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Contact Info:

Office:

 

I currently provide services by telehealth and am able to work with people located anywhere in the State of Texas. I expect to be a member of PSYPACT in the near future, at which point I will be able to provide services to the majority of US states. Check here to see if your state participates in PSYPACT.

Mailing Address:

 

8127 Mesa Dr.

B206-304

Austin, TX 78759

Phone: 626-622-2150

Fax: 844-216-8557

Email: drcharlescouchman@yahoo.com

Communication Policies:

I try to return calls in a timely manner, typically by the end of the next business day. I cannot guarantee that I will receive and be able to return your call immediately.

If you ever need urgent assistance for a mental health concern and are located in Travis County, Texas, call the Travis County 24-hour crisis hotline at 512-472-HELP. Outside of Travis County, call the National Suicide Prevention Line at 1-800-273-8255. If you ever need immediate assistance, call 911.

Due to confidentiality concerns, I do not typically use email or text messaging to communicate with clients.

Appointments:

I offer prospective clients a complimentary, 15-minute phone consultation to discuss your needs and how I can help.

Once we are scheduled to meet, please download, complete, and return the following forms to me at least one day before our meeting:

Psychologist-Client Services Agreement

HIPAA Policies

Client Information Form

Telemedicine Consent Form

Payment:

Payment for individual sessions is collected at the beginning of each session via credit card unless you prefer another method.

If you would like to use health insurance, your insurance company will be able to inform you about whether or not your sessions will be covered, what percentage will be covered, and their procedures for reimbursement. If you plan to file a claim for reimbursement with your insurance company, I can provide you with a “superbill,” which is an itemized statement and receipt for services provided.

Cancellation/“No Show” Policy:

I require 24 hours notice for cancellation or rescheduling of an appointment. No shows, cancellations, or reschedules within 24 hours of our appointment time will be billed to the client at the full session rate. Insurance companies will not pay for any portion of missed appointments.

 

Good Faith Estimate Notice:

 

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance a "Good Faith Estimate" of the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before 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.

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

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