Getting Started

Initial Session

The initial session is typically 90 minutes for Individual, Couples and or Family Therapy. During this time, we will:

• Talk about your main concerns and goals in therapy
• Determine your level of comfort in working with me
• Discuss the process of therapy
• Review HIPAA Forms and confidentiality, policies and procedures, consent for treatment, Good Faith Estimate (GFE)

Please fill out the following forms prior to our initial session:

• HIPAA Notice Form
• HIPAA Signature Form
• Clinical Services-Policies and Procedures
• Biopsychosocial History
• Client Information Form
• Release of Information
• Consent for Treatment Form
• Consent for Telehealth Form
• Credit Card Authorization Form

Rates for Individual, Couples, and Family Therapy

Please call Dr. Nicolle for rates.

Insurance

Dr. Nicolle does not participate in any insurance plans and as such cannot accept your insurance for payment. She is able to share an itemized invoice with details needed (including necessary diagnostic codes and codes for services rendered) to seek reimbursement from your insurance plan. If you have any questions, she is happy to speak with you further.

Good Faith Estimate (GFE) Disclaimer

Under Section 2799B-6 of the Public Health Service Act (PHSA), health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request, or at the time of scheduling health care items and services to receive a “Good Faith Estimate” of expected charges.

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 1 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 call 1-800-985-3059.

Payment

Cash, check, and all major credit cards accepted.

Cancellation Policy

Sessions must be cancelled 24 hours in advance or are subject to the full fee for the time scheduled.