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Insurance

I am happy to accept clients with insurance coverage. Almost always, insurance plans organize coverage by 'preferred provider groups' or 'provider networks' or 'panels'. This sometimes leads to the misunderstanding that a particular provider "takes" or does not take that insurance. However, most insurance will pay 'out-of-network' providers at the same or slightly lower percentage. I am happy to bill insurance 'in-network' when I am in that group, or 'out-of-network' otherwise.

I am currently a preferred provider ('in-network) with Regence, First Choice Health Network, and Group Health PPO. I would gladly be 'in-network' for many other insurances but in King County, Washington, the 'panels' are limited artificially by the insurers, and the wait for an opening is many many years.

The Affordable Care Act (ACA or 'Obamacare') and Federal mental health parity statutes have brought about many changes to insurance coverage of therapy and counseling services, to the benefits of consumers. For instance, the number of visits cannot be arbitrarily limited. On the other hand, disincentives to go out-of-network are increasing, and several carriers are still treating mental health services differently through different avenues. Overall the coverage situation is still fluid and at times complicated. While I encourage all potential clients to work with me before the first visit in checking eligibility, claims may still be denied on the grounds of medical necessity.

Providing insurance information implies that you are authorizing me to check with your insurance carrier. Checking the availability of benefits does not involve me passing on any 'clinical' or personal information.

Plans may or may not exclude couples therapy and family therapy (CPT code 90847), but most do accept it as a procedure, while requiring a diagnosis other than 'relationship issues'. If you have specific questions about this, please contact me to discuss it.