Practice Policies

Appointments:
Appointments are generally 53-55 minutes in length once per week. As goals are met, frequency of appointments usually are decreased until counseling is no longer necessary. The time scheduled for your appointment is for you and you alone. If you need to cancel or reschedule, please do so at least 48 hours ahead of the appointment. You will receive a text, email, or voicemail reminder 48 hours ahead. Reminders are highly recommended, as it will remind you to cancel and it helps you avoid late cancel/no show fees. These are not able to be charged to your insurance and will be charged to the credit card you are required to keep on file.
No Show/Late Cancelations:
The rate for a NO SHOW is $150.00.
The rate for a LATE CANCEL under 48 hours is $100.
In extreme circumstances where we both agree that you were unable to attend due to circumstances outside of your control, the fee may be waived which is between you and your therapist, who has the final say.
Cancellations and re-scheduled session will be subject to a full charge if NOT RECEIVED AT LEAST 48 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you may lose some of that session time.
PLEASE NOTE THAT CLIENTS USING STRAIGHT MEDICAID, MCLAREN MEDICAID, MOLINA MEDICAD, BLUE CROSS COMPLETE OR PRIORITY HEALTH MEDICAID ARE NOT ALLOWED TO BE CHARGED FOR LATE CANCEL/NO SHOW APPOINTMENTS. THEREFORE, EPIC COUNSELING PLLC USES THE THREE STRIKE RULE. UPON MISSING THREE APPOINTMENTS, IT WILL BE DETERMINED THAT THE CLIENT IS NOT DESIRING TO CONTINUE COUNSELING AND THE CASE WILL BE CLOSED!
If a client is 15 minutes late for an appointment, that appointment cannot be charged to insurance, therefore the no show/late cancel fee will be charged. If it is the last appointment of the day, the counselor may leave. However, if the counselor is still available the rest of the session can commence.
A $35.00 service charge will be charged for any checks or a denied credit card returned for any reason.
Any balances that are delinquent by 30 days, may result in Epic Counseling PLLC sending said balance to a collection agency, where client will be responsible for additional interest and fees related to being sent to collections.
If any payment is disputed by bank or credit card companies, client is agreeing to pay for all fees along with balance on account.
Contacting Your Therapist:
Your therapist is often not immediately available when in session or not in the office. At these times, you may leave a message or text (810)-373-5133. If you leave a message, Epic Counseling PLLC will return your message during business hours. You are encouraged to ask your therapist for their direct phone number to reach them. If you feel you cannot wait for a return call or it feels like an emergency, please go to the local hospital, or call 911.
Telephone Accessibility:
If you need to contact your therapist between sessions, please leave a message on Epic Counseling PLLC voicemail or via text. We are often not immediately available; however, we will attempt to return your call within 48 hours during normal business times.
Please note that Face-to-face sessions are highly preferable to telehealth sessions. However, in the event that you are out of town, sick or need additional support, telehealth sessions are available. If a true emergency situation arises, please call 911 or any local emergency room.
Social Media and Telecommunication:
Due to the importance of your confidentiality and the importance of minimizing dual relationships, Epic Counseling PLLC's therapists do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc.). We believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up during a scheduled session and we can talk more about it.
Electronic Communication:
Epic Counseling PLLC cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, we can do so. While we may try to return messages in a timely manner, we cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.
Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of Michigan. Under the California Telemedicine Act of 1996, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. If you and your therapist chose to use information technology for some or all of your treatment, you need to understand that:
1. You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled.
2. All existing confidentiality protections are equally applicable.
3. Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee.
4. Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.
5. There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy, better continuity of care, and reduction of lost work time and travel costs.
Effective therapy is often facilitated when the therapist gathers information from a session or a series of sessions, a multitude of observations, and experiences about the client. Therapists may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations, information, and experiences. When using information technology in therapy services, potential risks include, but are not limited to the therapist's inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as: your physical condition including deformities, apparent height and weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what he or she would consider important information that you may not recognize as significant to present verbally the therapist.
Minors:
If you are a minor, your parents may be legally entitled to some information about your therapy. Epic Counseling PLLC's therapists will discuss with you and your parents’ what information is appropriate for them to receive and which issues are more appropriately kept confidential.
Children in the Waiting Room:
There may be times when you wish to leave a minor child in the waiting room while you are in session with one of our providers. Please note that we are unable to provide supervision for children who are unattended in the waiting room. We are happy to respond to questions or needs of anyone visiting our offices but are not able to provide the supervision necessary for a child who requires this. If your child requires supervision, you are welcome to either bring someone along to attend to them or have them join you for your session. If you have any concerns, please speak to your clinician.
Discharge:
When it is agreed that the client has met goals for treatment, the counselor and client will determine next steps. Usually, this involves a termination session after which the case is closed. IF it is an unplanned termination, in which the client does not continue making appointments, the case will be closed in 30 days. It is Epic Counseling PLLC therapists’ wish to allow clients to come back to therapy in the future (ie: life changes) as long as their schedule allows. We strongly feel that a client should not have to “start over” with telling their story to another therapist unless that is what they desire to do.
Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, Epic Counseling PLLC must consider the professional relationship discontinued.
Insurance and Professional Fees:
If you have a health insurance policy, it will usually provide some coverage for your mental health treatment. Epic Counseling PLLC will submit claims on your behalf if you provide your insurance information and therefore giving Epic Counseling PLLC permission to do so. However, it is your responsibility for obtaining coverage information and determining what is expected of you for deductibles, co-pays, and knowing whether Epic Counseling PLLC is considered in-network as a provider. If you need help, we will help you determine and figure out all this information. It is usually required that Epic Counseling PLLC provides a diagnosis to the insurance company if they are to pay for any part of the services or if deductibles are to be applied.
In addition, there are times that insurance company require additional information that becomes a part of the insurance company’s files. By signing this agreement and providing your insurance information, you are giving Epic Counseling PLLC permission to provide that information to the insurance company. Also, some insurances require a prior authorization to pay for mental health services. If you did not obtain prior authorization and it was required, you may be responsible for paying the fees accrued for the services rendered.
Many insurance companies leave a percentage of the fees to be paid by the client, which is considered a co-pay. This amount is due at the time of service. The credit card or HAS card on file will be charged unless check or other card payment is provided at the session. Some insurances plans also have a deductible, or out of pocket amount to be paid at the time of services. This too, is to be paid at the time of services.
If Epic Counseling PLLC is not a participating provider for your insurance plan, we will supply you with a receipt of payment for services, which you can submit to your provider for reimbursement. Not all insurance companies will reimburse for out of network providers. However, they often have a list of in-network providers from which you can chose.
Cash and Professional Fees:
Epic Counseling PLLC also offers services for clients who wish to pay entirely out of pocket, not using insurance. This is called a private pay rate. Epic Counseling PLLC offers a sliding scale, which can be discussed with your individual therapist. To receive sliding scale fees, you must present proof of income through recent pay stubs or tax forms. Outside of this agreement, fees are NON-NEGOTIABLE.
Clients are responsible for paying at the time of the session unless prior arrangements have been made. If you refuse to pay your debt, Epic Counseling PLLC reserves the right to use an attorney or collection agency to secure payment. If you anticipate becoming involved in a court case, we recommend that we discuss this fully before you waive your right to confidentiality. If Client’s therapy with Provider is brought into a court and Provider is subpoenaed to appear, Client will be responsible to pay Provider the rate of $185 per hour for both travel and court time, along with paperwork preparation, time in the courtroom, discussion with your legal team.
Fees can change at Epic Counseling PLLC's discretion with 30 days’ notice given.
Payments
1. All co-payments are due at the time of services which is a requirement by insurance companies in order to use insurance benefits.
2. All deductibles must be met before co-payments apply. This may require Client to pay full session payments at the beginning of the insurance company’s fiscal year until this deductible is met.
3. Having insurance authorization does not guarantee payment by insurance. It is Client’s responsibility to pay Provider for charges incurred.
4. Provider accepts cash, credit card, or personal check.
5. Provider requires that Client sign a Credit Card Authorization at the beginning of therapy to ensure payments for missed appointments.
6. If Client’s credit card is declined, there will be an additional $35 fee; a statement will be mailed to Client’s address on file.
7. Any returned check by Client’s bank will incur a $35 fee; Client’s credit card on file will be billed.
8. Client understands any balances that are delinquent by 30 days, may result in Epic Counseling PLLC sending said balance to a collection agency, where client will be responsible for additional interest and fees related to being sent to collections.
9. If any payment is disputed by bank or credit card companies, client agrees to pay for all fees along with balance on account.
10. If Client’s therapy with Provider is brought into a court and Provider is subpoenaed to appear, Client will be responsible to pay Provider the rate of $185 per hour. After 2.5 hours, Client is responsible to pay Provider $0.75 a mile from the Provider's primary office. Client agrees to cover all related travel expenses, including transportation (e.g. mileage, airfare, taxis), lodging, meals, and other related costs. An estimate of travel expenses will be provided in advance.
a. In the event that a provider is subpoenaed to appear in court, Client is responsible for court related costs. These costs apply even if the clinician is not called to testify by the judge on the day initially scheduled.
b. If the Client is in need of any supporting documentation including but not limited to, disability paperwork, FMLA, or ESA letters. The Client may be responsible for administrative fees. These fees are as follows: $75 base rate, and $1.50 for each page that needs to be completed and/or faxed by the clinician. In addition, these costs will apply in the event a clinician will apply in the event they are subpoenaed to present in court. In order to ensure they are prepared to best meet your needs additional time may be billed if needed to adequately prepare.
11. Client understands any type of paperwork required outside of court for disability and/or other paperwork is $25 base rate and $1.50 for each page that needs to completed and/or faxed by the clinician.
Security Cameras in Waiting Areas
• For the safety and protection of all individuals on the premises, security cameras are in place in the waiting areas of the clinic.
• These cameras are used solely for the purpose of ensuring a safe environment and preventing unauthorized access or incidents.
• Please note that there are no security cameras in any therapy rooms to maintain the confidentiality and privacy of your treatment sessions. Your privacy during therapy is paramount, and we are committed to creating a secure space for your personal discussions.
Smoking, Substance Use, and Alcohol Policy
• Smoking: Smoking is prohibited inside the building and in any areas that are within close proximity to the clinic entrances. Smoking is only permitted in designated outdoor areas, if applicable.
• Substance Use and Alcohol: The use or possession of illegal substances or alcohol is strictly prohibited on the property.
o If you are under the influence of alcohol or drugs during your session, we may reschedule your appointment for safety and therapeutic effectiveness.
o We ask that clients refrain from using drugs or alcohol on the clinic property prior to or during their appointments to ensure that treatment is effective and to maintain a safe and respectful environment for all.
Weapons Policy
• For the safety and well-being of everyone in the clinic, weapons are strictly prohibited on the property.
o This includes firearms, knives, and any other items that could cause harm.
o If you are found carrying a weapon on the premises, you may be asked to leave and could face legal consequences.
o Please understand that this policy is in place to ensure that all clients and staff feel safe and secure while receiving services.
Client Behavior and Expectations
• Respectful Environment: We expect all clients and visitors to maintain respectful behavior while on the clinic premises. This includes being polite and courteous to staff, therapists, and other clients. Disruptive behavior, including threats or aggressive actions, will not be tolerated and may result in immediate dismissal from the clinic.
• Violence or Threats of Violence: If there is any threat of harm or violence to self or others, we are legally obligated to take appropriate actions, including notifying authorities.
• Confidentiality and Respecting Others' Privacy: Please be mindful of others' privacy in the waiting area. We ask that clients refrain from discussing personal or sensitive matters in the public areas of the clinic.
Animal Assisted Therapy:
Animal-Assisted Therapy (AAT) is a type of therapy that incorporates human-animal interactions into a therapeutic treatment process. It is considered an adjunct to existing therapy, and is led by Nichole O’Keefe, MA, LPC, NCC, a licensed professional counselor who has a certificate in AAT. AAT is incorporated as an adjunct part of therapy sessions by using the human-animal bond to reduce stress/anxiety and enhance positive emotional responses.
About Animal Assisted Therapy
• Animals have their own natural defenses. While the therapist handler will do everything possible to prevent any injury, it is possible that someone could get scratched or bitten.
• Animals often use their mouths in play. Therefore, even when playing, it is possible for light biting to occur.
• Animals will be groomed and her nails will be kept short; however, there may be a risk of getting scratched and the therapist, Nichole O’Keefe or Jennifer Peel, will not be liable in the event such an accident happens.
• Animals communicate their wants and needs through body language and barking. For example, they wag their tail in excitement or brush or lean against you to show love or get your attention, and as such there is a possibility of losing you balance and falling down. Since this is the nature of dogs, the therapist CANNOT be held liable if such an occurrence happens.
• Animals have been screened by a veterinarian before joining our therapy team. Because your contact is minimal, there is little risk of transfer of zoonotic disease which is carried by fecal matter or urine.
Duty to Warn
At Epic Counseling PLLC, we are committed to your safety and well-being. Our therapists adhere to ethical and legal guidelines designed to protect you and others during treatment. As part of this responsibility, we have a Duty to Warn, which is a legal and ethical obligation to take appropriate action if there is a threat of harm to yourself or others.
What does Duty to Warn mean?
The Duty to Warn means that if a therapist believes that you pose a risk of harm to yourself (such as suicidal thoughts or behavior) or others (such as plans to harm another person), they are required to take appropriate steps to prevent that harm. This may include:
1. Contacting Emergency Services: If there is an imminent threat to your safety or the safety of others, your therapist may contact emergency services (such as law enforcement or medical professionals) to ensure immediate intervention.
2. Notifying Potential Victims: If there is a credible threat of harm to an identifiable person, the therapist may be required to inform that person or other appropriate authorities to prevent harm. This could include warning potential victims or those at risk.
3. Breaking Confidentiality: In cases where there is a clear risk of harm, confidentiality may be broken without your consent to protect you or others. However, this will only occur when it is necessary to prevent serious harm.
While we prioritize your confidentiality and privacy, the Duty to Warn takes precedence in situations where there is a clear and imminent risk. Your therapist will always work with you to address any concerns and will aim to minimize any impact on your confidentiality as much as possible.
Abuse, Neglect, and Exploitation Policy
Epic Counseling, PLLC is dedicated to ensuring that all individuals seeking treatment are treated with respect and care. As part of our commitment to providing a safe and supportive environment, we take any allegations of abuse, neglect, or exploitation very seriously.
What is Abuse, Neglect, and Exploitation?
1. Abuse refers to any intentional act that causes physical, emotional, or psychological harm to another person. It may include but is not limited to:
o Physical abuse (hitting, slapping, or causing bodily harm)
o Emotional or psychological abuse (verbal threats, intimidation, humiliation, or manipulation)
o Sexual abuse (any unwanted sexual contact or behavior)
2. Neglect refers to the failure to provide necessary care, assistance, or attention to a person who is unable to care for themselves. This can involve:
o Failing to meet the basic needs of a vulnerable person (food, shelter, medical care, etc.)
o Abandoning or leaving someone without appropriate support in place
3. Exploitation refers to taking advantage of a vulnerable individual for personal gain, such as:
o Financial exploitation (stealing or coercing money or property)
o Using someone’s personal vulnerabilities or weaknesses for manipulative purposes
Your Rights in Relation to Abuse, Neglect, and Exploitation
• Reporting Abuse or Neglect: If you experience or suspect any form of abuse, neglect, or exploitation, you have the right to report it. Our therapists are legally required to report any suspected abuse or neglect to the appropriate authorities (such as Child Protective Services, Adult Protective Services, or law enforcement).
o Mandatory Reporting: In accordance with state and federal laws, all licensed therapists are mandated reporters, meaning they are required to report any suspicion of abuse, neglect, or exploitation that involves children, elders, or vulnerable adults, whether or not the individual wishes to report it.
o If you are a minor or vulnerable adult, and you express that you are being harmed or are at risk, your therapist is legally obligated to report the concern to protect you.
• Non-Retaliation: You will not face retaliation or negative consequences for reporting abuse, neglect, or exploitation. Your safety and well-being are our highest priority, and you can trust that your concerns will be taken seriously and handled appropriately.
• Support and Assistance: If you are a victim of abuse, neglect, or exploitation, your therapist will provide you with support, referrals, and resources to assist you in ensuring your safety. This may include referrals to legal services, shelters, or community organizations that specialize in supporting individuals who have experienced abuse or neglect.
What Happens if Abuse, Neglect, or Exploitation is Suspected or Reported? If a situation arises where abuse, neglect, or exploitation is suspected, the following steps will be taken:
1. Immediate Action: The therapist will assess the situation and, if necessary, intervene to ensure your safety and the safety of others involved.
2. Reporting: The therapist will file a report with the appropriate authorities. Depending on the situation, this may include contacting law enforcement, social services, or other relevant agencies.
3. Investigation: The appropriate authorities will investigate the situation further to determine whether abuse, neglect, or exploitation has occurred.
4. Follow-Up: Your therapist will work with you to help you manage the emotional and psychological impact of any abuse or exploitation and will connect you with appropriate resources.