I am looking for some guidance. I am a registered psychologist in Nova Scotia and I have a private practice.

I am writing about one of my clients, whom I met for over 40 sessions. Most of our sessions went without any concerns. Unfortunately, this client just stopped paying for sessions a number of months ago and then amassed a large outstanding balance (over a $1000) with the promise of payment. When payment was not received she was approached about this and she explained that her busy schedule had prevented her from reviewing the outstanding balance and that she would address this matter ASAP. Since then she has simply stopped responding to correspondence (her last message to the clinic was in July). She is a very well known public figure and has regularly featured in the news since then so I am aware she is alive and well, but has simply stopped contact with the clinic – leaving the balance unpaid. We have sent a number of reminder emails for payment with deadlines/offer of a payment plan. We have also asked her to get in contact to prevent future sessions from being cancelled. She has not.

I would like to pursue the outstanding balance, however I am concerned about protecting this person’s identity. Staff at the clinic have suggested passing her debt to a collections agency or pursuing the matter in a small claims court however I am concerned doing so would be a breach of confidentiality.

Does NSBEP has a stance on how best to manage a situation like this?

I have consulted on your enquiry. While NSRP would not state this to be a “position”, we are happy to share some ofnthe typical information that NSRP references for questions about billing.

Principle 6nA registrant shall reach an agreement with an individual, group or organization concerning the psychological services to be provided, the fees to be charged and the billing arrangements prior to providing service.

6.1 A registrant sets fees based on the amount of time spent and complexity of the services rendered and does not base fees on the basis of advantage or clinically significant benefits accruing to the individual receiving services.

6.2 Interest may be charged on an overdue account as long as the client is informed of this practice at the time of billing.

6.3 Prior to using a collection agency or legal option to collect fees, the registrant informs the client of this intent and provides an opportunity for payment to be made.

6.4 A registrant does not request advance payment for psychological services however funds may be held in trust if agreed on by the client. Trust funds are applied only to services rendered with any excess returned to the client on the termination of services.

As noted above, the Standards of Practice expect the psychologist to contact the client in advance and let them know what they plan to do, in order to provide an opportunity for the client to address the issue before it is sent to collections. I would expect the information provided to Collections could be limited in nature so that it does not reveal any more information than is necessary. (i.e., services received on such and such date). The Code of Ethics does not contain a provision for dealing with collections, and in this situation, the Standards of Practice allow the psychologist to proceed as above if they provide advance notice of their intentions, so that the client has an opportunity to address the outstanding amount prior to the matter being forwarded to Collections.

This might also be something you may wish to consider developing a policy for in future and place into consent forms (sending to a collection agency for non-payment of fees).

nCheers, Lee