Ethical Standard6.Record Keeping and Fees Flashcards
Psychologists create and to the extent the records are under their control, maintain, disseminate, store, retain, and dispose of records and data relating to their professional and scientific work in order to…
6.01 Documentation of Professional and Scientific Work and Maintenance of Records
(1) facilitate provision of services later by them or by other professionals
(2) allow for replication of research design and analyses
(3) meet institutional requirements
(4) ensure accuracy of billing and payments
(5) ensure compliance with law
(see standard 4.01 maintaining confidentiality)
APA (2007) has Record Keeping Guidelines and in the application section on Guideline 2, it notes that for each substantiative contact with a client a record should include the following…
(1) Date
(2) Duration of the session
(3) type of service(s) provided (e.g., assessment, treatment)
(4) he nature of the intervention or contact (e.g., treatment modality)
(5) summary of the client’s status
APA (2007) Record Keeping Guideline, in the application on Guideline 7 it states that a “psychologist strives to be aware of applicable laws and regulations and to retain records for the period required by legal, regulatory, institutional, and ethical requirements” (p.997). What are the Guideline 7 state for retention of records in the absence of superseding laws or institutional regulations:
6.01
Psychologists may consider retaining full records until 7 years after the last date of service delivery for adults or until 3 years after a minor reaches the age of majority, whichever is later.
In some circumstances, the psychologist may wish to keep records for a longer period, weighing the risks associated with obsolete or outdated information, or privacy loss, versus the potential benefits associated with preserving the records (APA 2007, Guideline 7, p.999)
Do psychologists maintain confidentiality of records in creating, storing, accessing, transferring, and disposing of records under their control and whether these are written, automated, or in any other medium?
- 02 Maintenance, Dissemination, and Disposal of Confidential Records of Professional and Scientific Work
(a) YES
How do psychologists protect the confidentiality of participants when entering confidential information into databases or systems of records?
6.02(b)
psychologists use Coding or other techniques to avoid the inclusion of personal identifiers. keeping files in a locked filing cabinet or room and making sure that access to records stored in electronic databases is limited.
If psychologists withdrawal from a position or practice do they take appropriate steps to ensure protection of confidential records?
6.02(c)
YES, psychologists make plans in advance to facilitate appropriate transfer and to protect confidentiality of records and data in the event of psychologists’ withdrawal from positions or practice.
One way to do this is to specify in one’s professional will or elsewhere how client records should be handled;and alternatives include having an agreement with a responsible colleague about the management of the records, instructing one’s spouse or executor to seek advice on record keeping or asking a professional association to assist in managing or maintaining the records (Koocher & Keith-Spiegel, 1998).
(See standards 3.12 interruption of psychological services and 10.09 interruption of therapy)
Can psychologists withhold records requested when clients/patients have not made their payments?
6.03 Withholding Records for Nonpayment
Psychologists may not withhold records under their control that are requested and needed for client’s/patient’s emergency treatment solely because payment has not been received.
What is HIPAA and how does it relate to client records?
HIPAA is the Health Insurance Portability and Accountability Act (HIPAA) which allows clients to have access to inspect and amend the information contained in their physical or mental health record, although the physical record by law is granted to the practitioner or institution.
What is FERPA and what type of records does it relate to?
FERPA law (or Buckley Amendment) Family Education Rights and Privacy Act applies to records maintained by educational institutions receiving federal funds. Prohibited to disclose without parental consent except in certain circumstances: providing records to education professionals who have a legitimate educational interest in the student, to appropriate individuals for the purpose of financial aid decisions, and to another school to which the student is transferring. It grants parents and students the right to inspect the student's educational records and challenge their content.
In a professional or scientific relationship, When do psychologists and recipients of psychological services reach an agreement specifying compensation and billing agreements?
6.04 Fees and Financial Arrangements
(a) As early as is FEASIBLE
(b) fee practices are consistent with law
(c) do not misrepresent their fees
(d) if limitations to services can be anticipated because of limitations in financing, this is discussed with the recipient of services as early as is feasible. (see standard 10.09 interruption of therapy, 10.10 terminating therapy)
When discussing fees, psychologists must make sure the client is aware of the therapist’s hourly fee, policy regarding missed appointments, arrangements with third party payors, and procedures for collecting unpaid bills.
If a client is unable to pay for services agreed and if a psychologist intends to use a collection agency or legal measures to collect fees, what measures does the psychologist take?
6.04 (e)Using a collection agency but only after notifying client of that intent and giving him/her an opportunity to pay the outstanding fees. Giving collection agency only limited info it needs to seek payment.
When is Bartering acceptable with clients/patients?
6.05 Barter With Clients/Patients
When it is NOT Clinically Contraindicated AND Not EXPLOITATIVE.
Canter et al. (1994) propose that psychologists consider several factors when contemplating bartering such as:
theoretical orientation
client’s diagnosis and dependency needs
the expected duration of treatment
the nature of the barter arrangement
When considering exploitation-the client and psychologist should both be considered, while client exploitation is of greatest concern, the psychologist may also feel exploited if client not meet expectations in turn “a very negative impact on psychological services rendered”(p.52)
Conclude that the exchange for certain services for therapy (e.g., housekeeping or childcare) would be clearly clinically contraindicated because of the potential negative consequences if those services are not performed satisfactorily.
Do psychologists take reasonable steps to ensure accurate reporting of the nature of the service provided or research conducted?
6.06 Accuracy in Reports to Payors and Funding Sources
In reports to payors for services or sources of research funding, psychologists take reasonable steps to ensure accurate reporting of the nature of service provided or research conducted, the fees, charges, or payments, and where applicable, the identity of the provider, the findings, and the diagnosis. (see standards maintaining confidentiality, 4.04 minimizing intrusions on privacy, and 4.05 disclosures).
When psychologists pay, receive payment from, or divide fees with another professional, other than in an employer-employee relationship, what is each of the payment based on?
6.07 Referrals and Fees
The Services provided (clinical, consultative, administrative, other) and is not based on the Referral itself.
Referral fees are not prohibited BUT when they are paid to an individual professional (as opposed to a referral service), they must be based on the actual costs of the services provided and not the referral itself.(charge a referral fee represents the costs associated w/the colleague’s use of the office space)
(see also 3.09 cooperation with other professionals)
