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Spoken Balance Culture

How do I know I will be safe or welcomed?

Spoken Balance strongly adheres to a “Hate Has No Home Here” policy. This means Spoken Balance “promotes just and inclusive communities by encouraging neighbors to declare their homes, schools, businesses, and places of worship to be safe places where everyone is welcome and valued.”

Spoken Balance is boldly committed to equitable mental health services without discrimination against, or harassment of, any person on the basis of age; ancestry; citizenship; color; creed; cultural background; disability status; domestic partnership; economic status; education; ethnicity; gender expression; gender identity; genetic information; health status; household composition; housing status; immigrant status; intellectual ability; marital status; medical condition; mental ability; national origin; neurodiversity; non-qualifying disability; parental status; physical ability; pregnancy; race; relationship status; religion; sex; sexual orientation; socioeconomic status; and veteran status.

All client’s will be treated with dignity, compassion, and respect as an individual—gender identity will be respected, and you will be referred to by your name and pronouns.

Spoken Balance invites, encourages, and nourishes an environment where individuals can feel safe discussing all intersections of marginalization.

Any unproductive expressions of hate, intolerance, or similar towards staff or other clients, will be worked through therapeutically. If one is not open to doing so, Spoken Balance reserves the right to refer one elsewhere for treatment.

Spoken Balance utilizes the “Healthy at Every Size” body positively framework.

Informed Consent model

Spoken Balance operates under the presumption you are a self-determined person with insight and awareness about how to use your bodily autonomy. The Informed Consent model is described by the American Medical Association Journal of Ethics as:

“Informed consent is a concept that is familiar to clinicians. On a practical, day-to-day basis, informed consent is often implied rather than explicitly ensured, and whether explicit or implied, informed consent is the ethical and legal basis for most patient care decisions. It requires that clinicians […] effectively communicate anticipated benefits and potential risks of a treatment, as well as the reasonable alternatives to that treatment. It relies on the patient’s capacity for understanding and weighing these options. Integral to the practice of informed consent is the principle of respect for patient autonomy—that is, respect for a person’s right of self-determination—and the belief that clinicians will work to facilitate patients’ decisions about the course of their own lives and care” (AMA J Ethics. 2016;18(11):1147-1155. doi: 10.1001/journalofethics.2016.18.11.sect1-1611).

Policies

What is the no show/late cancellation policy?

In brief, Spoken Balance maintains a 48 hour cancellation policy.

Missed sessions

To maximize the benefits of therapy and out of respect for our therapists’ time, you are required to consistently attend your scheduled sessions. Missing 2 or more scheduled sessions in any 1 month period may result in the loss of your recurring session time slot. Missing 4 or more sessions in any 2 month period may result in you being discharged from the therapy process.

Late arrivals

Spoken Balance requires all attendees (including client(s) and therapist) be in session no later than 10 minutes past start time.

To ensure that all sessions start on time, Spoken Balance clinicians are required to end sessions at their scheduled end times. If you arrive late, your session will still end at it's previously scheduled end time.

What if I live in or visit another state?

Clinicians may only see clients who are physically located in the state in which the clinician is licensed in; regardless of home residency. Your clinician has a right to ask for verification of where a client is located to ensure services may be provided. This can be done via asking for a piece of postal mail or alternative forms of verification.

What if I vacation in another state and forget to cancel my appointment? Your clinician cannot see you unless they are licensed in the state you are physically located in. Even if the clinician is licensed in the state you are physically located in, insurance may not be able to be submitted and private pay may apply.

What if I am going home temporarily due to a situation beyond my control? Your clinician cannot see you unless they are licensed in the state you are physically located in. Even if the clinician is licensed in the state you are physically located in, insurance may not be able to be submitted and private pay may apply.

These are licensure laws and has little to do with anything else.

All things money

Payment methods

Spoken Balance requires a credit card on file, regardless of how you plan to pay for your sessions.

Spoken Balance accepts all major debt/credit cards as well as HSA/FSA as forms of payment directly through the client portal. For payments related to appointments, payments are processed once claims are processed with insurance companies. For payments related to fees (ie., no show/late cancel), payments are typically processed within 48 hours.

Refunds

Spoken Balance operates under the presumption you are a self-determined person with insight and awareness about how to use your bodily autonomy. The Informed Consent model is described by the American Medical Association Journal of Ethics as:

All services provided including counseling sessions, forms, documents, letter writing, or similar are non-refundable. Refund requests on a service that has been rendered will not be honored regardless of reason. The goal of Spoken Balance is to empower clients to state their needs immediately to address any concerns proactively instead of reactively.

Insurance

Insurance

IAs a practice, Spoken Balance accepts most Aetna, BCBS, Cigna, Medicare, and United plans as in-network providers; depending on clinician. Before your first session, please understand from your insurance company your co-payment, co-insurance, deductible, pre-authorization requirements, etc. All session fees not covered by your insurance are your responsibility. Spoken Balance cannot legally waive any co-payment, co-insurance, deductible, and/or pre-authorization requirements.

For Medicare clients: We are unable to accept Medicare clients that are also enrolled in the Qualified Medicare Beneficiary (QMB) program and/or Medicaid, as we are not in-network with Medicaid.

Insurance changes

If you pay with insurance and your insurance changes, Spoken Balance will work with you to determine your future coverage and, if necessary, refer you to another therapy practice. It is your responsibility to inform Spoken Balance of any changes to your insurance at least 30 days before those changes take effect.

Self-funded versus fully-funded insurance plans

Employers with self-funded plans pay for medical claims and fees out of their general assets, basically acting as their own insurers. With the fully-insured plan, employers pay a fixed premium to an insurance carrier that then covers the medical claims.

Please ask your insurance or employer if your plan is either self-funded or fully-funded.

Self-funded insurance plans are regulated by the federal government, not each individual state. Therefore, federal rules/regulations override state rules/regulations and any specific laws passed on a state level will not apply to plans governed by federal rules/regulations.

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans.

Learn more about ERISA here.

ERISA plans (PDF link)

If I am on someone else's insurance; will they find out about my sessions?

The short answer is yes. Every service provided under an insurance policy, the insured (ie., your parent or spouse if one is listed under their policy) will receive an “Explanation of Benefits” either electronically or by postal mail. Spoken Balance cannot avoid this.

The “Explanation of Benefits” would give providers name, billing code, date of service, and some other things. This is a good example of what an “EOB” looks like.

What's the difference between Medicaid and Medicare?

Medicare is the federal healthcare program for those aged 65 or greater or those on disability.

Spoken Balance is in-network with Medicare (specific clinicians only).

Medicaid is the state-run health insurance program for low-income individuals regardless of age or disability.

Spoken Balance is out-of-network with Medicaid.

Additionally, we are unable to accept Medicare clients that are also enrolled in the Qualified Medicare Beneficiary (QMB) program and/or Medicaid, as we are not in-network with Medicaid.

Let's talk Medicaid

Spoken Balance cannot accept Medicaid benefits in any capacity — either as primary or secondary insurance (as Spoken Balance is not considered in network with Medicaid). Medicaid recipients cannot pay out of pocket for services as it would jeopardize Medicaid benefits.

Do you take EAP?

Spoken Balance is not in-network with any EAPs. Unfortunately, most EAPs do not reimburse at a rate that makes it feasible to pay clinicians appropriately. Further. EAPs limit the amount of sessions per “issue” which can create an ethical conflict for clinicians to continuously create diagnosis for clients.

Appointments

Before your first appointment

Please see this page for details about steps in establishing care with Spoken Balance.

Is there a plan to return to in-person sessions?

Currently, Spoken Balance is only providing tele-health appointments. We do not have a timeline for when our practice will transition back to providing in-person services. While we understand COVID restrictions may have lifted in local governments — ultimately — client, clinician, and community safety is paramount to all decisions Spoken Balance makes. We want to be respectful of the therapeutic process and alliance

Misc

Illinois telehealth legislation

HB3308 was passed into law on May 30, 2021 and signed by the Governor on July 22, 2021. While this legislation is significant progress towards expanding healthcare access across Illinois by broadening access to tele-health visits, the law applies differently to self-funded insurance versus fully-funded insurance plans (see below).

HB3308 (PDF link)

What are my rights to access my records?

Spoken Balance follows the guidance outlined in the Illinois Foundation for Quality Healthcare Illinois Special Records Protections. The age of consent in Illinois is 12.