Client Information & Notices

Insurance

I currently accept:

• Blue Cross Blue Shield of Michigan

Enrollment is currently in progress with:

• Blue Care Network

• Priority Health

• Aetna

BCN, Aetna and Priority Health cannot be billed as in-network until my participation and effective dates are confirmed. Please contact me for the most current information.

Insurance participation and coverage can vary among plans, employer groups, and behavioral-health networks. Being in network with an insurance company does not guarantee that every service will be covered under your particular plan.

Before beginning therapy, I recommend contacting your insurer to ask:

• Is Christian Smith, LMSW, in network with my specific plan?

• Does my plan cover outpatient telehealth psychotherapy?

• What are my deductible, copayment, and coinsurance?

• Do I need prior authorization or a referral?

• Are there limits on session length, frequency, or number of visits?

I will help verify your benefits when possible, but information provided by an insurer is not a guarantee of payment. You are responsible for costs not covered by your plan.

Private Pay Session Fees

The standard out-of-pocket fee for a 53–60 minute psychotherapy session is $175.

Fees for longer sessions, ketamine support, or other services will be discussed and agreed upon before the service is provided.

Medical evaluation, prescribing, medication, monitoring, and facility charges associated with ketamine treatment are billed separately by the medical provider or clinic. My fee covers psychotherapy services only.

Self-Pay and Good Faith Estimates

You may choose to pay privately whether or not you have insurance.

If you do not have insurance or do not intend to use insurance you have the right to receive a Good Faith Estimate explaining the expected cost of your care.

If you receive a bill from a provider that is at least $400 more than that provider’s Good Faith Estimate, you may be able to dispute the charge through the federal patient-provider dispute process.

You may request a Good Faith Estimate before scheduling or at any time during treatment.

Telehealth

Telehealth psychotherapy is available to clients located in Michigan. Telehealth has benefits and limitations, including the possibility of technical interruptions and reduced privacy depending on your location. These considerations will be reviewed during informed consent.

Privacy and Confidentiality

Your privacy is important. Information about the use and disclosure of protected health information is available in the Notice of Privacy Practices.

Email, text messages, website forms, and voicemail should not be used to communicate highly sensitive clinical information. Current clients should use the SimplePractice portal whenever possible.

Website and Professional Relationship

Information on this website is educational and does not constitute medical advice, diagnosis, or emergency care.

Visiting this website, sending a message, or scheduling a consultation does not by itself establish a therapist-client relationship. That relationship begins after we determine that working together is appropriate and complete the informed-consent and intake process.

Crisis and Emergency Care

Humaning Psychotherapy does not provide emergency or 24-hour crisis response. Email, voicemail, and portal messages are not continuously monitored.

If you are in immediate danger or unable to remain safe:

• Call 911

• Call or text 988

• Go to the nearest emergency department

Practice Information

Humaning Psychotherapy
Christian Smith, LMSW
A registered assumed name of Christian Smith Psychotherapy LLC
Telehealth psychotherapy throughout Michigan

HUMANING PSYCHOTHERAPY NOTICE OF PRIVACY PRACTICES

Christian Smith Psychotherapy LLC, doing business as Humaning Psychotherapy Christian Smith, LMSW, Privacy Officer Phone: 734-249-8267 Email: christian@humaning.us Website: humaning.us

Effective date: August 16th, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

You have the right to receive this notice in paper or electronic form and to discuss it with Christian Smith, LMSW, using the contact information above.

About This Notice

Christian Smith Psychotherapy LLC is the legal entity responsible for your records and operates under the assumed name Humaning Psychotherapy. In this notice, “Humaning” and “the Practice” refer to Christian Smith Psychotherapy LLC doing business as Humaning Psychotherapy. Christian Smith, LMSW, is the treating psychotherapist and Privacy Officer.

This notice applies to health information created or maintained by the Practice in connection with psychotherapy and related services. It does not apply to records independently created or maintained by a ketamine clinic, prescribing professional, hospital, or other collaborating provider. Those providers have their own privacy practices and responsibilities.

Protected health information, or “PHI,” includes identifiable information about your health, treatment, payment for care, or receipt of healthcare services, whether communicated orally, electronically, or in writing.

The Practice’s Responsibilities

The Practice is required to:

• Protect the privacy and security of your PHI.

• Provide you with this notice of its legal duties and privacy practices.

• Follow the privacy practices described in the notice currently in effect.

• Notify you if a breach occurs that may have compromised the privacy or security of your information.

• Limit uses and disclosures to the information reasonably necessary for the permitted purpose when the minimum-necessary standard applies.

• Follow federal or Michigan law when it provides greater protection for your information.

The Practice will not use or disclose your PHI in a way that is not described in this notice unless you authorize it in writing or applicable law permits or requires the use or disclosure.

If you provide written authorization, you may revoke it in writing at any time, except to the extent that the Practice has already acted in reliance on it.

Your Rights

Obtain a Copy of Your Record

You may ask to inspect or obtain an electronic or paper copy of the clinical and billing records maintained about you.

The Practice will act on your request within the time required by applicable law, ordinarily within 30 days. The Practice may charge a reasonable, cost-based fee permitted by law.

If all or part of your request is denied, the Practice will explain the reason in writing and tell you whether the decision may be reviewed.

The general right of access does not include psychotherapy notes maintained separately from your clinical record or information compiled in reasonable anticipation of a legal proceeding. Other limited exceptions may apply.

Ask the Practice to Correct Your Record

You may ask the Practice to amend information that you believe is inaccurate or incomplete.

The Practice may deny the request under circumstances permitted by law but will explain the reason in writing, ordinarily within 60 days. Even when the original record is not changed, you may have the right to submit a written statement of disagreement to be maintained with it.

Request Confidential Communications

You may ask the Practice to contact you in a particular way or at a particular address. For example, you may ask that communications be sent only through the client portal or to a particular telephone number.

The Practice will agree to reasonable requests.

Request Restrictions

You may ask the Practice not to use or disclose particular information for treatment, payment, or healthcare operations. The Practice is generally not required to agree.

If the Practice agrees to a restriction, it will follow that restriction except when disclosure is necessary for emergency treatment or is otherwise permitted or required by law.

If you pay for a service in full out of pocket, you may ask the Practice not to disclose information about that service to your health plan for payment or healthcare-operations purposes. The Practice will honor that request unless disclosure is required by law.

Obtain an Accounting of Disclosures

You may ask for an accounting of certain disclosures made during the six years preceding your request.

The accounting generally does not include disclosures for treatment, payment, or healthcare operations; disclosures you authorized or requested; or certain other disclosures excluded by law.

The Practice will ordinarily respond within 60 days. One accounting during any 12-month period will be provided without charge. The Practice may charge a reasonable, cost-based fee for additional accountings after notifying you in advance.

Obtain a Copy of This Notice

You may request a paper or electronic copy of this notice at any time, even if you previously agreed to receive it electronically.

Choose Someone to Act for You

If someone has legal authority to act as your personal representative, such as a court-appointed guardian or a person authorized to make healthcare decisions under an applicable patient-advocate designation or power of attorney, that person may exercise your privacy rights within the scope of that authority.

A parent or legal guardian will ordinarily act as the personal representative of an unemancipated minor, subject to exceptions under federal and Michigan law.

The Practice will verify a person’s identity and legal authority before allowing that person to act for you.

File a Privacy Complaint

You may file a privacy complaint with Humaning Psychotherapy by emailing christian@humaning.us or calling 734-249-8267 and stating that you wish to make a privacy complaint.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at hhs.gov/hipaa/filing-a-complaint or by calling 1-877-696-6775.

The Practice will not retaliate against you for asking questions, exercising a privacy right, or filing a complaint.

Your Choices

Family, Friends, and Others Involved in Your Care

With your permission, the Practice may share relevant information with a family member, close friend, or another person involved in your care or payment for your care.

If you cannot communicate your preference, for example, during an emergency, the Practice may share relevant information when permitted by law and when, in professional judgment, doing so is in your best interest or necessary to address a serious and imminent safety concern.

Listing someone as an emergency contact does not ordinarily authorize routine disclosure of your clinical information to that person.

Uses and Disclosures Requiring Written Authorization

Your written authorization is required for:

• Most uses or disclosures of psychotherapy notes.

• Uses of your PHI for marketing.

• Other uses or disclosures not described or otherwise permitted by this notice.

Humaning Psychotherapy does not sell your health information.

An authorization may be revoked in writing at any time, except to the extent that the Practice has already acted in reliance on it.

How the Practice May Use or Disclose Your Information

Treatment

The Practice may use your PHI to provide, coordinate, or manage your care. When permitted by applicable law, relevant information may be shared with other professionals involved in your treatment.

Example: The Practice may coordinate with a prescribing clinician or collaborating ketamine clinic concerning treatment planning, medication effects, safety, or continuity of care.

When applicable law requires written authorization for a particular treatment disclosure, the Practice will obtain it.

Payment

The Practice may use or disclose PHI to bill you, submit claims to an insurer, determine eligibility or benefits, obtain payment, respond to claim questions, or conduct collection activities permitted by law.

Example: An insurance claim may include your identifying information, diagnosis, dates of service, procedure codes, and other information required to process the claim.

Healthcare Operations

The Practice may use or disclose PHI as permitted by law to operate the practice, including for scheduling, quality improvement, credentialing, licensing, compliance, billing support, legal or accounting services, and secure technology services.

Example: The Practice may use a healthcare-record or billing service to schedule appointments, maintain records, process claims, or collect payment.

Vendors that receive PHI on behalf of the Practice must be appropriately authorized and, when required, enter into agreements obligating them to protect it.

Appointment and Service Communications

The Practice may use your contact information to send appointment reminders, scheduling messages, billing communications, or information about treatment alternatives or services that may be relevant to your care.

Required by Law

The Practice will use or disclose information when federal or Michigan law requires it. Any disclosure will be limited to the requirements of the applicable law.

Safety and Protective Disclosures

The Practice may use or disclose relevant information when required or permitted by law, including:

• To report suspected abuse or neglect of a child.

• To report suspected abuse, neglect, or exploitation of an adult in need of protective services.

• When the Practice believes in good faith that disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or that of another person.

• When Michigan law requires protective action in response to a communicated threat of physical violence against a reasonably identifiable person.

Any disclosure will be directed to a person or organization reasonably able to address the concern and will be limited to information reasonably necessary for the protective purpose.

Public-Health Activities

The Practice may disclose PHI to a public-health authority when authorized or required by law. Such disclosures are uncommon in this psychotherapy practice.

Health Oversight

The Practice may disclose PHI to a legally authorized health-oversight agency for an audit, investigation, inspection, compliance review, or professional-licensing or disciplinary matter.

Workers’ Compensation and Government Functions

The Practice may use or disclose information as authorized or required for workers’ compensation matters, lawful government benefit programs, correctional-institution healthcare, military or national-security functions, or other specialized government activities permitted by law.

Law Enforcement

The Practice may disclose information to law enforcement only when permitted or required by applicable law—for example, in response to a legally sufficient order or warrant, to report certain injuries or crimes when legally required, or to address a serious and imminent threat.

Medical Examiners and Funeral Directors

The Practice may disclose information to a coroner, medical examiner, or funeral director when authorized or required by law.

Legal Proceedings

The Practice may disclose PHI in response to a valid court or administrative order or other lawful process, but only as permitted or required by applicable federal and Michigan law.

Receiving a subpoena does not necessarily authorize the Practice to disclose privileged psychotherapy communications or records. As appropriate, the Practice may seek your authorization, assert an applicable privilege, object to the request, request a protective order, or obtain legal guidance before responding.

Mental-health records, psychotherapy notes, and records protected by 42 C.F.R. Part 2 may receive additional protection.

Psychotherapy Notes

The Practice may maintain psychotherapy notes for some clients.

“Psychotherapy notes” is a specific legal term referring to notes that document or analyze the contents of counseling conversations and are maintained separately from the clinical and billing record.

Progress notes, diagnoses, treatment plans, symptoms, functional information, prognosis, test results, session times, and summaries of progress are not psychotherapy notes merely because they relate to psychotherapy.

Most uses or disclosures of separately maintained psychotherapy notes require your written authorization. Authorization is not ordinarily required for:

• Use by the note’s originator in treating you.

• Certain legally permitted training or supervision.

• Defending the Practice in a legal proceeding brought by you.

• Certain legally authorized oversight or compliance activities.

• Disclosures required by law.

• Disclosures permitted to address a serious and imminent threat.

• Other limited circumstances permitted by HIPAA.

Psychotherapy notes remain protected health information. Keeping them separately does not make them immune from every possible court order or legally required disclosure.

Substance Use Disorder Records

Not every reference to alcohol or substance use is a record protected by 42 C.F.R. Part 2.

To the extent the Practice receives or maintains substance-use-disorder treatment records protected by 42 C.F.R. Part 2, those records will receive the protections required by Part 2.

Such records, or testimony describing their contents, may not be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you unless:

1. You provide the written consent required by Part 2; or

2. The use or disclosure is authorized by a qualifying Part 2 court order accompanied by a subpoena or similar legal requirement.

Records received from a Part 2 program may retain their Part 2 protection after being received by the Practice.

Changes to This Notice

The Practice may change this notice and its privacy practices. Changes may apply to information already maintained by the Practice as well as information created or received after the change.

The Practice will not implement a material change before the effective date of the revised notice unless the change is required by law.

The current notice will be available upon request and posted at humaning.us. If a material change affects your rights or the Practice’s responsibilities, the revised notice will be made available as required by law.

Acknowledgment of Receipt

By signing below, I acknowledge that I have received a copy of Humaning Psychotherapy’s Notice of Privacy Practices.

My signature acknowledges receipt only. It does not authorize any use or disclosure of my health information beyond what is otherwise permitted by law.

If I am signing as the client’s personal representative, I certify that I have legal authority to act for the client concerning the healthcare matters covered by this acknowledgment.