POLICIES

Payment & Insurance Options for Individual & Group Therapy

At Connections Restored Therapy, LLC, my top priority is providing high-quality mental health care tailored to your unique needs. As an out-of-network provider for ALL insurance companies, you can choose the services that best fit your treatment goals and potentially receive reimbursement directly from your insurer.

Payment for individual and group therapy sessions is due at the time of service, with group therapy billed as a monthly fee. I accept credit card payments. Your credit card information will be securely stored on file for automatic billing, ensuring your details remain safe and confidential.

You may contact your insurance company to learn more about your out-of-network mental health benefits, which can help determine how much you might be reimbursed for your care. When speaking with your insurance provider, be sure to ask:

• What is my annual out-of-network deductible, and has it been met for this calendar year?

• What percentage of each session will be reimbursed after my deductible is met (e.g., 60%, 70%)?

I am happy to provide you with a superbill at the end of each month, which you can submit to your insurance company for potential reimbursement.

Below are the CPT codes for the services we commonly provide:

• Initial Assessment/Evaluation - CPT Code, 90791

• Individual Psychotherapy - CPT Code, 90834 or 90837

• Group Psychotherapy - CPT Code, 90853

• Family Psychotherapy - CPT Code, 90846, 90847

FOR MORE PRICING INFORMATION, FEEL FREE TO CONTACT ME AT (973) 255-9188

Cancellation Policy

I require a minimum of 48 hours’ notice to cancel any scheduled individual or group therapy session. You will be charged the full session fee if you cancel with less than 48 hours’ notice or do not attend your session. This policy allows me to fill the appointment slot with another client and sustain my practice. Exceptions are made only for documented medical emergencies or hazardous road conditions if your session is in person.

Payment for Body Image Coaching Sessions

Body Image Coaching is a 12-session program that can be paid in full or through a three-installment payment plan. If choosing installments, payments are divided as follows:

• The first payment is due before the first session.

• The second payment is due before the fifth session.

• The third and final payment is due before the ninth session.

All payments are processed via credit card, which will be securely stored on file for automatic billing. Your payment information is kept confidential and protected.

FOR MORE PRICING INFORMATION, FEEL FREE TO CONTACT ME AT (973) 255-9188.

Cancellation, Refund, and Completion Policy for Body Image Coaching

When you enroll in my 12-week individual Body Image Coaching Program, you commit to a structured process to help you achieve lasting change. To maintain the integrity of the program, I have the following cancellation, refund, and completion policies:

• No refunds will be issued once the program has started.

• If you need to cancel before the first session, you may receive a 75% refund of your total program fee.

• If you choose the installment plan, you are responsible for the entire program fee, even if you discontinue before completing all 12 sessions.

• Rescheduling sessions requires at least 48 hours’ notice; otherwise, the session will be forfeited.

• Program Completion Time Frame:

  • All 12 sessions must be completed within 16 weeks from the start date. This allows some flexibility while ensuring consistency in your progress. Sessions not used within this time frame will be forfeited.

FOR PRICING INFORMATION, FEEL FREE TO CONTACT ME AT (973) 255-9188 or email me at tracyfredericks@connectionsrestoredtherapy.com

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