Lodestone Counseling Policies

Informed Consent

Nature & Purpose of Therapy

Psychotherapy is a collaborative process that may involve discussing personal experiences, thoughts, behaviors, emotions, and relationships. The purpose of therapy is to help improve mental & emotional functioning, increase insight, and support personal growth or behavior change. The specific goals and approach will be discussed and agreed upon throughout treatment. 

Potential Risks & Benefits

Potential benefits of therapy include improved coping skills, symptom reduction, increased self-awareness, and improved relationships. However, therapy may also involve discussing difficult topics, which can temporarily increase emotional distress. There are no guaranteed outcomes, and some clients may experience little or no change. 

Alternatives to Treatment

I understand that I may choose not to engage in therapy at all. Other options may include medication, support groups, self-help resources, or other types of mental health or medical services. I am free to discuss alternative options at any time. 

Right to Withdraw

I understand that I may discontinue therapy at any point. I am encouraged to discuss any concerns with my therapist before ending services so that appropriate closure or referrals can be provided. 

Confidentiality and Its Limits

I understand that the information shared in therapy is generally confidential and protected by law. My therapist may not release information without my written consent, except in the following situations:

  • If there is a risk of serious harm to myself or others
  • If there is a suspicion of abuse or neglect of a child or vulnerable adult
  • If required by court order or legal process
  • To comply with professional licensing or legal requirements

Questions or concerns about these policies can be discussed at any time during treatment.

Use and Disclosure of PHI

Your PHI may be used and disclosed for treatment, payment, and healthcare operations. Examples include sharing information with other healthcare providers involved in your care or for billing purposes. Any other uses require your written authorization. 

Your Rights Regarding PHI

You have the right to:

  • Access & obtain a copy of your health records
  • Request corrections or amendments to your records
  • Request restrictions on certain uses or disclosures of your PHI
  • Request confidential communications
  • Receive an accounting of disclosures of your PHI

Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint with Lodestone Counseling LLC or with the U.S. Department of Health and Human Services for Civil Rights. 

Provider’s Duties

Lodestone Counseling LLC is required by law to maintain the privacy of your PHI and to provide this notice. We are required to abide by the terms of this notice and notify you if there is a breach of your unsecured PHI. 

Contact Information

For questions, complaints, or more information about this notice, please contact:

Andrew “AJ” Owens, LCSW
(317) 268 – 5040
ajowens@lodestonecounseling.com

I understand that telehealth involves delivering mental health services using electronic communications, such as video conferencing, rather than in-person sessions. Telehealth allows me to receive therapy remotely using secure platforms. 

I acknowledge the following risks associated with telehealth:

  • Potential breaches of confidentiality due to technology or internet security limitations
  • Technical difficulties or interruptions during sessions
  • Limitations in assessment and treatment compared to in-person care

I understand that I have the right to refuse telehealth services at any time. Furthermore, I understand that at this time Lodestone Counseling LLC does not provide in-person sessions. Should I not wish to engage in telehealth services any longer I may request referrals to other practices that provide in-person services.

I confirm that I will be physically located within the state of Indiana during all telehealth sessions, as required by law.

Acceptable Methods of Communication
Communications related to scheduling, billing, and brief administrative matters may occur via phone, voicemail, e-mail, or text messaging. Clinical discussions should occur only during scheduled sessions on secure platforms. 

Security Limits
Phone calls, voicemail, e-mail, and text messages are not fully secure and may be subject to unauthorized access. Sensitive or private information should not be shared through these methods. All contact methods above occur via google workspace and google voice platforms and all relevant business associate agreements (BAA) are signed, up to date, and on file. 

Encrypted Sessions
All therapy sessions will be conducted via secure, encrypted telehealth platforms (Google Meet). This ensures confidentiality and compliance with HIPAA standards. 

Client Responsibility
Clients are responsible for maintaining the privacy of their own environment during sessions (e.g., using private spaces, secure internet connections). Clients should avoid public or unsecured Wi-Fi networks and ensure devices are password protected.

As your therapist, I am required by Indiana law to report certain information to appropriate authorities. This includes:

  • Suspected abuse or neglect of children, elderly, or vulnerable adults
  • Threats of harm to yourself or others that present imminent risk
  • Any court orders or legal requirements to disclose information

I have a legal duty to make these reports to protect your safety and the safety of others. Because of these obligations, confidentiality has limits, and information related to these situations may be shared without your consent. However, whenever possible and appropriate, reasonable effort will be made to inform you of any mandatory disclosures. 

If you have questions or concerns about these limits to confidentiality, please discuss them with me at any time.

Session Fees (self pay):

Initial/Intake Session 
$150

Individual Therapy Session (50 minutes) 

$150

No Show

$150

Cancellation within 24 hours of session

$75 (or $0 if first cancellation in the calendar year)

Cancellation greater than 24 hours from session

$0 

All cancellation and no show appointments are subject to the cancellation and no show policy below. 

Payments are due at the time of service unless other arrangements have been made in advance. 

Accepted Payment Methods:

  • Credit Card
  • Debit Card
  • HSA Card
  • FSA Card

Due to virtual-only sessions cash and check are not viable payment options

Sliding Scale

Sliding scale fees may be available based on financial need on either a continuous or temporary basis. Please discuss eligibility and terms with your therapist. 

Late Payment Consequences

Failure to pay fees on time may result in suspension or termination of services. Clients are responsible for all balances. 

Receipts / Superbill

You may request receipts or superbills for services rendered. These documents can be used to seek reimbursement from insurance companies or flexible spending accounts / health savings accounts. Superbills include necessary information such as diagnosis codes and CPT codes. Please note that clients are responsible for submitting these documents to their insurance providers and verifying coverage or reimbursement eligibility. 

Ivy Pay

Payments for services are rendered through Ivy Pay. The following information is collected by the app: Mobile number, client initials, session date, session time, length of session, type of session (completed or no show/cancel), session fee amount, and form of payment. At the beginning of your first session, Ivy Pay will send you a text message (any related fees apply) link to put a card on file and complete payment. Your payment information and other information above will be stored for the next visit. Please let your therapist know if you would like to change your method of payment to a different card.

You are entitled to a Good Faith Estimate of the expected charges for the therapy services provided. See above for an estimate of the costs based on the anticipated services. Please note that these are estimates and actual charges may vary depending on the number and types of sessions provided, as well as any additional fees or services. 
If you receive a bill that differs significantly from the above estimates, you have the right to dispute the charges. Please contact Andrew “AJ” Owens, LCSW at (317)268-5040 or ajowens@lodestonecounseling.com to discuss any concerns regarding your billing.

Clients are required to provide at least 24 hours’ notice to cancel or reschedule an appointment. 

A fee of $75 will be charged for cancellations made with less than 24 hours’ notice. Each client will be given one free cancellation with less than 24 hour’s notice per calendar year. 

The full session fee of $150 will be charged for any no show appointments. 

Please note that there are extenuating circumstances where the cancellation or no show fee could be waived at the discretion of the therapist. 

A no show is considered being more than 15 minutes late to your scheduled appointment time. 

While Lodestone Counseling LLC understands that “life happens” and there are times you may be unable to attend your session as scheduled, please make every effort to attend when possible. After any combination of 3 (three) cancellations or no shows, your services may be at risk of being terminated. Keep in mind that if you have a standing appointment with me (e.g., every other Thursday at 3:00 PM) that your standing appointment time may become forfeit after repeated cancellations or no shows at the therapist’s discretion.

Please be sure to discuss any scheduling issues with your therapist so that appropriate modifications to your schedule can be made in order for you to best participate in services.

Click Here to Schedule
signing document
Search