Fees, Payments, Forms, And Everything Else

Fees, Payments, Forms, And Everything Else

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Getting Started

Finding the right therapist is the first step in making your therapy work. I encourage you to choose the therapist that feels like the best fit. Many factors are important, including your personal preferences, time, resources, and readiness. If you are looking for a therapist, I am available to talk briefly about your goals and current situation. For more information about scheduling, cancellation policies, emergencies and other consideration, please contact me.

Fees, Payment, and Forms

Fees (Effective as of 1/1/2022)

Typical Session (50-55 min)  @ $160)

Extended EMDR Session (100 – 110 min @ $320)

Group Therapy/Workshops (50-55 min @ $60 per participant; Minimum of 3 participants)

Consultation/Telephone Counseling ($5.00 per minute)

Contracting Work (Negotiable)

*Other Fees May Apply Dependent Upon Client Needs Assessed At Time Of Intake or Occurring During The Course of Counseling.  These Fees are outlined on the Consent For Treatment Form Provided During Intake/Assessment.

Note: For clients who are unable to attend session in office, but still have permanent residence in California, I can provide services via telehealth (Utilizing the HIPAA compliant platforms) utilizing insurance and/or for same fees above.

Payment

credit-cards

I accept cash, money order, or cashier’s check. I also accept debit/credit cards, including FSA/HSA cards. I am able to accept payment via contactless methods.  Payment is due at time of service. You may also prepay.

Insurance

I am currently accepting select insurance plans: CIGNA, MHN (HEALTH NET), KAISER (BEACON), KAISER (KP DIRECT), AND AETNA.

*Note: Insurance providers may require prior authorization for services.  Please check with your individual insurance by phone, utilizing the number on the back of your insurance card, prior to engaging in services.

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.  Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.  You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.   For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

If you have an insurance plan that I am not in network with, but your plan is a PPO, my services may be partially covered, and I can provide you with a monthly statement of services which you can submit to your insurer for reimbursement. Be sure to check with your insurance company for your plan’s mental health coverage for ‘out of network’ providers. Additionally, if you have a Flex Spending Account (or HSA) and an associated card (with a Visa or MasterCard logo), you may be able to use that account to pay for our sessions.

Using insurance has risks and benefits. While it can lower costs, it typically requires me to make a clinical diagnosis. This is something that will become part of your medical record, and can have current and future implications.  Also, if your insurance denies coverage of services, you will be responsible for payment of services rendered.

It’s also important to know that using your insurance can impact your ability to control your therapy, as your insurer may limit the number of sessions or what you work on in sessions.

Cancellation Policy

If you do not show up for your scheduled therapy session, and you have not notified me at least 48 hours in advance, you are required to pay the full cost of your session ($180.00). Insurance does not reimburse for missed sessions OR sessions cancelled outside the cancellation window.

Forms

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Intake Form

Authorization to Disclose HIPPA and Patient Rights

Client Informed Consent and Office Policy Statement

Legal Proceedings Policy and Social Media Policy

Credit Card Agreement

Before your first appointment, you will need to receive, review, complete, and sign some paperwork. Please email me in order that I can forward you the requisite documents in PDF.

Note: Please fill out Intake and Patient Information forms prior to your first visit.  If you need me to coordinate care with other provider (s) or entity (s) please fill out an Authorization to Disclose HIPPA and Patient Rights for said provider (s) or entity (s) prior to your first visit.

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