Insurance

Preferred Provider (PP). I am a PP for most plans administered by Regence, Blue Cross, Premera, First Choice, or Uniform/LifeWise. If I am a PP on your plan the charges for your sessions will be billed to your insurance plan and I will be reimbursed directly. You will be billed for the balance not covered by insurance. Copays need to paid at each session with a personal check. At the point that benefits are exhausted, terminated, or disallowed by your plan you will be required to pay the full fee for those and any subsequent services.

Records Given to Insurance Carriers. Your insurance plan requires that I provide a clinical diagnosis (DSM) and may reqiure that I provide other information relevant to the services that I provide to you (e.g., treatment plans, summaries of progress of treatment, or copies of your entire Clinical Record). In such situations, I will make every effort to release only the minimum information about you that is necessary for the purpose requested. This information will become part of the insurance plan computer files. I will consult with you prior to any discussion I have with insurance case managers. A copy of any report submitted to your insurance plan will be kept on file for you and you will have access to it upon request. If you have concerns about how your insurance plan manages your medical information contact them.

Disallowed Services. It is sometimes difficult to know fully what services insurance plans will cover. Plans may limit care to short-term treatment of symptoms or focus on a specific problem. They may require approval for services beyond the initial authorization. They may base the continuation of service on information about the progress of treatment and your diagnosis. They may determine that either present or past services are or were not medically necessary. Many plans will not cover couple’s counseling. Most insurers will not reimburse for telephone sessions even under emergency conditions. None will pay for late-cancellation or missed sessions. You will be required to pay the full fee for any services disallowed regardless of the reasons and for any sessions missed or cancelled with less then 24 hours notice.

Right to Self-Pay. Once we have all of the information about your insurance coverage, we will discuss what we can expect to accomplish with the benefits that are available and what will happen if those benefits are exhausted before you feel ready to end your sessions. It is important to remember that you always have the right to pay for my services yourself. There is no requirement that you utilize your insurance benefit.