Insurance and Fees

Fees

Unless you are a Blue Cross/Blue Shield, Regence Blue Shield, Premera Blue Cross, Kaiser Permanente PPO, First Choice, Lifewise member or prior arrangements have been made, my fee for a eighty minute initial evaluation is $170 and a fifty minute individual therapy session is $135. My fee for couples therapy is $160 for a fifty minute session. I accept cash or check at the time of your appointment if I am not billing your insurance. 

During our first meeting, I will ask you to read, complete, and sign the following forms. You may download them here if you would like to save time by reviewing, completing, and signing them in advance.


Forms

Policies and Practices: This document describes my practice and policies with regard to my professional qualifications, approach to treatment, fees, scheduling, cancellations, and consent for treatment. When you sign this form, you are stating that you consent to my services and policies as described in the disclosure statement. 

Notice of Privacy Statement:  I ensure my clients confidentiality. This form explains my policies related to this as well as the few exceptions to privacy. Washington State law requires that I provide clients with contact information for the Department of Health should you have any complaints against the services I provide. When you sign this form, you are stating that you have received this document.

New Client Information: Please complete this form so that I may have some basic information about you before we begin.

Release of Information: When I need to consult with other professionals about our work together, I will ask you to download, print, read, and complete this form. This document gives me your written consent to share information about our work together with specific persons whom you designate. 

 


Insurance

In-Network

I am a Blue Cross/Blue Shield, Regence Blue Shield, Premera Blue Cross, First Choice and Kaiser Permanente PPO, First Choice, and Lifewise provider. I will submit claims to your insurance company for you. It is always best to check your benefits to determine your yearly deductible and copay or co-insurance fees per session. I can help you obtain this information if needed. I provide monthly bills to clients. Your bill will be your co-pay or co-insurance fee.  If you have a deducible that is still being met, your bill will include your copay or co-insurance fees plus the amount your insurance company has applied toward your deductible for the session. I am happy to go over this in detail with you.

Out-of-Network

Most insurance companies have mental health benefits for out-of-network providers. I can help you understand the procedure for obtaining information about your out-of-network benefits. My fee is due at the time of service. Upon request, I can provide you with a statement at the end of each month which you can submit to your insurance company for reimbursement. Your insurance company may have a special form for such submissions which I am happy to help you complete.

Employee Assistance Programs

I am an Employee Assistance Provider for several programs. If your employer contracts with any of these organizations for EAP, I am able to see you under this program’s benefits for the number of sessions your employer allots. When that number is met and it is recommended, I will offer you referrals for at least three providers so you can continue therapy. I will include my name on that list. Feel free to contact me to determine if I am credentialed with your EAP program.