attachment and bonding center of ohio

gregory c. keck phd

Application Process

A complete application package is provided to help expedite the collection of information and the assessment process. If you wish to pursue the assessment process, please return all the requested material to ABC of Ohio. Include at the time submission of any other materials that you have, i.e., social history, adoption information, psychological/psychiatric treatment summaries, etc. You may print the entire application packet, along with the checklist and return the completed package with your fee of $110.00.

Please note -- Application materials should only be sent by mail or alternate delivery service. We do not utilize the Internet or Faxing for application processing. All phone calls will be returned promptly.

Financial Information

The total application fee for this process is $110.00. The fee, $110.00 is due with the return of your application material. Your books will be shipped at no additional cost upon receipt of your application and fee. A receipt will be provided for your county should you apply for PASSS funding after the assessment is completed. Please make your check payable to ABC of Ohio.

If you have more than one child to be evaluated, the sibling application fee is $55.00 ($5.00 prepayment + $50 balance) for each child. One set of books will be issued per family.

Please be aware that due to the time intensive nature of attachment and bonding therapy, Medicaid is not accepted.

Our Financial Agreement has been prepared to help you in researching and arranging for payment of treatment. Please be prepared to provide accurate billing information for County/agency contacts and billing personnel, or other funding sources at the assessment appointment. If payment is to be made by a County or agency, it is necessary for you to provide a letter of financial commitment prior to the beginning of treatment.

A 50% prepayment is required for intensive therapy sessions. The prepayment is due on or before the first date of scheduled treatment. If County/agency payment is expected, this term will be waived upon receipt of a letter of financial commitment from the County/agency.

Medicaid funding is not accepted for treatment at ABC of Ohio.

State of Ohio PASSS Funding

You can get a PASSS application from either a Children Services Board (CSB) or the Ohio Department of Job and Family Services (ODJFS) in the county in which you reside. You can not apply for PASSS from the county from which your child was adopted. Provider credentialing forms are required with all PASSS applications. Please print a copy to enclose with your application form.

If you are from Ohio and do not plan to access PASSS funds, and choose to attempt to get insurance reimbursement, we will process insurance submissions when your account is paid in full.  It is unlikely that insurance will cover attachment therapy or any therapy requiring multiple units on one day.  Most mental health coverage is limited to one unit on a given date.  In the intensives, six units are billed daily; the biweekly format (90-minutes every two weeks) or the follow-up format (90-minutes every two weeks) also exceeds what most companies will pay.  In the intensives, we always use two therapists; insurance companies will not cover two therapists for the same period of time.  If your company is one with which we have a contract, you will not be able to access benefits for attachment therapy as we are only contracted to provide traditional therapy at an agreed-upon UCR.

If you are from another state or country, we will, also, process your insurance for your reimbursement when your balance is paid in full, subject to the above issues.

ASSESSMENT: $375.00
Prior to the child's assessment, the therapist talks with the parent(s) to discuss the history of the problem, current status of the child being referred, and other family issues. Prior to the end of the assessment, the parent(s) and child are seen together. The quality of the family relationship is critical as we work with the child. Most children with attachment difficulties often have quite effectively created a split between the parents, and, as a result, some erosion of the family relationship may have occurred. It is helpful in the treatment of your child for us to thoroughly understand the nature and quality of your family's relationship.

INTENSIVE THERAPY: $600.00 per Day -- 10-Day Model (Maximum)
The intensive model is a maximum period of 10 days during which the parent(s) and child spend three hours daily in outpatient treatment. There are times when progress made is such that the intensive is shortened. This is a clinical determination that is made during the treatment process. Intensive therapy is scheduled Monday -- Friday.

FOLLOW-UP: $250.00 -- 90-minute session
Follow-up to the intensive is required. Some families choose to use the Attachment and Bonding Center of Ohio; others choose to work with a therapist who may have referred them to ABC of Ohio. If people choose to work with a therapist outside the office, we strongly recommend that the therapist participate in the intensive treatment process in an effort to provide continuity of care.

BI-WEEKLY THERAPY MODEL: $250.00 -- 90-minute session
Children who are not so severely disturbed benefit from our biweekly 90-minute sessions. This option may be recommended at the time of assessment.

Lodging

Lodging can be provided at a discount rate at the TownePlace Suites by Marriott in Middleburg Heights, OH. Click here to learn more.

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You can download the Full Application Package or you may download by sections.

All of the following sections are required to complete your application:

• Child Registration Form

• Financial Agreement

• Permission to Treat

• Child History Report
  
  
• Physician's Statement
  
  
• Caregiver Autobiography

• Attachment Symptoms for Children Under 5

• Attachment Symptoms for Children Over 5

• Notice of Privacy Practices and Consent to Use and Disclose Your Health Information

Please return all completed application materials, the application fee ($110.00) payable to ABC of Ohio, and any additional case information. You will be contacted when a review of all information is complete.

Partial application packets will be held until all required material is received.

In preparation for the treatment of your child in this office, we are providing copies of two books with your paid application fee: "ADOPTING THE HURT CHILD" and "PARENTING THE HURT CHILD" by Gregory C. Keck, PhD, and Regina Kupecky, MAT, LSW. These books will be referred to throughout the treatment process. You will be better prepared for the assessment and treatment process after reading them.

Upon receipt, all material will be reviewed and, if appropriate, you will be contacted to schedule the assessment. If there are issues that would be best treated by another approach at another setting, you will be informed at this time. The application package can be printed from the link provided below.

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MUST HAVE BOOKS
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Gregory Keck, PhD

Attachment and Bonding Center of Ohio

Cleveland Office  440-230-1960
12608 State Road
Suite 1
Cleveland, Ohio  44133

Columbus Office  614-850-9800
3966 Brown Park Drive
Suite H
Columbus, OH 43026

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