Most of our visits take place virtually using telebehavioral health services. This has become one of our most celebrated features since psychiatry clinics everywhere learned we’re uniquely tailored to offer remote care in 2020. We have worked hard to offer all the benefits of an in-person psychiatry visit from the comfort of your home.
Certain medications may require an in person visit once a year. We will plan for this with individual patients.
Patients enjoy the benefits of eliminating travel, check-in, physical payment malfunctions, and filling out paper forms that they already filled out online, freeing up hours of valuable time. They are also able to invite trusted loved ones to join in on a visit, even if they live across the state or in another country. However, the biggest benefit is that we can leverage technology to help us teach patients about their care and monitor our progress using digital visual aids and custom monitoring forms.
Because our clinic may only see patients in person once a year, most of our visits utilize secure telehealth video conferencing with ‘Zoom Meetings’. Zoom recommends access to the following:
From time to time, we will need to obtain your vital signs remotely. You should have access to:
We offer neurodivergent centered therapy in addition to diagnostics and medication management. These follow up visits are twice as long as our typical follow up visits to allow more time for effective therapy.
See the “Our Services” Page for more details.
For Depression, Anxiety, PTSD, Insomnia…
Patients being evaluated and treated for depression or anxiety-related disorders typically schedule their follow-up visits about 6 weeks apart until they feel stable. However, we adjust the frequency of visits depending on a patient’s individual needs, the severity of their symptoms, and progress toward their goals.
Most patients do well, and after 3-6 follow-up visits, they enter the maintenance phase of treatment, during which we refill medications and support additional skill-building and self-care. At this point, patients can choose to follow up 4 times a year (once every 3 months).
For ADHD…
Patients being evaluated and treated for ADHD should expect to schedule their second visit for ‘assessment results’ about 7 days after their initial ‘new patient assessment.’
If ADHD is confirmed, patients can expect 3-4 follow-up visits for medication trials scheduled about 1 or 2 months apart.
Afterward, additional follow-up visits for optimizing medications for other co-occurring conditions (e.g., sleep disorders, anxiety) are typically scheduled every 1-2 months. Visit frequency is dependent on our patient's individual needs and goals. We find that treatment is effective in more than 90% of individuals.
See the “Our Services” Page for more details.
Step One - Fill out our Intake Packet
Filling out forms is often the hardest part of joining a new practice. But, at Fox Fern ADHD Clinic, we’re all about removing barriers to care.
Our intake packet includes agreeing to our consent forms and our clinic policies so we can legally treat you. Our policies are meant to clarify how our clinic operates differently from other clinics and highlights many of the unique features of our clinic.
It also has lots of questions that gather your patient history and screen for the most common hidden or coexisting conditions. This takes about an hour to complete and helps facilitate our unhurried atmosphere. Every question you answer helps your provider focus more on answering your questions and listening to your story during your first visit.
Step Two - Schedule your appointments
We’d rather you schedule more appointments than you need and then cancel a few appointments after your first visit if we discover they’re unneeded. This helps patients avoid having to wait for openings when the schedule fills up.
If considering Depression, Anxiety, PTSD, Insomnia…
We typically recommend new patients who may have depression and/or anxiety-related disorders schedule two 1-hour visit slots about 4-6 weeks apart.
Followed by 2 additional 30-minute follow-up slots, each about 4-6 weeks apart, after they complete their intake packet.
If considering ADHD or ASD evaluation…
We typically recommend new patients considering evaluation or treatment of ADHD or ASD schedule two 1-hour visit slots, about 1 week apart.
Followed by 2-3 additional 30-minute follow-up slots, each about 4 weeks apart, after they complete their intake packet.
Some of these visits may be canceled during your first visit, but it’s easier to make extra appointments and cancel them than try to fit several appointments into a busy schedule.
Step 3 - Enjoy your Visit!
During our initial new patient assessment visit, you are a prospective patient. At the end of the visit, you and your provider will decide together whether you are a good fit to join our practice.
We’ve purposefully designed our intake process to complete the information-gathering and screening questions that normally consume most of the first visit. Our providers also spend about 30 minutes reviewing your intake and analyzing your screening assessments before your first visit. This means you’ll have more time to tell your story and get any important questions answered.
Yes. We can write specific letters or fill out forms for your work or other agencies upon request.
Generally, we support short-term medical leave (e.g., FMLA, MHDL). We believe, as a culture, we tend to overemphasize working, but continuing to work through a mental health crisis can often be much more professionally detrimental than taking some time off.
We offer a range of supportive ancillary services; however, these services require a separate visit and are billed at the same rate as any other ‘follow-up’ visit. This ensures we have enough time to perform any evaluation the service may require and to confirm your consent for the disclosure of information we provide.
We offer a range of supportive ancillary services that require separate visits and are billed at the same rate as your medication management ‘follow-up’ visits unless you are on our ‘Plus’ treatment path in which case ancillary services are included. These services are optional and only useful in specific circumstances. For example, if you are taking a standardized test like the SAT or GRE, you may decide you would like a letter for specific accommodation. These services are fulfilled on an as-needed basis and are available upon request to current established patients. We cannot guarantee the result or outcome of these official medical endorsements, but we will do our best to advocate for your needs.
We offer a range of supportive ancillary services that require separate visits and are billed at the same rate as your medication management ‘follow-up’ visits. If you schedule a follow-up visit for one of our ancillary services, please prepare the following information. FMLA forms, Leave of Absence Request forms, or Short-term Mental Health Disability Leave (MHDL) forms.
It’s common for Neurodivergent and ADHD patients to feel judged or shamed for seeking out an assessment for ADHD. We’re often dismissed, talked down to, or outright ignored when we bring up our legitimate concerns. We are a Neurodivergent clinic filled with Neurodivergent practitioners and staff, we’ve been through this too. One of our primary goals is helping our patients feel heard, validated, and accepted. Our diagnostic assessments are thorough and take heavily into account your lived experience acknowledging how our patients are often very capable, successful people because they have learned to mask and cope with their overwhelming ADHD symptoms.
We do not invalidate your past ADHD diagnosis or symptoms with our objective testing.
We do not discontinue our new patient’s current medication plans that are working well in an arbitrary or egotistical effort to start over from scratch. Rarely, we may find a patient is on a medication that may be dangerous to them. In these instances, we have always been able to clearly educate our patients and work together to make a healthcare decision that is best for them while respecting our duty to do no harm.
Some patients have been refused 1st line medications for their ADHD in the past due to them being on a high blood pressure medication or concurrent substance use disorder. We treat all our patients circumstances individually, this means you will never hear from us that our hands our tied because of a protocol. Neglecting the treatment of one disorder because of another co-occuring disorder is not good medicine. We aim to mitigate risk from a holistic and patient centered perspective."
The patient-centered approach considers each individual patient’s needs, priorities, beliefs, culture, occupation, education, and learning styles when working together to jointly develop a plan of care.
Shared decision making aims to incorporate our patient’s needs and priorities into our treatment plans by combining medical evidence, clinical expertise, and our patient’s unique values and preferences.
Fox Fern ADHD Clinic is founded on the principles of Patient Centered Care and Shared Decision making.
Psychiatric treatments are individualized and often require extensive investigation to accurately determine the cause of a medication side effect or the most appropriate adjustment to an unoptimized plan of care. Often communication between patient and provider is very difficult because providers are in high demand and are booked with patient appointments during normal business hours.
As such, we do not currently offer consultations by email or over the phone and recommend setting a follow-up appointment in one of our scheduled slots reserved for “urgent follow-up” instead."
Yes, we do screen for Autism Spectrum Disorder and can diagnose high-functioning autism in adults.
Did you know over a third of patients diagnosed with ADHD also experience clinically significant ASD, and over half of ASD patients also meet the criteria for an ADHD diagnosis? There are likely more people in the world who have both ADHD and ASD together than people who have only one of those disorders alone.
We've built some specialized screening tools that focus on neurodivergent sensory sensitivity, ASD and ADHD overlap, as well as rejection sensitivity and hyper empathy syndrome.
The differentiation between ADHD and ASD has to be done carefully because there is significant overlap in symptoms, and ASD is a difficult condition to diagnose with any degree of certainty.
We've pulled together about 780 questions from 14 different validated tests for ASD to help clarify and differentiate these diagnoses. It takes about 5-7 hours to complete all these potential tests, so we select only the appropriate tools and they are completed at home at the patient's convenience.
Yes, not even all psychiatry providers treat ADHD, so it was important to us that our clinic help to improve ADHD awareness and let prospective patients know that we have a unique diagnostic and treatment process for ADHD. We focus on ADHD, Depression, Anxiety disorders like Generalized Anxiety Disorder or PTSD, and Sleep disorders because we have developed uniquely capable treatment protocols and diagnostic tests for these disorders.
We do treat many other behavioral health conditions. As an example, these are the disorders we do initial screening for in our digital intake assessment:
Anxiety Disorders
Neurodivergence
Sleep Disorders
Mood Disorders
Other Common Coexisting Behavioral Health Conditions
Yes, some complex mental disorders are not compatible with outpatient telehealth psychiatry and would be best treated at a clinic that has wraparound care, inpatient services, or direct access to long-term injectable medications. Fox Fern ADHD Clinic will refer you to general psychiatric care elsewhere when it is in your best interest.
Diagnoses that would likely best be treated elsewhere include:
Yes, some complex mental disorders are not compatible with outpatient telehealth psychiatry and would be best treated at a clinic that has wraparound care, inpatient services, or direct access to long-term injectable medications. Fox Fern ADHD Clinic will refer you to general psychiatric care elsewhere when it is in your best interest.
We’re one of the only clinics in Washington certified to administer and interpret the QbCheck, the only test in the world cleared by the FDA to help diagnose and treat ADHD. QbCheck is a “Computerized Continuous Performance Test” (CPT) widely considered the gold standard for diagnosing ADHD.
So kind of you to ask!
Patients are assessed with an initial battery of valid and reliable screening tools for obscuring and comorbid mental disorders, including:
Generalized Anxiety Disorder 7-item (GAD-7) - 7 questions
Patient Health Questionnaire-9 (PHQ-9) - 9 questions
Adult ADHD Self-Report Screening Scale for DSM-5 (ASRS-5) - 6 questions
Suicide Behaviors Questionnaire-Revised (SBQ-R) - 4 questions
Adverse childhood experiences questionnaire (ACEs) - 9 questions
Sheehan Disability Scale (SDS) - 5 questions
Arizona Sexual Experiences Scale (ASEX) - 5 questions
Adjusted or selected questions from: DSM-5 crosscutting measures - 18+ questions
Eating Attitudes Test-26 (EAT-26) - 3 questions
Autism Spectrum Quotient (AQ) - 4 questions
Brief Pittsburgh Sleep Quality Index (PSQI) - 5 questions
Total of 74 questions
Based on the results of our initial assessment, follow-up investigation of co-occurring mental disorders may include some of the following testing:
Alcohol, Smoking, Substance Involvement Screening Test (ASSIST v3.0) - 10+ questions
Rejection Sensitivity Questionnaire, Adult version (A-RSQ) - 18 questions
Highly Sensitive Person Scale (HSPS) - 27 questions
Wender Utah Rating Scale (WURS) - 61 questions
Trauma Screening Questionnaire (TSQ) - 10 questions
Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) - 5 questions
Panic Disorder Self-Report (PDSR) - 24 questions
Mini-Social Phobia Inventory (Mini-SPIN) - 3 questions
Rapid Mood Screener (RMS) - 6 questions
General Behavior Inventory-Bipolar (GBI-Bipolar) - 73 questions
Bipolar Spectrum Diagnostic Scale (BSDS) - 20 questions
Prodromal Questionnaire–Brief (PQ-B) - 21 questions
Obsessive Compulsive Inventory-Revised (OCI-R) - 18 questions
Yale-Brown Obsessive Compulsive Scale II (Y-BOCS-II) - 77 questions
MacLean Screening Instrument (MSI) - 10 questions
Brief Pittsburgh Sleep Quality Index (PSQI) - 6 questions
Epworth sleepiness scale (ESS) - 8 questions
IRLSSG Rating Scale (IRLS) - 10 questions
Premenstrual Symptoms Screening Tool (PSST) - 19 questions
Fibromyalgia Rapid Screening Tool (FiRST) - 6 questions
Autism Quotient (AQ) - 50 questions
Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS–R) - 80 questions
Camouflaging Autistic Traits Questionnaire (CAT-Q) - 25 questions
Adult Repetitive Behaviours Questionnaire-2 (RBQ-2A) - 20 questions
VIA inventory of strengths - 96 questions
Vulnerable Attachment Style Questionnaire - 22 questions
No, if you have Medicare Part B and wish to join our practice, you must enter into a private contract with us. This is required by Medicare for all providers that have opted out of Medicare. You must request a Medicare contact form by email and complete it before our appointment together. The form states you will not submit reimbursement claims to Medicare for our work together.
In psychiatry, patient history is key in establishing the right diagnosis, and in general, we will accept your diagnoses from your previous providers if you feel comfortable with them. We do often re-examine previous diagnoses at our patient’s request.
It is our standard to screen all new patients for undiagnosed or coexisting behavioral health conditions. Many of our patients discover they have never been screened for several of the conditions we test for. This is one of the most widely praised features of our intake process.
Because we are committed to a high standard of psychiatric care, if your diagnoses came from a commercial mental health start-up (e.g., Cerebral or Done, which are currently being federally investigated for dangerous and negligent clinical practices), then we will re-evaluate your diagnoses with you.
Within the boundaries of the law, we will not answer any inquiries. We will not acknowledge any relationship with any patient—past, current, or prospective—unless otherwise directed by our patients.
We keep our patient’s health care information and medical notes in a HIPAA-compliant electronic medical record system. A detailed explanation of our privacy policies can be found in our privacy policy notice and can be downloaded from our ‘knowledge base’ page.
If you are over 15 minutes late to your appointment, then your payment method on file with us will be charged a missed appointment fee as follows:
Patients can cancel their appointments through the patient portal without penalty as early as the day before their appointment and reschedule a new appointment as early as an hour beforehand. We have tried to make our online same-day scheduling as easy as possible in order to help our patients feel more autonomy and control over their visits.
We require that a cancelation be done at least 24 hours in advance. If an appointment is canceled only 8 hours or less before your scheduled visit, we will consider your cancelation “late,” and you will automatically be charged a $25 “late cancelation” fee. Insurance does not cover this fee.
This modest late fee helps motivate patients to cancel early enough that patients who want a same-day appointment have an opportunity to schedule them. However, we ask that our patients cancel and reschedule their appointments well in advance when possible.
We purposefully create flexible prescription plans and leave some visits open only for urgent follow-up appointments each week. If you follow our recommendations on when to schedule your follow-up visits, then you will not be in a situation where you run out of your medication even if you miss an appointment or your appointment must be rescheduled.
By law, we must see patients receiving a prescription for a controlled substance (e.g., stimulants for ADHD) no less frequently than every 90 days. This means prescriptions for controlled substances should probably be scheduled about 83 days from the date of your last appointment. This way, if you miss an appointment, you can reschedule in an urgent slot and not worry about running out of your prescription.
Stable patients who are not receiving a controlled substance prescription must be seen for follow-up no less frequently than every 120 days (every 4 months). However, they will typically receive about 6 months of refills for their prescription to ensure they will not run out if they miss a visit or need to reschedule.
If you’re moving within Washington state, then simply let us know during one of your regularly scheduled appointments, and we’ll make a plan a switch to your new Washington pharmacy. If you’re already set up with a home delivery pharmacy, you can change your address in their pharmacy App or web portal.
If you’re temporarily moving out of state or doing some extended travel that will be longer than 90 days if you have a controlled medication or longer than 120 days if you do not take controlled medications, then you should set an appointment for about 1-2 weeks before your expected departure date where we will send the maximum refill we can send to your pharmacy. You will need to find a temporary provider at your university or another clinic local to your destination.
If you’re moving out of state permanently, you should still set an appointment for at least 8 weeks before your expected departure date. Let us know during one of your appointments, and we’ll do our best to prescribe for you the maximum allowed amount of medication supply to help give you time to find a new provider. We do not send prescriptions to out-of-state pharmacies. Once you have an appointment with your new provider in your new state, you can fill out one of their “Request of information” release forms for us to FAX or secure message them your medical records.
If you have an urgent update we reserve several crisis appointments each week so that you can be seen quickly.
Please call 911 if there is a medical emergency or call 988 if you are in crisis. If you experience sudden, concerning, and intolerable symptoms with a new medication, you should stop taking the new medication and schedule a more rapid follow-up appointment if needed.
The following symptoms are an emergency and should be evaluated by immediately visiting an emergency room or calling 911 for EMS. Do not delay an evaluation by trying to contact your provider:
If you can answer yes to the statements below, you should immediately speak with a crisis responder or visit your local ER to speak with a social worker there.
Please, call 988 and speak with a trained crisis responder.
Yes, we use e-prescribing to send both controlled and non-controlled prescriptions to the pharmacy of your choice. We have also partnered with Alto, a local home delivery pharmacy so that you can receive free same-day doorstep delivery.
Yes, we may prescribe stimulants as part of your regular treatment plan for ADHD as these medications are the established “1st-line” medication for ADHD. Stimulants for the treatment of ADHD remain more effective than any other medication for any other mental health condition.
We will consider prescribing benzodiazepines in limited quantities, generally for indications such as panic attacks or a specific phobia.
We do not prescribe opioid pain medications.
It is our policy to prescribe plenty of medication to last until our next scheduled appointment. For this reason, refill requests between appointments are rarely needed.
By law, we must see patients receiving a prescription for a controlled substance (e.g., stimulants for ADHD) no less frequently than every 90 days. Stable patients who are not receiving a controlled substance prescription must be seen for follow-up no less frequently than every 120 days.
Most of the time, when patients think they are out of refills before their next appointment, if they call their pharmacy and speak to a pharmacist, they will find their prescription is available. We recommend switching to a ‘home delivery pharmacy’ like Alto or Genoa and setting up automatic refill deliveries to your home or office in order to avoid interaction with your pharmacy as much as possible.
Controlled substance prescriptions will always say there are ‘no refills.’ This is because we must prescribe controlled substances as separate “post-dated” prescriptions. Many automated systems do not recognize “post-dated” controlled substance prescriptions as refills. In these instances, you must call and speak directly with a pharmacy attendant who will confirm that your prescription is indeed active and ready for another if it has been at least 30 days since you last picked up the same prescription. Switching to a ‘home delivery pharmacy’ like Alto or Genoa and setting up automatic refill deliveries to your home or office often resolves this common issue.
We favor flexible dosing instead of prescribing patients early refills when requested. We follow the Drug Enforcement Administration (DEA) recommendations on prescribing controlled substances. This includes denying early refills, even for unexpected travel or expected emergent weather conditions. Most often, when patients request an early refill, it is due to inadequate dosing. Patients can reschedule their next appointment to resolve this issue once and for all with a dosing adjustment and forever avoid being in a position where they feel they must ration their medication. Flexible and optimized dosing is more convenient and improves safety for our patients rather than needing to request and fill early refills without an attached visit.
Accidents happen. If your medication is not a controlled substance, you should be able to pay out of pocket for an early replacement if you call your pharmacy. Your insurance will likely not cover your refill if it is early, but you can use a Good Rx coupon, and if it’s generic, then it likely will not be overly expensive. You should have an extra few months of medication refills for non-controlled generic medications.
If a controlled or ‘brand name’ prescription is lost, stolen, or damaged, we require you to make an appointment to discuss a replacement prescription. Unfortunately, there is no way to replace controlled or ‘brand name’ medications without an attached appointment. We may even be forced to make a slight adjustment to a ‘brand name’ prescription for you to get your normal discount. If a pattern of irresponsible handling of a controlled medication becomes apparent, we reserve the right to require a drug contract and/or a random urine drug test.
If you are uninsured or have government-subsidized or Kaiser insurance, then I must have missed that when we were discussing medication options. The only option other than paying out of pocket with a Good Rx coupon is to apply for financial assistance. You would need to make under 400-500% of the national poverty line to qualify for any available program. If you qualify, great; the medication will be free. You can fill out the application by searching “needymeds” + “name of your prescription” in google and clicking the form you qualify for under the programs applications and forms subheading on the needymeds website.
If you’re using a ‘mail-order pharmacy’ like Express scripts or Optum, then we can just switch to a “home delivery pharmacy” like Alto or Genoa, and that will probably solve the problem. You can ask your pharmacist to send a non-controlled prescription to your new pharmacy. But if you need to switch to a controlled prescription, then your pharmacy will not forward it to a new pharmacy. Depending on the supply of your maintenance dosing or if we are doing a stimulant medication trial, you may have to email me with a pharmacy change request (instructions are at the end of this FAQ).
If you have a high-deductible insurance plan, you’ll have to pay the cost of the prescription until your deductible is filled. The good news is the manufacturer coupon will help pay down your deductible faster. For example, if your deductible is $2000 for the year, and you are prescribed Vyvanse, you’ll likely pay about $180 for 30 capsules, but about $270 will be paid down on your deductible. Most patients will fill their deductible within the first 6 months of the year, depending on the coverage of their medical appointments. If you typically fill your deductible each year, then it still makes financial sense to use brand-name medications because the manufacturer coupon is essentially free money. If you do not plan on filling your deductible this year or you’re on a fixed income, then your only option is to qualify for financial assistance (see above) or switch to a generic medication. We recommend all patients with high deductible plans have an HSA or FSA savings card so they can use pre-tax money to pay for their healthcare.
If the problem is that the medication will be too expensive unless a “prior authorization” is made, see the question below.
Prior Authorization is a time-consuming process that involves registering the request, submitting and resubmitting forms, and answering surveys that explain to the insurer why the medication is being prescribed. This includes justifying the amount, quantity, diagnosis, and outcomes of prior trials using other less expensive FDA-approved medications for that diagnosis. A ‘Prior Auth’ can take several business days to process and be approved. There is also a possibility that your insurance company will reject the Prior Auth request altogether, necessitating we write them an individual letter for an appeal or trail another generic medication first, both of which can only be done during a scheduled visit.
We highly recommend you check with your pharmacy to see how much the medication costs out of pocket with a GoodRx Coupon if they tell you that they are waiting to fill your medication until a Prior Auth is approved. Busy pharmacies will often assume you want to wait weeks for Prior Auth approval when it might only save you $10-30. They will often not tell you that you can still receive your medication without a Prior Auth or what it might cost using a GoodRx coupon instead of your insurance unless you directly ask them.
The following generic ADHD medications are fairly inexpensive. They might not be worth potentially waiting weeks for a Prior Auth if we are planning on a short trial:
We immediately register Prior Auth requests with your pharmacy on all prescriptions that require them. If a pharmacy requires additional survey paperwork, it will take a few days to complete. If your pharmacy has not received authorization from your insurance provider after 7-10 days, please email me a ‘Prior Auth Request’ (instructions are at the end of this FAQ). If the Prior Auth is denied, then we will have to write an appeal letter, and this must be resolved at our next scheduled appointment.
If your insurance changes or your pharmacy decides they no longer accept your insurance, then you can ask your pharmacist to send your non-controlled prescriptions to your new pharmacy. We recommend switching to a home delivery pharmacy (Alto or Capsule) as they offer free next-day doorstep delivery and accept all insurance types.
If you need to switch a controlled prescription, then your pharmacy will not forward it to a new pharmacy. Depending on the supply of your maintenance dosing or if we are doing a stimulant medication trial, you may have to email me with a pharmacy change request (instructions are at the end of this FAQ).
If your brick-and-mortar pharmacy is experiencing a manufacturer shortage or a stocking delay and is unable to fill your prescription for weeks. Then it may be necessary to switch to a different brick-and-mortar pharmacy between scheduled visits to avoid delaying your medication trial and your needing to reschedule your next appointment. Depending on the supply of your maintenance dosing or if we are doing a stimulant medication trial, you may have to email me with a pharmacy change request.
To better facilitate flexible refills, we recommend all our patients switch to a home delivery pharmacy (insurance's preferred mail order pharmacy or Capsule) as soon as their prescription plan of care is stable. There are a number of substantial benefits and resolved barriers when switching to a home delivery pharmacy:
Part of trialing new medications includes a risk that the medication we try may have side effects or be less effective. If we suspect this is likely, we often schedule a follow-up appointment for about 2 weeks out or develop a contingency plan for you to adjust your medication before our next scheduled appointment safely.
Psychiatric treatments are individualized and often require extensive investigation to accurately determine the cause of a medication side effect or the most appropriate adjustment to an unoptimized plan of care. Communication between patient and provider is difficult because providers are in high demand and are booked with patient appointments during normal business hours.
To keep the highest standard of safety for our patients, we do not send new prescriptions to trial in-between visits by email or over the phone.
The best way to make an immediate adjustment is to check the schedule for openings and move up your appointment.
Controlled substance prescriptions will always say there are ‘no refills.’ This is because we must prescribe controlled substances as separate “post-dated” prescriptions. Many automated systems do not recognize “post-dated” controlled substance prescriptions as refills. In these instances, you must call and speak directly with a pharmacy attendant who will confirm that your prescription is indeed active and ready for another if it has been at least 30 days since you last picked up the same prescription. Switching to a ‘home delivery pharmacy’ like Capsule or Alto and setting up automatic refill deliveries to your home or office often resolves this common issue.
Most of our patients have out-of-network insurance plans. This means they will pay our rates detailed on the Services page with their payment method on file and then submit the payment to their PPO insurance for an “out-of-network” reimbursement.
To make reimbursement easier, we’ve partnered with ‘Reimbursify.’ An app that facilitates filing digital insurance reimbursement claims in as little as 10 seconds. They do not take a percentage of your reimbursement. Each claim costs $4 to file digitally and saves substantial time and effort.
Regence BlueShield of Washington insurance plans will be processed as in-network until 2/16/2025. After this date, all insurance plans, including Regence plans, will be processed as out-of-network.
Most employer-sponsored PPO insurance plans will reimburse you if you choose to see an out-of-network psychiatry provider. The level of reimbursement often ranges from 30-80% of typical visit rates, but this is different for each plan. Not all psychological services are covered by all insurance plans, and your insurance provider may only cover a small portion of our fees or none at all. The best way to get an estimate of what your financial liability might be is to contact your insurance company directly.
You can call your insurance company using the customer service phone number on the back of your insurance card and ask what your reimbursement may be for an out-of-network provider billing a particular group of CPT codes. The most typical CPT appointment codes we use are listed below. New Patient Assessment Visit: 99205, 90836 & 96127New Patient Results Visit: 99214, 90833 & 96132 (this visit is for ADHD test results)Follow-up Visits: 99214, 90833 & 96127
Your specific codes may differ because they’re billed according to medical complexity guidelines, which means you may be reimbursed more or less than their estimation.Out-of-network patients are billed at our discounted rate, so instead of $330 for the initial appointment, they’re billed $285. Assessment results visits are billed at $330, and standard follow-up appointments are billed at $165.
After you’re billed, you can download the bill invoice anytime you want through our patient portal. We partnered with a company called Reimbursify which will file a claim for reimbursement with your insurance for you. After you set it up, it takes about 10 seconds to file a claim, costing $4 per claim.
You may also want to clarify with your insurance company whether your payment will count towards your deductible and out-of-pocket limit and whether there are separate rules about in- vs. out-of-network providers. Some patients have a high out-of-pocket deductible, even with their ‘in-network’ providers, and they decide to choose our clinic because they will pay for the full cost of a visit either way.
We accept HSA or FSA payment cards for all services, which allows you to pay with pre-tax dollars. Depending on your financial circumstances and total medical costs for any year, psychological services may also be tax-deductible expenses. However, we encourage you to discuss this with a tax advisor.
We offer patient assistance guidance for free brand-name medications if your income level qualifies:
We offer unique ~90% off “manufacturer savings cards” for brand-name drugs to all qualified patients with commercial insurance plans.
Once in the maintenance phase of treatment, patients who are not receiving a controlled medication may elect to be seen every 4 months at an annual self-pay rate of $495 or about $1.35/day.
Once in the maintenance phase of treatment, patients receiving a controlled medication for ADHD must follow DEA regulations by scheduling a follow-up visit a minimum of every three months at an annual self-pay rate of $580.
Some patients prefer the confidentiality of payment outside of insurance billing, even when they have insurance. Patients who pay out of pocket avoid all disclosure of diagnosis and treatment to third-party insurance companies and clearing houses.