Client Legal Disclosures

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost

  • Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.

PSC Fee Policy

The Psychological Services Center is a low-fee-for-service clinic.  We provide an alternative for individuals who may not otherwise be able to receive services.  We do not, however, offer a sliding fee scheduled as our fees are very low In comparison to other providers in the community.

Individual Therapy, 50-min session:      $30
Individual Therapy, 90-min session:      $40
Couples Therapy, 50-min session:        $30
Group Therapy:                                     $15
ADHD Testing:                                       $400
Neuropsychological Testing:                  $700 – OR - $1,300*
WICS for private school admission:       $250

* Annual income less than $85,000 will qualify automatically for the reduced fee of $700.

The PSC reviews the fee schedule at the end of each May for the upcoming academic year, with any changes in the fee schedule set for implementation on September 1st, following the review. Should the review of our fee schedule result in a change of fee for clients, the following policy will apply.  If the change results in a rate reduction for some client services, clients will be billed at the lower rate beginning the September 1st, following the review.  If the change results in an increase in client service related fees, current clients will be notified of the rate increase but will not be charged the increased amount until January 1st, following the review to provide sufficient time to plan accordingly.

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Notice of Privacy Practices

 

THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY

 

Protecting Your Personal and Health Information

The Psychological Services Center (PSC) is committed to protecting the privacy of patient personal and health information.  Additionally, both Federal and Massachusetts laws require us to maintain the privacy of our patients’ personal and health information.  This Notice explains the PSC’s privacy practices, our legal duties, and your rights concerning your personal and health information.  In this Notice, your personal or protected health information (PHI) is referred to as “health information” which may include information about your health care treatment and contain identifiable information such as your name, age, address, income or other financial information. 

 

How We Protect Your Health Information 

We protect your health information by: 

  • Treating all your health information as confidential. 

  • Stating confidentiality policies and practices in our clinic staff handbooks, as well as disciplinary measures for privacy violations. 

  • Restricting access to your health information to only those clinical staff who need to know your health information in order to provide services to you. 

  • Only disclosing the health information necessary for an outside service company to perform its function on the clinic’s behalf; such companies have by contract agreed to protect and maintain the confidentiality of your health information. 

  • Maintaining physical, electronic, and procedural safeguards to comply with federal and state regulations guarding your health information. 

  • Keeping you continuously informed of policy changes by providing you with updates to this document, making it available in our waiting room and on our website (www.umass.edu/psc).   

  • Asking for separate, written authorization for any disclosures not covered above.