Esther Pfeiffer, LMHC | Individual | 50 minutes | $180

Cindy Holt, LICSW | Individual | 50 minutes | $180

Schedule Appointment Now ⧁

Payment

Full payment is required at the beginning of each session so that we can fully utilize the allocated session time to focus on your therapy.

Methods of payment accepted:

cash
check
credit cards
flex spending accounts (FSA)
health savings accounts (HSA)
payment online

Cancellations

24-hour advanced notice is required for cancellations. The scheduling of an appointment reserves time specifically for you. If a scheduled appointment is canceled with less than 24 hours notice prior to the appointment time a full session fee will be charged.

Insurance

We are currently out-of-network providers with most insurance plans but our desire is to assist you in every way possible. Essentially, that means two things. First, the full fee for each session is due at the time of service. Second, we are happy to provide you with a statement that you can submit to your insurance company for reimbursement.

If you chose to collect from your insurance, it’s important that you find out your out-of-network benefits. We suggest you contact them before setting up your first appointment. We’ve had clients receive 90% coverage and others who received 0% coverage. We don’t ever want you to get into a situation where you don’t know what to expect.

Before you make that decision, we want you to know that your privacy is important to us—that is a big part of the reason why we do not bill insurance. In order for your insurance to cover your counseling services, you will have to be given a mental disorder diagnosis; one that will be listed on your medical records permanently.

Many of our clients do not have a mental health disorder. They come to counseling for a variety of reasons like addressing relationship issues, dealing with the death of a loved one, or navigating parenting challenges.

In situations such as these, a diagnosis indicating a mental health issue might not be worth the money gained by your insurance. In some cases, a mental disorder diagnosis on your record could create problems for you later—like if you were applying for a job that requires a security clearance, seeking to adopt a child, or purchasing life insurance.

Your reasons for coming to therapy along with what is covered during your sessions is your personal business. We want to protect your confidentiality and help you avoid any potential problems that can come with having a diagnosis on your record.

That being said, you know best what needs to happen in your particular financial situation and we are here to help in every way we can.

We admire your courage for taking the steps to seek professional help and we know you will make the decision that is right for you.

Your progress and success are important to us and we will strive to help you reach your goals in as few sessions as possible.

Our experience and training have prepared us to give you the best value possible for the services you receive.

Schedule Appointment Now ⧁

We look forward to meeting you!

Your Rights and Protections Against Surprise Medical Bills

(OMB Control Number: 0938-1401)

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities
Your health plan generally must:

Cover emergency services without requiring you to get approval for services in advance (prior authorization).
Cover emergency services by out-of-network providers.
Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact your therapist at Integrity Counseling at (360) 356-8756.

You can also contact WA Department of Health | Health Systems Quality Assurance (HSQA) | Customer Service Center | P.O. Box 47865, Olympia, WA 98504-7865 | Ph. 360-236-4700

Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.

All of our counselors are licensed in Washington State. Our counseling office is physically located in Vancouver, Washington. Our online therapy services are available to all residents in Washington State.