Please review these details about fees and insurance.

• I am not contracted with any private or public health insurance plans; I am considered an "out-of-network" provider.

• Patients are responsible for the entire fee for each appointment or service.

• Full payment is due at the time of service.

• Patients are required to keep a valid credit card on file securely in the electronic medical record system (Sessions Health).   I do not ever see your complete credit card data myself. Sessions Health accepts credit card payments via Stripe, a payment services provider.  

• You are responsible for keeping your credit card information up-to-date in Sessions. 

• You can enter more than one card if you wish, and designate a default card. Please alert me if you do not want your default card charged or if you want to make sure a specific card is charged.

• Patients are able to download an invoice/receipt after each visit is billed, often called a "superbill."

• Patients may choose to submit this "superbill" to their insurance plan to seek reimbursement or simply keep it for their own records.

• You must be familiar with your own plan, including pharmacy benefits and any "out-of-network" coverage.  

• I do not directly bill any insurance plans on behalf of my patients.

• If you do plan on submitting claims to your insurance, please let me know.

• For those who do submit a claim to their insurance, the amount of any reimbursement is between the patients and their insurance plan. This does not change my fees or your responsibility to pay for your treatment in full.

• I am unable to offer a sliding-scale reduced fee schedule; all patients pay the same fees.

• My rates are comparable to those of other psychiatrists in the Seattle area.

• My rates are re-evaluated once each year, and they may increase over time. I will generally inform my patients of any anticipated rate increase 2-3 months beforehand.

• I cannot see any patients covered under a public health plan.  This means that if you have Medicare or Medicaid, I cannot accept you as a patient even if you are choosing to go outside of your health plan and pay out-of-pocket. 

• If any current patient obtains coverage with Medicare or Medicaid, they must let me know and they will not be able to continue treatment with me.  

• Patients are responsible for keeping me informed of their insurance status and any changes in coverage.  

• Your time is valuable and so is mine.  Therefore, there is a charge for missed appointments, late cancellations and some (but not all) contact between appointments.  Please also see FAQs.

FEE SCHEDULE (effective July 1, 2023)

1. INITIAL PSYCHIATRIC EVALUATION or CONSULTATION:   $450 per appointment (1.5-2 hours = ~80-110 minutes video time)

Please note that initial evaluations and consultations generally require 1-2 appointments (total fee is $450-900).

Occasionally a 3rd appointment is necessary (total fee $1350).

2. MEDICATION MANAGEMENT:  $225 per appointment (0.5 hours = ~25 minutes video time) & $350 per appointment (1 hour = 50 minutes video time)

3. MEDICATION MANAGEMENT WITH PSYCHOTHERAPY: $350 per appointment (1 hour = ~50 minutes video time)

4. PSYCHOTHERAPY: $350 per appointment (1 hour = ~50 minutes video time)

5. ADDITIONAL FEES:  $350 per hour of time (billed in 10-minute increments, first 10 minutes no charge)

Additional fees are charged for clinical and administrative tasks outside of your appointment time which require more than 10 minutes of my time.  Examples include but are not limited to phone calls, messaging and emails, copying/faxing/mailing, pharmacy and pre-authorization requests, completion of any documentation, paperwork or forms, and any tasks related to your insurance coverage if you are submitting an out-of-network claim for reimbursement. I will discuss anticipated additional fees with you ahead of time so that you have a chance to ask any questions and so you are aware of the additional time and fees. I do not want you to be surprised by additional fees.

Please note that additional fees are generally not reimbursed by third-party insurance carriers.      

Additional fees are billed in 10-minute increments, $58.33 per 10 minutes, first 10 minutes no charge, rounded to nearest dollar (As examples, up to 10 minutes is no charge, 11-20 minutes is $58, 21-30 minutes is $117, 31-40 minutes is $175, 41-50 minutes is $233, 51-60 minutes is $292, etc.).

6. CANCELLATION, MISSED APPOINTMENT ("no-show") and LATE-TO-APPOINTMENT FEES:  Full cost of the scheduled appointment

There is no charge for appointments cancelled at least 2 calendar days prior to the appointment or if there are extenuating circumstances (addressed on a case by case basis).

The full cost of the scheduled appointment (from $225 to $450) will be charged if you do not follow the cancellation policy (please see FAQs for full cancellation policy).   Please note that insurance does not usually reimburse patients for these charges.

THE NO SURPRISES ACT

Effective January 1, 2022, all health care providers must comply with new federal legislation called the No Surprises Act.  This act was enacted to protect patients from being surprised with higher-than-anticipated medical expenses when receiving care at a facility that is in-network but the provider in that facility is actually out-of-network for their insurance plan.  This law aims to protect patients from these "surprises," and the authors did not have private psychiatric practices in mind when they wrote this law.  They were instead focusing on emergency rooms, hospitals and larger clinics with multiple providers.

The No Surprises Act caught many psychiatrists in private practice, off guard.  We were "surprised" that some of the requirements of this law apply to psychiatric providers in private practice even though there are no potential surprises for our patients.  In my case, as with most psychiatrists in solo practice, my fees are transparent and disclosed up front (see Fee Schedule).   My patients and I decide together how often they will have appointments, how long the appointments will be and how long their course of treatment is expected to last.  Any additional fees for significant services requiring my time between appointments are also billed at a known rate.  And my patients know that they are responsible for the full fee for each appointment whether or not they submit a claim to their insurance company, and whether or not they ultimately receive any reimbursement from their insurance or not.  There really are no "surprises" in this type of practice.  As it turns out, the surprise billing protections for patients under the No Surprises Act do not apply in physician offices, but may apply for emergency services and certain non-emergency types of pre-scheduled care in hospitals, hospital outpatient departments, critical-access hospitals and ambulatory surgical centers.  Most care provided in a physician's office is not included.

However, some parts of the No Surprises Act do apply.  Per the law, I will provide some patients with a Good Faith Estimate (GFE) before treatment begins.  Although all patients pay for each session up front with a credit card on file, GFEs will be provided to, (1) uninsured patients who do not have health insurance of any kind, (2) self-pay patients who do have health insurance that would potentially pay for some or all of the costs of treatment but who will not be submitting a reimbursement claim their insurance, and (3) patients who are shopping for care and want to be able to compare my fees to those of other psychiatrists.  Patients who do intend to submit a claim to their health insurance for full or partial reimbursement do not receive a GFE, whether they ultimately are reimbursed by their insurance or not.    

The GFE will contain the patient's name and birth date, a description of the primary service being provided with expected dates of service, an itemized list of services that are reasonably expected (such as those listed in a fee schedule), any applicable diagnoses if available, my identifying information as a provider, and a list of any additional services outside of routine care that might require separate scheduling.  There are also disclaimer statements explaining that (1) there may be additional services recommended in the future that are not reflected in the estimate, (2) the estimate is indeed only an estimate and that actual services and charges may differ, (3) patients have the right to initiate a patient-provider dispute resolution process if actual billed charges substantially exceed expected charges in the GFE (including information about how to initiate a dispute, and noting that a dispute will not adversely affect the quality of health services being provided), and (4) the GFE is not a contract and does not require uninsured or self-pay patients to obtain services from me.  A new GFE will be issued each year.

Disputes: patient are allowed under this law to file a complaint if their actual expenses for scheduled services are more than $400 greater than the cost listed in the GFE.  This is unlikely in my case, since my patients know up front how often they will be seen and how much each session costs.  The GFE will very likely over-estimate the anticipated costs of your care.  

For those patients who DO plan on submitting a claim to their insurance company for reimbursement for out-of-network care, please keep the following in mind.  Interacting with health insurance companies is often very time-consuming. As with all additional administrative tasks, you will be charged the prorated fee of $350 per hour for time spent completing these tasks (please see Fee Schedule, #5, above).  If this is a concern, please keep in mind that you may be able to complete much of the work yourself (for example, obtaining and completing forms, providing contact information for your insurance, etc).  In the end, if ensuring you receive significant reimbursement from your health insurance company for your out-of-network care psychiatric treatment is a top priority, it is better for you to find a psychiatrist who is in-network with your plan.  

Please do not hesitate to discuss treatment costs with me at any time.