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Cost of Sessions:
Intake and therapy sessions are conducted for forty-five minutes unless otherwise arranged in advance. The initial intake fee is $200.00. A fee of $145.00 per forty-five minute session is charged for most other services including Individual, Couple, and Family Therapy. However, if you are covered by a “preferred provider” or managed care insurance plan with which Dr. Nix is contracted, the specific fees for services are determined by contract, and may vary from the usual and customary fees listed above. If Dr. Nix is a contracted provider for your insurance plan, payment is expected at the time of service for all portions of the contracted fee that are determined by insurance to be the responsibility of the client, including co-payments, coinsurance amounts, and deductibles. If your insurance plan is not one with which Dr. Nix is contracted, payment of the full fee is expected at the time of service. However, upon request, Dr. Nix can still routinely bill your insurance as a courtesy, and any fees that your insurance pays will normally be sent directly to the insurance subscriber. Insurance billing is normally submitted electronically on the date of service, so direct billing of insurance by Dr. Nix is generally the most efficient way to insure timely reimbursement to clients who do not have insurances with which she is contracted. Client payments may be made in cash, by personal check, or by MasterCard/Visa.
Insurance:
Dr. Nix’s services are usually covered by virtually any insurance plan that has “out of network” benefits, and she is a contracted Provider with a number of major insurance carriers including Regence, Premera, Providence, Group Health*, Medicare*, and Uniform. Dr. Nix is also a provider with First Choice Health Network, but payers using this provider network vary quite dramatically in what is covered and whether they use behavioral health providers within the First Choice Network. Prospective clients need to contact their insurance carrier to verify mental health benefits, and whether Dr. Nix is a covered provider. If your insurance plan requires preauthorization, it is your reponsibility to arrange this prior to your first appointment.
If you are covered by Sound Health & Wellness (formerly Retail Clerks), please note that they have a strict limit to what they will pay, and that they have a history of inconsistencies in what they will cover. Although the plan states that they will pay 85% of the allowable charges, they have a strict maximum of $50 per visit. They also reserve the right to arbitrarily determine what diagnoses they will cover, and historically, they have at times refused payment for issues that are routinely covered by other insurances. As a result, I cannot guarantee that they will cover my services.
For more detailed information about insurance coverage and the questions that clients need to ask when making inquiries about insurance coverage, please see “Tips for Determining Mental Health Benefits” in the “Downloadable Forms” section of this website.
Please note that Dr. Nix does not accept Labor and Industries, Crime Victim’s Compensation, or Tricare. Dr. Nix is not a contracted provider with Aetna, although many of this company’s plans include “out of network” benefits that do cover Dr. Nix’s services. However, the Aetna Public Employees plan currently offered to Washington State employees restricts coverage to network providers, and as such it does not cover services provided by Dr. Nix.
Dr. Nix does not routinely bill any secondary insurance plans with which she is not contracted. There are a few exceptions to this policy, however, and Dr. Nix can routinely provide clients with the necessary documentation to submit claims directly to their insurance carrier. Please note that Medicare does automatically forward secondary billing to some supplemental plans. If you have a Medicare supplemental policy, please contact your insurance carrier directly to determine whether your plan is one to which Medicare automatically forwards secondary claims.
*Currently, Dr. Nix is not taking any new clients who are covered by Medicare or Group Health (GHC). Administrative problems in obtaining prompt payment, as well as low reimbursement levels are the primary considerations in limiting Medicare clients at this time. Because Group Health is a "managed care" organization, and requires considerably more administrative documentation than traditional insurers, Dr. Nix has had to limit the number of GHC clients that she accepts at any given time. Currently, she is providing services to as many GHC clients as she can manage, and still meet mandatory GHC administrative requirements.
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