Initial Evaluation
New clients and those who have not had an appointment in the past year will be scheduled for this type of appointment, which typically lasts 60-90 minutes. This assessment is very detailed and is intended to clarify the onset and nature of the current problem as well as identify physical, situational, and psychological factors that may be affecting it.
My charge for this initial evaluation is $350 - $450. Following evaluation, you and I will work together to set treatment goals and make a plan to help you reach those goals. This plan may include medications, behavioral strategies, therapy and/or referral to other specialists. Sometimes, we are able to do this during the initial appointment time. If not, we will do this at your next appointment.
It is very important to be prepared for this appointment. Once your appointment has been scheduled, you will receive an invitation to the OnPatient secure portal. Please log in, and complete the required tasks at least 3 business days before your appointment. Doing this ahead of time gives you time to consider your symptoms, collect information about your personal and family medical history, and familiarize yourself with my policies. It helps us be more efficient at your intake appointment, and is a sign that you are committing to treatment. Your appointment may be given to someone on the waiting list, if you do not complete this step.
Follow-Up Assessments
These appointments are extremely important. At each appointment, we will check progress toward your treatment goals, evaluate medication responses, review teaching points and coping skills, discuss any new questions or concerns, and revise our goals and treatment plan as necessary. These appointments are generally 25-30 minutes long, but can be as long as 60 minutes, if your case is complex, you are experiencing new or more severe symptoms, have many questions, or need time to process difficult feelings. In the interest of getting you well faster, I treat every interaction as an opportunity to develop skills, process difficult emotions, and foster a strong therapeutic relationship with you. These brief therapy interventions are meant to supplement or support the work you may be doing with your regular therapist.
Follow up assessment charges are generally $150 - $250.
A payment plan or sliding scale may be available for patients experiencing severe economic hardship.
Follow up assessment charges are generally $150 - $250.
A payment plan or sliding scale may be available for patients experiencing severe economic hardship.
How Charges Are Determined
I follow guidelines set by the American Medical Association to select the appropriate billing code
for each appointment or patient interaction. These guidelines take into account appointment length, number and severity of symptoms we are trying to address, treatment prescribed, and whether or not I incorporate therapy interventions. Because those factors will vary during the course of your care, it is not possible for me to tell you exactly which code I will use prior to your appointment. I am legally and ethically required to bill for all services provided.
for each appointment or patient interaction. These guidelines take into account appointment length, number and severity of symptoms we are trying to address, treatment prescribed, and whether or not I incorporate therapy interventions. Because those factors will vary during the course of your care, it is not possible for me to tell you exactly which code I will use prior to your appointment. I am legally and ethically required to bill for all services provided.
Prescriptions
Prescriptions will be written with enough refills to last until your next appointment. I recommend scheduling your next appointment at the end of each session, so that we can be sure you are able to come in before you run out of medication. My strict policies primarily reflect my concern for my clients' well being. Self-assessment of psychiatric symptoms can be difficult, and requires quite a bit of practice and feedback, especially early in treatment.
I will deny all pharmacy generated refill requests. If you cannot come in for an appointment before you run out of medication, you must send me a message in the portal or contact my office to request an out of appointment refill. I will charge $25 for non controlled substances. It is not always possible or appropriate for me to refill controlled substances outside an appointment, but if I am able to, these will have a fee of $50.
Please note that I do NOT authorize early refills for stimulant medications. Please keep your paper Rx and medications in a safe, secure location because I cannot replace lost, damaged, or stolen prescriptions.
Medications such as benzodiazepines and stimulants are tightly regulated by the DEA. These medications can be extremely useful, but require more monitoring and must be part of a comprehensive treatment plan. If you do not honor the agreed upon treatment plan, I will continue to work with you, but will not continue to prescribe controlled substances.
I will deny all pharmacy generated refill requests. If you cannot come in for an appointment before you run out of medication, you must send me a message in the portal or contact my office to request an out of appointment refill. I will charge $25 for non controlled substances. It is not always possible or appropriate for me to refill controlled substances outside an appointment, but if I am able to, these will have a fee of $50.
Please note that I do NOT authorize early refills for stimulant medications. Please keep your paper Rx and medications in a safe, secure location because I cannot replace lost, damaged, or stolen prescriptions.
Medications such as benzodiazepines and stimulants are tightly regulated by the DEA. These medications can be extremely useful, but require more monitoring and must be part of a comprehensive treatment plan. If you do not honor the agreed upon treatment plan, I will continue to work with you, but will not continue to prescribe controlled substances.
Cancellations
My goal is to help as many people as possible to not just live their lives, but thrive. To do that, I must be efficient with my time and minimize unplanned downtime. Cancellations must be made 48 hours in advance, not including weekends. (A 9am Monday appointment must be cancelled by Thursday 9am the previous week). Except in the case of illness or true emergencies, there will be a fee for appointments missed, or cancelled without 48 hours notice. The fee for a missed intake appointment is $300. For missed/late cancellation of follow up appointments, the fee is $125 for a 30 minute follow up and $175 for 45 minute or longer follow up appointment. Please note that insurance companies will not reimburse for missed appointment fees and you will be responsible for payment. Late cancellation fees must be paid prior to making a new appointment. More than three missed appointments in a year may result in termination of services.
Phone & Email Communications
Phone and electronic messaging cannot replace face-to-face interaction. In certain situations, they can be useful for quick questions. I will not make medication changes outside of an appointment.
I check my email, online messaging center, and voicemail daily Tuesday-Friday. I will do my best to respond within two business days, but urgent messages should be directed to the office during normal business hours. If you are experiencing an emergency that cannot wait until the next business day, please call 911 or go to the nearest ER.
Phone, portal, and email communications with you or other people / providers involved in your care will incur a $35 charge per 10 minute increment. That charge is often not covered by insurance. Information sent to me via portal that does not require a response outside of a scheduled appointment will not incur a charge.
Please remember that while I take precautions to keep my email private, there are security risks inherent to email communication. Please limit email for general questions or about scheduling, etc. Questions about your symptoms or treatments should be sent through the OnPatient patient portal. Messages sent through the portal are secure, and become a part of your medical record. Please notify the office if you have any difficulties with accessing the portal.
I check my email, online messaging center, and voicemail daily Tuesday-Friday. I will do my best to respond within two business days, but urgent messages should be directed to the office during normal business hours. If you are experiencing an emergency that cannot wait until the next business day, please call 911 or go to the nearest ER.
Phone, portal, and email communications with you or other people / providers involved in your care will incur a $35 charge per 10 minute increment. That charge is often not covered by insurance. Information sent to me via portal that does not require a response outside of a scheduled appointment will not incur a charge.
Please remember that while I take precautions to keep my email private, there are security risks inherent to email communication. Please limit email for general questions or about scheduling, etc. Questions about your symptoms or treatments should be sent through the OnPatient patient portal. Messages sent through the portal are secure, and become a part of your medical record. Please notify the office if you have any difficulties with accessing the portal.
Completion of Forms & Letters
When possible, forms and other requested documentation will be completed in the appointment. In the event that this must be done outside of appointment time, due to scheduling or extensive documentation requirements a fee will be charged. That fee, typically $25 - $50, is not generally reimbursed by insurance companies. Higher fees may be charged for lengthy forms or letters.
Release of Records
By asking me to bill your insurance provider, you are giving consent for me to release your records to your health insurance company. They usually only want information about your appointment, such as date of appointment, diagnosis and billing code, but they have the right to request full records.
Federal privacy laws allow me to communicate essential information with other members of your healthcare team. I do this only when it is important to your health and safety, and usually talk directly to other providers in a telephone consult, or by faxed memos or treatment summaries. We can discuss any concerns about this at your appointment, but in the vast majority of situations, open lines of communication between healthcare providers improve patient outcomes.
Because of the highly sensitive information included in psychiatric chart notes, I release written chart notes in certain circumstances, and following a specific procedure. With your written and signed permission, I will provide copies of my notes to other providers, free of charge, as a professional courtesy. If your records are extensive, a summary of your care may be more useful to your other providers.
Records released to lawyers, life insurance companies, or other non healthcare organizations will incur a fee as allowed under Washington law (WAC 246-08-400.) Records will only be released directly to you after we have reviewed them together in my office. In certain situations, I am legally permitted to refuse to release some or all mental health records directly to you.
Federal privacy laws allow me to communicate essential information with other members of your healthcare team. I do this only when it is important to your health and safety, and usually talk directly to other providers in a telephone consult, or by faxed memos or treatment summaries. We can discuss any concerns about this at your appointment, but in the vast majority of situations, open lines of communication between healthcare providers improve patient outcomes.
Because of the highly sensitive information included in psychiatric chart notes, I release written chart notes in certain circumstances, and following a specific procedure. With your written and signed permission, I will provide copies of my notes to other providers, free of charge, as a professional courtesy. If your records are extensive, a summary of your care may be more useful to your other providers.
Records released to lawyers, life insurance companies, or other non healthcare organizations will incur a fee as allowed under Washington law (WAC 246-08-400.) Records will only be released directly to you after we have reviewed them together in my office. In certain situations, I am legally permitted to refuse to release some or all mental health records directly to you.
Legal Services
Please note that I do not do psychiatric evaluations to determine competency, disability status, or evaluations that are court mandated, or for use court in cases, including child custody cases.
In the event that I am court ordered to appear in court or communicate with members of your legal team, I will bill an hourly rate as well as an additional fee if this activity interrupts my ability to care for other patients. Please contact me for more information.
In the event that I am court ordered to appear in court or communicate with members of your legal team, I will bill an hourly rate as well as an additional fee if this activity interrupts my ability to care for other patients. Please contact me for more information.
Insurance
My office staff will directly submit claims for patients who have Blue Cross/Blue Shield, Premera, Regence, HMA, Lifewise, Kaiser PPO, Aetna, and First Choice Insurance.
Please note that a few local employers (ex: Swedish / Providence Hospital) as well as some out of state Blue Cross/Blue Shield plans contract with third parties for mental health benefits, that I am not in network with. This information may not be on your card.
All patients must call their insurance company to verify that I am contracted to provide mental health services for you. When you call your insurance company, you will need to provide them with my full name (Katherine, not Kit). Some companies may ask for my NPI #, which is 1891927000.
If you are covered under two insurance policies, it is your responsibility to confirm which policy is primary, and which is secondary, and complete a “Coordination of Benefits” process with both companies. Insurance companies do not permit medical provider offices to do this process for you. Many patients think that being double covered means that they can choose which insurance policy they use, but this is not the case. Errors on this can be an accounting nightmare for all involved, and will often result in out of pocket costs for you.
If you need help understanding your insurance benefits or details about the good faith estimate please see here.
Please note that a few local employers (ex: Swedish / Providence Hospital) as well as some out of state Blue Cross/Blue Shield plans contract with third parties for mental health benefits, that I am not in network with. This information may not be on your card.
All patients must call their insurance company to verify that I am contracted to provide mental health services for you. When you call your insurance company, you will need to provide them with my full name (Katherine, not Kit). Some companies may ask for my NPI #, which is 1891927000.
If you are covered under two insurance policies, it is your responsibility to confirm which policy is primary, and which is secondary, and complete a “Coordination of Benefits” process with both companies. Insurance companies do not permit medical provider offices to do this process for you. Many patients think that being double covered means that they can choose which insurance policy they use, but this is not the case. Errors on this can be an accounting nightmare for all involved, and will often result in out of pocket costs for you.
If you need help understanding your insurance benefits or details about the good faith estimate please see here.
Payment
Payment is due at time of service, or as outlined in an agreed upon payment plan. I accept major credit cards, including those linked to HSA accounts, and exact change US currency. I do not accept checks for intake evaluations, but do accept them for follow up appointments. Please read my financial agreement carefully to avoid frustrating misunderstandings, late payment fees, referral to collections, or discharge from care.
Please contact me about any concerns you may have about any policy or fee.
Updated 2023
| Notice of Privacy Practices.pdf |