[rothfan6]

My T randomly charges me more for going over our time but its not like i'm asking to go over. I leave it up to him to keep track of the time. We go over most sessions but its really inconsistent on when he bills me for more. Last session was 15 mins over and he billed me for the extra time. The session before that was 30mins over and he didnt bill me for any extra. I dont get it. Does anyone else's T do this?

[stopdog]

No - and it would completely piss me off to not be informed, asked if I wanted to go over and pay more, etc. I don't let them manage the time - I get up and walk out - but if it goes over - it is on them, not me.

[Waterbear]

My T regularly goes over. We are contracted for 50 mins but I always get 75, every session, and she does not charge extra. Twice we have had nearly 90 minutes to resolve something and she has not charged for that either.

I couldn't deal with the situation you are describing. Can you challenge it?

[rothfan6]

I asked him why he charged more this time and didnt last but I havent got an answer yet. I expected him to charge more last week but he said not to worry about it? It doesnt make sense. Its really frustrating and pisses me off. I hate the inconsistency. He knows i'm barely getting by most weeks financially so he could at least have the decency to warn me hes going to charge for going over. Hes typically always late too.

If I asked for extra time, I would expect to pay for it. If the therapist went over time without me asking for it, that would be on his tab.

It was sort of a non-issue in my case, because my out-of-pocket copay was the same no matter what the length of the session, but it allowed him to bill insurance for his services if we did go overtime in some way, and occasionally that certainly happened. (Would be one benefit to therapists who do accept insurance.)

[atisketatasket]

Originally Posted by Waterbear

My T regularly goes over. We are contracted for 50 mins but I always get 75, every session, and she does not charge extra. Twice we have had nearly 90 minutes to resolve something and she has not charged for that either.

I couldn't deal with the situation you are describing. Can you challenge it?

Yes, my experience with No. 3 was much the same - she'd arrange her schedule so she could give me an extra 15-20 minutes as much as possible. She wouldn't accept payment.

My psychiatrist, however, is prone to charge unexpectedly and inconsistently. If I texted her about medications she wouldn't charge - but has now started to do so. (I don't believe it takes her 15 minutes to tell me to lower a dose and by how much if I'm having negative side-effects and write that down on her chart.) I can't track her time, since I'm not there - my solution has been to stop texting her.

I would either start tracking the time yourself or insist on a more specific accounting.

[Yours_Truly]

I've never had any therapist charge me for overtime ever. I would definitely have to discuss this with him & tell him I can't afford it & ask him to keep better track of time, & if not, do it on my own even if I had to seem rude by interrupting the flow of the session when time was coming up. Sorry you have to deal with this. It should be up to him.

[rothfan6]

I hope he has a good explanation. We haven't been on the same page for a lot of things lately it's to the point were I'm considering just taking a break. I could definitely use the extra money.

[guilloche]

Ack - that would drive me nuts! It sound completely frustrating, and really not good on his part to not only be so inconsistent, but to move the "job" of time-keeping to you. The client should not have to keep track of the time (it's hard enough to be present and keep track of your own thoughts and emotions, keeping track of time is T's job!).

But! The good news is - this is actually a really easy thing to talk about and fix! Honestly - it's all "administrative" stuff.

Here's what I'd do. At the beginning of the next session, I'd say, "T - I've got something that I need to talk to you about."

Then, I'd approach it like this: I've noticed that sometimes we go over time, and you charge me extra. Other times we don't. I'm a little confused about what's going on, and I'm on a pretty tight budget as it is. When we unexpectedly go over time, it throws off my budgeting and makes it hard for me to meet my other obligations.

(I might pause here and give him a chance to talk, like, "Can you help me understand what your policies are around this?")

Then I'd continue with something like: I have budgeted $XX (cost of 1 session) for therapy each week, and I can't afford to go over that. Is there any way that we can manage my session so that they end on time, and I don't get charged extra?

This is sort of the "nice" or softer way of saying (i.e. "can we manage our time better"). If you want to be a bit more direct you could just say, "I'm not comfortable paying for additional time that I didn't request, and honestly didn't realize that I was getting. As the therapist, you are in control of the session time. I'm not going to be able to pay extra going forward, so please find a way to manage your time better." But I'd go with a softer "let's talk about this first".

Everything that you're saying is 100% reasonable - your T is wrong here. I'd go so far as to say your T is taking advantage of you (you're clearly not in charge of the time, and he's able to keep you longer when he wants, and thus charge you more - it's not fair.)

If he wants to continue charging you more for longer sessions - the way to handle that is for him to pause when it gets close to ending time, and say something like... "We've got about 5 minutes left. I have some free time, and am happy to keep talking for another 20 minutes if you like - but I'll need to charge you an extra $XX to do that. Do you want to keep going, or would you prefer to wrap it up now?" That would at least give you a choice... though if you're tight on the budget, it makes sense to tell him that you don't ever want to run over, b/c of the cost, so he shouldn't ask.

I'm sorry you're dealing with this. It seems like such an incredibly basic concept. Not to be totally rude, but does your T show other signs of being unprofessional or incompetent?!?

[ScarletPimpernel]

My T usually doesn't have the time to go over our 50mins. Thankfully she always starts and ends on time. If we did go over (both of us agreeing to) then I would get charged extra.

[Zenbass]

that's totally unethical IMO. if he really doesn't have time to go over, then he should stop the session and tell you.

[rothfan6]

I can't figure out what he's thinking. He's always loose with time. It makes me feel like he charges more because he needs more money that week or something. It's so random.

That's completely uncool. Do you have health insurance to cover all or part of his fees, or are you paying completely out of pocket? If you're on insurance, you should definitely have a conversation with a representative from your insurance provider to see how they feel about his billing practices. If you're paying out of pocket, put the smack down and tell him that you're not comfortable with the way he's doing business.

[rothfan6]

Yeah it's all out of pocket. It's more than I should really pay for therapy but I'm comfortable with him so I haven't switched to someone that takes my insurance. I don't really want to start over with someone.

[Lauliza]

I think that's pretty shady, to be honest. If you are not requesting extra time then you should not be charged. It's up to the T to manage the time and if they go over its on them, not you.

[runlola72]

My T's schedule is full but he gives 55 minutes. I don't feel bad going till 5 minutes before the hour because he often starts 5 min late, offering me a glass of water then going to get one for himself. If he did go over time, I'm sure he wouldn't charge me. Once I was out of town visiting family who were sending into a tailspin of anxiety and I emailed him and he offered a phone call. We talked for a full hour. When I got back and tried to settle with him, he said there was no charge, that it was built into the fee. I said no, and insisted on paying because I don't want special favors.
Anyway, I would definitely address this issue with your T. It's really not ethical, in my opinion, especially if he is in charge of time-keeping.

I'm sure it's not easy for psychiatrists to find a full case load of patients wealthy enough to pay for their expensive services out of pocket. At the risk of seeming confrontational, you should address the issue and tell him that you only want to pay an agreed-upon fee for each session, not on an arbitrary sliding scale. That would drive me nuts.

[rothfan6]

Originally Posted by Lefty the Salesman

I'm sure it's not easy for psychiatrists to find a full case load of patients wealthy enough to pay for their expensive services out of pocket. At the risk of seeming confrontational, you should address the issue and tell him that you only want to pay an agreed-upon fee for each session, not on an arbitrary sliding scale. That would drive me nuts.

It's a part time job for him. He's got another full time job. He gives me a reduced rate so I feel like I shouldn't complain but I never know what to expect. Hopefully I'll get an answer soon. It screws me up since I'm on a really tight budget to adjust for extra.

I didn't want to go there in case you were loaded and didn't want to plead poverty as an reason, but you could definitely cite your inability to pay for his services on an arbitrary sliding scale from a fixed budget.

[rothfan6]

Originally Posted by Lefty the Salesman

I didn't want to go there in case you were loaded and didn't want to plead poverty as an reason, but you could definitely cite your inability to pay for his services on an arbitrary sliding scale from a fixed budget.

I wish I was. I usually have about $10 from most pay checks that doesn't go to bills.

[LonesomeTonight]

My T never goes over, but my marriage counselor sometimes does, up to 20 minutes over (today was 10-15 extra minutes). He never charges us for it, though. He tends to give us more time if we're on a difficult topic (or maybe if his break is right after the session, which I think was the case today because no one was waiting for him after). There was one time he could only stay for 20 minutes because of an emergency, and he didn't charge us for that session.

I think if you're not requesting the extra time, then it's unethical for your T to charge for it. If he was like, "We're out of time, and we could stay longer, but I'd have to charge you extra," that would be OK. Or if you had discussed it in advance about payment, and he let you know when you were approaching that time. And you said, "Yeah, I need those extra 15 minutes today, so I'll pay." Then it would be OK. But not so arbitrary.

[rothfan6]

Originally Posted by LonesomeTonight

My T never goes over, but my marriage counselor sometimes does, up to 20 minutes over (today was 10-15 extra minutes). He never charges us for it, though. He tends to give us more time if we're on a difficult topic (or maybe if his break is right after the session, which I think was the case today because no one was waiting for him after). There was one time he could only stay for 20 minutes because of an emergency, and he didn't charge us for that session.

I think if you're not requesting the extra time, then it's unethical for your T to charge for it. If he was like, "We're out of time, and we could stay longer, but I'd have to charge you extra," that would be OK. Or if you had discussed it in advance about payment, and he let you know when you were approaching that time. And you said, "Yeah, I need those extra 15 minutes today, so I'll pay." Then it would be OK. But not so arbitrary.

I wasn't sure if that was right or not. It didn't feel right since he never gives me any warning and it seems so random but I figured it might be standard practice since we had an agreed upon time frame for the session.

I predict that if you were to confront him about the situation, he would cite his "reduced rate" concession as an excuse to bill you for overtime as he pleases. You probably want to have prepared an answer for that justification.

[rothfan6]

Originally Posted by Lefty the Salesman

I predict that if you were to confront him about the situation, he would cite his "reduced rate" concession as an excuse to bill you for overtime as he pleases. You probably want to have prepared an answer for that justification.

True I might need to. He's typically good about owning his mistakes and taking feedback but this is different so I'm not sure how this will go. Just being consistent with what I can expect will probably be my answer if he goes that way. Set the standard ahead of time that going over costs more. I'd be ok with that and would watch the time more and stop on time. Well stop 2 hours from when we started since it's not usually right at 9am.

[sweepy62]

I have the regular 50 minutes through insurance, but we go over quite a few times 60 minutes when there are issues, there are no extra charges, also when she is out , the next week I see her she keeps me longer. I would be annoyed at the inconsistencies which you are describing.