Please sign, and return, the “Intake Form” and “Signature and Consent Form”. Please bring them with you to your first appointment. You may also send a hard copy to the office or you can also email a PDF. Thanks!
- Intake Form
- Limits of Confidentiality
- Notice of Privacy Practices
- Office Policies
- Signature and Consent Form
- Good Faith Estimate
If you are requesting an appointment on behalf of a loved one, please be sure that they are with you when you request the appointment. With substance use and dependency issues the client is the one who must make the important decision to come to counseling.
We are committed to your privacy. Do not include confidential or private information regarding your health condition in any written communication online.
For telehealth appointments I am currently using HIPPA Compliant DoxyMe. https://doxy.me/rivercovecounseling
Fees and Insurance
My fee is $100-$125 per hour
** UPDATE SEPTEMBER 2023 **
- Community Care (VA CNN)
- Optum (this includes – Harvard Pilgrim, United Healthcare, United Behavioral Health, United Student Services, Health Plans and Allways Health Partners)
- BC/BS of Massachusetts (including BC/BS Federal, Anthem & others)
- Carelon/WellSense (Beacon Health, Fallon/Wellcare; BMC, MBHP (MaHealth))
- Tufts (Commercial and MaHealth
If your insurance will accept an out-of-network provider I can provide a form for you to submit.
Cash or credit/debit cards are accepted. I ask that you pay at the beginning of each session, if in person, or within 24 hours if paying online. You will receive a receipt either via text or email. I use SwipeSimple which is directly connected to M&T Bank and it is not a 3rd party.
Please check with your insurance and ask:
Do I have out-of-network mental health insurance benefits?
What is my out-of-network deductible and has it been met?
Is it possible to receive reimbursement for sessions?
Do I qualify for reimbursement under my current plan?
What are the deductible and reimbursement amounts involved when using an out-of-network provider?