New Client Intake Process

How to Become a New Client

Step 1: Send a text or email

To become a new client of Marriage and Family Therapy Services is VERY SIMPLE! Simply send a text to 828-302-2978 or email admin@powertothrive.com with the subject line "New Client Inquiry." We will need the following information for all participants seeking therapy:

1.) Full Legal Name as well as name you like to be called

2.) Email Address

3.) Cell Phone Number

4.) Any minor child's date of birth

We will add this information to our confidential Electronic Medical Records System, which will then send each participant an email invitation to our patient portal.

IMPORTANT: Remember to document your portal user name, as this is not customizable and is not easy to remember (this is purposeful, as it is designed to be more secure). Also record your password somewhere in case you forget it! Additionally, please BOOKMARK THE PORTAL LOGIN PAGE! If you lose this login page, you can always return to this website. Scroll to the bottom of the Home page and you will see our patient portal login link.

Once each participant has created their patient portal account, they will be prompted to complete the intake documents. Please be sure to complete all demographic information as well (emergency contact information, address, additional phone numbers, credit card information, etc.) When these forms are completed, you will be contacted by our staff to set your initial appointment.

IMPORTANT: If all participants have not completed their intake forms prior to their initial appointment, they will be asked to do so during their session. To avoid cutting into your therapy time, please be sure everyone has completed their forms and portal demographics information. If you have any difficulties completing the forms, please contact us at 828-302-2978 for assistance.

See below for details on how to request appointment for minor children clients, multiple participants, and insurance information.

Requesting Initial Appts. for Minor Children

All therapy sessions with minor children are considered family therapy and thus, require the participation of at least 1 custodial adult. This Adult must request the initial appointment and will be expected to participate without the minor child for the first session. This helps the therapist get a better understanding of the issues that have been occurring with the child and allows the parent(s) to speak freely without concern over whether the child should hear or not.

Be sure the adult(s) complete their own paperwork from THEIR point of view (describing the issues THE ADULT is having as they are responding to/dealing with the problems that are bringing the child into therapy).

To request a session for family therapy with a minor child, please follow the above steps. If child is capable, please have him/her complete as much of his/her own intake as possible (with supervision, of course!). If you must complete the paperwork for the child, be sure you complete your own paperwork from YOUR point of view, and the child's paperwork as you believe they would see the situation if they could describe it.

Details Regarding Custody of Minor Children:

Therapists at MFTS may request contact with non-participating legal guardian(s) of child at any time during treatment, and may also request participation in treatment by these guardian(s), regardless of custodial status, unless this contact would present a threat to the child.

Please remember that any time we are working with a minor child, we may require documentation of custodial rights prior to seeing the child for therapy.

If an appointment is not specifically set up for your child/children, we ask that you do not have them present in the session. Appointments may be rescheduled if a child is present during an appointment that is not specifically set for them to attend, and the late-cancelation fee incurred. Optionally, the child can attend the session as a family member (at therapist's discretion based on clinical value), however, all paperwork and parental consents must be signed before they can do this.

Fees as of February 6, 2023:

WE BELIEVE IN TRANSPARENCY!

Below, you will find our current fees for services, effective February 6, 2023

We do not currently accept insurance, but are happy to provide you with a “Superbill” to submit to your insurance for “Out of Network” claims. See section below for more detailed information on how to file claims yourself.

We CANNOT make any claims or guarantees regarding reimbursement from insurance companies, as your coverage is a function of the contract between you and the insurance company.

Our therapists have a very limited number of appointment slots reserved for temporarily discounted fees. If you are having financial difficulties and need a fee reduction, please contact our office to discuss possible options.

In Person Individual/Couples/Family/Group Sessions -- Carolina Beach location only

New Intake (Individual/Couples/Family Assessment): $230.

90 minute Follow Up: $225.

60 minute Follow Up: $150.

30 minute Follow Up: $75.

Clinical Testing (such as Connors Scale for ADHD): $300. for Test; $150 for follow up to discuss results

Zoom (Teletherapy) Prices for all above sessions -- prices are same as above. Only if Client(s) who are within the State of NC at time of service can receive Zoom Teletherapy. Clients outside of the State of NC at the time of receiving services cannot receive therapy, as Liza is only licensed to practice within NC.

Life coaching services are available for out of state clients, however this service does NOT address or treat mental illness such as depression or anxiety. We approach your life's personal and professional goals and I provide accountability, assistance with action plans, support for inevitable breakdowns, evaluation of success, expanding on leadership skills, healthy team building, empowered time management and strategic planning for small businesses. We also assist people with chronic illness with tools to cope, help them explore approaches to their healing process, get tested for certain sensitivities or illnesses in some cases, and help them choose the type of treatments that would best fit the needs of the patient as well as searching for and finding a specific doctor.

Remote/In Person Life/Health/Business Coaching for Clients In or Out of State of NC at time of service (Never covered by insurance):

30 minute session: $80.

60 minute session: $160.

90 minute session: $240.

Voluntary/Involuntary Legal Consults/Testimony (Never covered by insurance) -- $1,250 per 3-hour or less time block; $1,500 retainer fee required

Copies of Documentation: .75 cents per page for first 25 pages; .50 cents per page for pages 26 through 100; .25 cents per change for each page thereafter.

Late Cancel/No Show Fee: Without a minimum of 48 hours' notice, non-emergency late cancelations/no-shows will incur the above posted fees for each service listed.

The above fees may be subjected to change with a minimum of 1 months' notice. When changes to our fees occur, we will inform active clients via a notification in their patient portal, as well as posted notifications in the office, at least 1 month prior to changes. At that time, clients will be given new Good Faith Estimates to demonstrate the estimated costs of treatment based on the new fees. (see section below for more details on Good Faith Estimates).

Download Detailed Insurance Information Below

As a private practice, we have determined that being "in-network" with insurance companies can present a conflict of interest by putting therapists in the position of being responsible to insurance companies rather than to our clients. We believe that clinicians should be able to make treatment decisions based on professional and clinical judgment -- not based on "what the insurance company will allow/cover."

Many insurance plans offer "out of network benefits." These benefits provide reimbursement directly to the patient, after they have paid the provider their fee, out of pocket. We encourage our clients to research the benefits their insurance plans provide and to file claims themselves if their coverage allows for this benefit. We also encourage clients to insist on reasonable coverage for out-of-network benefits, (if applicable).

Many of our clients use their "out of network" benefits and are reimbursed for the out of pocket fees paid for our services.

Be sure to let your therapist know if you will be planning to file out of network claims.

Please click on the link, below, to learn how to contact your insurance company for

out of network Benefits information.

~ YOUR RIGHT TO A GOOD FAITH ESTIMATE ~

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

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 in-network insurance coverage an estimate of the bill for health 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, but also includes psychotherapy/marriage/family therapy.
A Good Faith Estimate should be available in writing at least 1 business day before your initial session whenever possible. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before/at the time when you schedule a 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.

Please see additional information at the bottom of this page, to learn more about your Federal rights to protection against "balance billing."

Learn More

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises services you offer.

Go to CMS Website

Your Rights & Protections: "Surprise Bills"

The following may not be applicable to private psychotherapy practice, however, the below information is Federally required to be posted by all health care practitioners.

_______________________________________________________________________________________

(OMB Control Number: 0938-1401)

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

Your health plan generally must:

Cover emergency services without requiring you to get approval for services in advance (prior authorization).

Cover emergency services by out-of-network providers.

Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact:

NC Office of the Secretary of State

PO Box 29622

Raleigh, NC 27626-0622

Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.