Clinician Fees for Records Requests, Court Appearances, Lett
Clinician Fees
Amanda has a full roster of clients. She schedules 35 sessions a week, which means that she’s busy, but her workload is manageable and she feels well compensated for her efforts. However, lately Amanda’s been inundated with client requests that are leading her to work overtime. Multiple clients, each going through a divorce, have asked for copies of their clinical records to be mailed to their attorneys. One client, who has been missing his college classes, has asked her to write a letter to the registrar confirming his depression diagnosis, treatment, and that his symptoms could be inhibiting his school performance. Lastly, Amanda needs to testify in court next week in regards to their care.
With all these requests, Amanda knows she’s headed towards burnout. She's also making less money because she’s had to cut back on her client sessions to accommodate the administrative demands.
Records Requests
Under the Health Insurance Portability and Accountability Act (HIPAA), a covered entity can charge reasonable cost-based fees for providing medical records to patients (45 CFR 164.524(c)). In addition, many states have published guidelines for what constitutes “reasonable” fees . Texas' most recent regulations are as follows:
- A charge of $25.00 will be collected for administrative costs. In addition;
- The cost of actual postage rate will be charged. In addition;
- Fees for copying documents may be:
- $25.00 for the first 20 pages
- $0.50 per page for the rest
- If an affidavit is requested, certifying that the information is a true and correct copy of the records, a reasonable fee of $15 will be charged for executing the affidavit.
Writing a Treatment Summary or Clinical Letter
In contrast to a records request, the cost of producing a treatment summary is at the discretion of the provider. We charge $200 for the letter, as we have to look through the complete client record and then write up said summary.
For clients who request a letter detailing that their mental health diagnosis is inhibiting their ability to attend class/perform their duties at work/etc., we also charge $200 for the letter. Please note that we will only used information that has been presented in therapy/evaluation session (separate fee).
Emotional Support Animal letters fall into this category. There will be the fee of $150 for the evaluation and then $200 for the letter.
Attendance in Court
Texas-based counselor Todd Daehnert, states in a document to his clients titled Court Action/Legal Fees, “Clients are discouraged from having their therapist subpoenaed…Even though you are responsible for the testimony fee, it does not mean that my testimony will be solely in your favor. I can only testify to the facts of the case and to my professional opinion.” Following Todd's example in our practice, the following fees are in effect:
- Preparation time (including submission of records): $220/hr
- Phone calls: $220/hr
- Depositions: $250/hour
- Time required in giving testimony: $250/hour
- Mileage: $0.40/mile
- Time away from office due to depositions or testimony: $220/hour
- All attorney fees and costs incurred by the therapist as a result of the legal action.
- Filing a document with the court: $100
- The minimum charge for a court appearance: $1500
A retainer of $1500 is due in advance. If a subpoena or notice to meet attorney(s) is received without a minimum of 48-hour notice there will be an additional $250 “express” charge. Also, if the case is reset with less than 72 business hours notice, then the client will be charged $500 (in addition to the retainer of $1500).
Finally, all fees are doubled if the clinician had scheduled plans to go out of town.