Please go to this link for more information: What is EFT?

I like to speak with new clients on the phone before scheduling the first session. For couples, this means that I want to speak with both of your (a 3-way call is fine if you can’t be in the same location) so we all stay on the same page. This allows me to make sure I'm the best fit for your needs, and vice versa. During the 20 minute conversation you'll tell me a bit about what you are wanting to work on and where you would like to end up, we will start to develop a plan, and discuss the structure of therapy. Then of course, schedule the appointment!

In the first appointment we will review the paperwork that you completed in the client portal and I will begin the process of getting to know you and what you're looking to work on more in depth.

For couples, I meet with you both in the first appointment and then I will meet with you each separately for individual appointments.

Sessions are 50 minutes in length. Once we start meeting, if you believe that longer sessions would be helpful, we can arrange to schedule two back to back 50-min sessions.

When I start working with a new couple, I see you together for one session and then each partner individually for one session.

Most therapy clients come weekly at least in the first couple of months. Committing to and prioritizing this time is ideal and may equate to a better outcome. A weekly cadence creates momentum and provides accountability to progress more quickly. As we progress we will have conversations to mutually determine whether to continue weekly or move to biweekly, then finally moving towards monthly for maintenance as your preparing to end therapy.

Longer sessions are an option for busier clients schedules or travel obligations that don’t allow for weekly sessions.

I have a “Reschedule Only” policy to preserve continuity of care.

What does this mean? Once a session is scheduled, you will be financially responsible for them, regardless of whether or not they are attended. If you are unable to attend a scheduled appointment, you will have the option to reschedule it, provided the rescheduled appointment occurs the week before, during, or after the original appointment date as long as you let me know before the time of the original appointment.

Have a kiddo wake up sick that morning? No problem, we can reschedule!

You’re a doctor and just got called into surgery an hour before our appointment? No problem, we can reschedule!

If you choose not to find an alternative or a workable alternative is not available, the original appointment will counted as a missed session and a fee equal to your session rate will automatically apply. I do my best to have enough scheduling flexibility so not being able to find a time to reschedule is a rarity.

Waived Session Fees: I appreciate that life can be unpredictable. That's why I offer the flexibility of waiving session fees for one missed appointment per calendar year. After you have utilized your waived session fee, any subsequent missed appointments not rescheduled within the three-week window will result in a cancellation fee equal to your session rate.

For the full policy please refer to the “Consent and Practice Policies” document in the “Forms and Notices” section.

Monday through Thursday 6am to 2pm PST.

Yes! All appointments are conducted remotely through video sessions.

Online therapy is very similar to in-person therapy, while being even more convenient and accessible. You may engage in therapy from any location in the state of Washington or participating PsyPact states (see below), avoiding the need to cancel or reschedule appointments due to transportation concerns, as well as the need to drive to and from your appointments. Rather than meeting in an office, we will meet on a secure, HIPAA compliant video conferencing platform. Detailed instructions regarding how to access the platform will be provided during your initial consultation.

See the “Why Remote Couples Therapy?” page for further information.

I can also see clients in the following PsyPact states through telehealth: Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Washington DC, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, & Wyoming

Not at this time. All therapy appointments are conducted through HIPAA approved and encrypted/secure video software.

Payment is expected at the time of session and can be made by cash, check, or credit card (including FSA or HSA cards). A credit card is kept on file and automatically charged for appointments unless a different payment method is requested.

Consultation Call: No Charge

Individual Sessions:

$350 (50 minute appointments)

Couples Sessions:

The initial session, also called a Family and Attachment History Session, is a one-time session totaling of 2.5 hours (50 min as a couple and one 50 min individual for each partner). There are two options:

(3) separate standard 50 min appointments, each session billed at $350 or
A single 2.5hr block billed at $900.

Ongoing sessions:

The standard 50 minute appointment is $350.

However, after trying different session times with couples, I find that longer sessions end up accomplishing more in less time, ultimately saving you time and money. Extended sessions are therefore priced at a slightly reduced rate to encourage this investment.

80 min appointments: $480
110 min appointment: $660

If cost is a concern, an 80 min appointment every other week works quite well.

I am not paneled with any insurance company. Most of my clients choose to attend therapy without using their insurance benefits. If they choose to use insurance, I may be an out-of-network provider. If you choose to use your out-of-network benefits, please contact your insurance company first so you know what your out of network benefits would cover.

Couples counseling is occasionally covered by insurance companies. It requires a diagnostic code for one partner of the couple. This means that I need to know who will be the one billing their insurance at the onset of our work and will need to evaluate you for a mental health diagnosis. Please note that I cannot guarantee a diagnosis. If you do not meet the criteria for a mental health diagnosis I cannot ethically diagnose one and will need to use the code Z63.0 (Problems with Spouse or Partner), which is not always reimbursed as a primary diagnosis.

Individual counseling is frequently reimbursed if you have out-of-network mental health benefits.

Here is a link to specific questions I recommend asking your insurance company: [click here]. The specific reimbursement that you can expect depends on your specific plan.

You would pay for sessions out of pocket at the time of your appointment and then I would provide you with a “superbill” once per month, which provides the information needed by your insurance company. You would then submit it to your insurance provider and receive reimbursement directly.

A Good Faith Estimate is a new piece of ethical paperwork required for all healthcare providers. Ultimately, it outlines the fee structure so you are not surprised by any bills once we begin working together. As stated on my fees page, all sessions are billed at a rate $350.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other provider you choose for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or contact Dr. Rachel Orleck at rachel@meaningfuljourneycounseling.com.