Good morning, Anthony. I enjoyed your Private Practice Strategies article on administrative fees in the July edition of Counseling Today. I find that most clients do not read most documents presented to them at intake. I quit giving my HIPAA form to clients to save printing costs, but indicate on the intake form they sign that the HIPAA form is available upon request. On other administrative costs, do you find it acceptable to provide the fees as a request comes in rather than listing them all in advance at intake? Also, what have you done when an attorney subpoenas you for court or deposition, but fails or refuses to pay your fees in advance? Thanks. –Mat
Good questions! First, regarding administrative fees. I find that it is best to inform clients of the late cancellation fees and no show fees during the intake appointment–not just by putting them in writing, but also by explaining to clients why we have them. This really pays off on the back end, if the day comes when that client no shows.
Regarding other admin fees, we want them to have them in writing, and we also post them in our waiting room. That way, when a client asks for a letter to be written on their behalf, and we tell them there is an administrative fee, they don’t feel like we’ve been hiding it from them (it was in their intake documents, AND it is posted in our waiting room, along with all our fees). I find that this is worth the additional printing costs.
Finally, regarding subpoenas, we are not often subpoenaed. If an attorney does subpoena us, if this was not facilitated by the client we of course exert our counselor-client privilege (an attorney subpoena is different from a court subpoena). If we were subpoenaed by an attorney on the client’s behalf, we would require payment up front. If (hypothetically) a client refused to pay and we were legally bound by the court to comply with the subpoena, we would comply. Again, our experience is limited here, as it rarely occurs.
In contrast, the provider I interviewed for the article gets court work almost constantly. It seems the word is out that he likes that kind of work, does it well, and he has a incoming stream of clients who come into counseling planning to use this services in the legal system.
I hope this helps!