based on your specific goals.

Should your needs change during treatment, Kim will provide you a new, updated Good Faith Estimate to reflect the changes to treatment, and the accompanying cost changes.

You may contact our facility to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.

The Good Faith Estimate is not a contract between you and Kim. It does not obligate you to maintain treatment from Kim or require you to participate in all services listed. Counseling with Kim is voluntary and you may stop or pause services at any time.

You have a right to initiate a dispute resolution process with the U.S. Department of Health and Human Services (HHS) if the actual amount charged to you substantially exceeds $400 beyond the estimated charges stated in your Good Faith Estimate. If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill. There is a $25 fee to use the dispute process for an agency review.

To learn more about your rights or get a form to start the process, go to www.cms.gov/nosurprises or call HHS at (800) 985-3059.

Be sure to keep a copy of this Good Faith Estimate in a safe place or take pictures of it.

You are encouraged to speak with Kim about any billing concerns. tem description

Effective January 1, 2024

Counseling Fees:

$155 - Rapport building & intake assessment

$125 - 50 minute individual session

*Ask about our courtesy rates for helping professionals.

Kim is contracted with BCBS insurances. You may choose to use your BCBS or self pay for services. Self pay allows you to be in charge of your treatment and protects your confidentiality from third parties. It allows you the opportunity to be the sole decision maker for what is best for you. If you choose to use BCBS, Kim will file claims for you. If you would like to submit our sessions to insurances for out of network reimbursement, Kim will provide you a superbill which contains the information needed for insurance to determine a claim for out of network services. Please contact your insurance to learn more about the claims process and your coverage for in network or out of network services.

Supervision Fees:

Individual supervision $80/ hour

Shared Triadic Supervision $45/participant per hour

Group Supervision $50/ 2 hours

*Ask about our reduced fee supervision packages.

Consultation Fees:

Clinical Case Consultation $80/ 50 minutes

LPCA Business Consulting $80/ hour.

*Ask Kim about supervision and consulting special pricing and packages.

Business Consulting $150/hour. Packages available.

*Contact Kim for pricing.

Clinical Director or Clinic Supervision Fees:

Services and fees are tailored to meet the needs of the practice.

*Connect with Kim for pricing.