Confidentiality

The communication between a Licensed Psychologist and client is privileged, which means that I am legally bound to keep confidential anything you reveal to me unless any of the following conditions exist:

I have reason to believe you are in immediate danger of harming yourself or another person.
I have reason to believe a child or elder person is at risk of abuse or endangerment. I am a mandated reporter for such situations.

Please read the Notice of Privacy Practices available on my website or request a copy. This document contains information about HIPAA (Health Insurance Portability and Accountability Act), which provides privacy protections and patient rights regarding the use and disclosure of your Protected Health Information (PHI). While you have a right to confidentiality, that right is not absolute.

Other limits to confidentiality include:

I may consult with another healthcare professional about your case while taking appropriate steps to safeguard your privacy and identity.
All external records and billing software I use have security and privacy safeguards, which I am happy to share upon request.
When your therapy includes another person, such as a spouse, family member, or relationship-group member, some information may be shared as part of the therapy process. If there is information you have told me privately and do not wish to be shared, please clearly tell me this.

Relationship & Family Therapy Confidentiality

When working with multiple partners or family members, I will not disclose information discussed privately with one participant to another without that person's permission.

By participating in relationship or family therapy, you acknowledge and consent that there may be information shared with me that I will not disclose to others without the permission of the person who shared it.

I reserve the right to withdraw from providing relationship or family therapy if maintaining confidentiality compromises my work, professional ethics, or effectiveness as a therapist. In such situations, referrals may be provided.

I do not testify in legal proceedings such as divorce or custody disputes.

If records are subpoenaed for legal proceedings, all clients related to the proceedings must provide written permission before records can be released.

Regardless of who is paying for therapy, I will not share information about clients without permission except in circumstances that legally override confidentiality.

Scheduling & Canceling Sessions

Sessions may be scheduled by phone, email, or text.

If you need to cancel or reschedule, please notify me as soon as possible.

A full 24-hour notice is required to avoid being charged for a missed or canceled appointment. Missed appointments and appointments canceled without 24-hour notice will be charged to your credit card and are generally not covered by insurance.

You may leave confidential voicemail or text messages at 314-440-5433. Messages are checked frequently throughout the week.

If you are unable to reach me and it is a true emergency, call 911 or go to the nearest emergency room.

Texts, emails, or phone consultations exceeding 10 minutes may be prorated at the regular session rate and charged accordingly.

Payment

Payment in full is due at the time of each session.

I use the HIPAA-compliant payment platform IvyPay. Using IvyPay means I do not need to store your payment information on file.

Before your first session, you will receive an IvyPay text message allowing you to enter your preferred payment method.

Insurance Reimbursement

I do not participate as an in-network provider for insurance companies and therefore do not accept co-payments.

Clients are charged in full at the time of each session.

Many insurance companies offer out-of-network reimbursement. It is your responsibility to determine your coverage, deductible, co-pay obligations, and reimbursement eligibility.

Claims may be submitted electronically upon request.

If you choose to use insurance benefits, I may need to assign a behavioral health or medical diagnosis based on symptoms and clinical presentation.

Medicare

I am unable to see Medicare clients in Individual Psychotherapy or Group Psychotherapy who have Medicare Supplement B coverage.

If you become Medicare eligible while under my care and enroll in Medicare Supplement B, you may need to transfer care to another provider.

Marital therapy, family therapy, and post-retirement counseling are not covered by Medicare and may still be provided.

Electronic Communications

I do not accept friend or contact requests from current or former clients on social networking platforms such as Facebook or LinkedIn.

You may text me regarding scheduling, cancellations, lateness, or appointment changes.

Please avoid sending confidential personal information through text messages or standard email whenever possible, as these communications may become part of your medical record.

All emails and text messages may be retained by Internet Service Providers and therefore cannot be guaranteed completely secure.

The most secure and confidential way to communicate between sessions is by phone.

Acknowledgement

By proceeding, I acknowledge that I have read and understand Dr. Sandra Shachar's Practice Policies & Procedures and that I have had access to the HIPAA Notice of Privacy Practices.