CHAMPION PSYCHOLOGICAL SERVICES, LLC
P.O. Box 2623 Mercerville, NJ 08619
Carmen Lynn Hodges, Psy.D., LCADC
New Jersey Licensed Psychologist #35S10049600
New Jersey Licensed Clinical Alcohol & Drug Counselor #37LC0006900
Psychotherapy can have benefits and risks. Since therapy often involves discussing difficult aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness.
At the same time, psychotherapy has been shown to improve relationships, to provide solutions to specific problems, and to reduce feelings of distress. Psychotherapy involves a large commitment of time, money, and energy, so you should be careful about the psychologist you select.
Also, please note as your psychologist I am not permitted to perform for you certain evaluations (e.g., disability or forensic exams) or to write letters regarding emotional support animals.
Please note office policies:
Location of Appointments & Electronic Equipment Needed
At the present time all appointments are held virtually. There are no face to face appointments. That said, the use of a computer/smartphone, email, or tablet is very important for the success the therapy process. Patients will require a camera and microphone, a bit of privacy to sit and use their device, and the commitment to regularly check their email for important messages.
Duration of Appointment
Psychotherapy session “hours” are typically 45 minutes to 50 minutes in duration at most. Psychologists typically use the balance of the hour to document what transpired in the session. And, begin the next session, at the start of the next hour.
At times it becomes necessary to close the office. When this occurs, you will be notified either during your session, or in an email. If there is an emergency closing, you will receive a phone call, and perhaps voicemail. And, during that time, (or shortly thereafter), you will also be provided with information regarding rescheduling any needed appointments.
Patient Appointments and Cancellations
Appointment times are set to accommodate client schedules as often as possible. To properly assist you, I ask that you keep your appointment on a regular basis. I will be glad to discuss any need for a change in scheduling. If you cannot keep your scheduled appointment, please call 609-638-7560.
By law, I am not permitted to bill insurance for missed appointments. Therefore, you will be billed for any missed appointments unless I am given 24-hours notice.
If you need to cancel an appointment, please call, and leave a message. Please do not text, or send messages via messenger. These modalities are not HIPAA compliant.
No Show Appointments
If you are 15 minutes late for your appointment without prior notification, you will be billed for a NO SHOW appointment.
If you NO SHOW an appointment, all subsequent appointments will be cancelled until patient pays No Show fee, and clarifies interest in continuing in treatment. This will prevent you from accruing any additional bills for missing sessions.
Please note, due to the high demand for psychological services, if you take a leave of absence from treatment, or no show consecutive appointments there is no guarantee of scheduling availability.
You may choose to contract for telepsychology services as a private payor if your insurance does not cover such treatment. You will agree to be billed. Payment is required at the time of service.
Currently, the rate for the initial session is $200 for an initial session and $180 for follow-up 45-minute to 50-minute sessions.
I can provide a sliding scale to clients who qualify.
These fees are subject to change.
In Network Provider Statement
This office is an in network provider for many insurance companies, and if you are using your insurance, this office accepts the insurance payment, along with your copay, coinsurance and/or deductible should they apply, as full payment.
In any professional relationship, payment for services is an important issue. This is a crucial issue in therapy, where clarity of relationships and responsibilities is a goal of treatment. Payment, or co-pay is expected 15 minutes before your visit. All Electronic Payments are processed via Square.com via our secure payment system on our website (www.championpsychsvcs.com).
I will log on after Square notifies that a copayment has been made. It is your responsibility to know how much your copayment , and deductible, and coinsurance is and when it is due. You can confirm this information with your insurance company. Please also contact my billing company as needed during weekday business hours at 877-587-7851.
Please note that you are responsible for your deductible amount as specified by your insurance company. Please advise of any insurance changes immediately.
The following are accepted methods of payment for Telepsychology appointments: Visa, Mastercard, American Express. Any bank fees will be your responsibility.
All bills not paid within 60 days are subject to collections.
If you are having financial difficulties that prevent timely payment, please advise.
Doctor’s Notes, Phone Calls and Medical Records Requests
Note: if the following services are not covered by your insurance company, you will be billed separately:
- A. Doctor’s Notes- there is a minimum $25 fee (min 3 business days to complete);
- B. Phone Calls- Please note phone calls that are 15 mins, or more are subject to your copayment , or the prorated hourly cash rate;
- C. Medical Records Requests- To receive your entire medical record (after signed/written consent), please allow 5 to 7 business days for completion. The fee is $75 for the first 100 pages and 20 cents for each additional page. This fee includes postage.
Worker’s Compensation and Legal Cases
This office bills a cash rate for Workers Compensation, and Legal Cases due at each time of Service.
These fees are subject to change
If you use your health insurance to pay a part of your fees, I must give the insurance company some information. They usually want your diagnosis, the fee, when therapy first began, and a treatment plan or summary of treatment. It is against the law for insurers to release any information about our office visits without your written consent.
I hope this information will prevent any misunderstanding later. In this way, treatment can proceed efficiently.
If you are having a psychological emergency, you may call me at (609) 638-7560 if you need to speak with me. Leave a message if I am unable to pick up the phone when you call, I will get back to you as soon as possible. If there is an emergency, please contact /go the nearest hospital immediately.
Please note, I am not available 24 hours per day, or 7 days per week.
I have provided some additional resources you may also find helpful on my website. Please print and use them as a resource.
Please note, for your convenience my practice email address email@example.com is a HIPAA secure website. You may email your intake paperwork, insurance documents, etc. to this website.
However, this site is to be used for the exchange of information and not for therapy sessions.
You may also fax pertinent information to my private office at the following number: 609-581-4762.
Please sign below to verify that you have read this orientation and agree to the terms indicated in these policies.
I am looking forward to working with you,
Carmen Lynn Hodges, PsyD, LCADC