New Clients - Pacific Integrative Therapy

Step 1

Visit Our Team page to find the best fit clinician for your need.

If you are not sure about which therapist may be a good fit for you, you may contact us to determine if a therapist at the Pacific Integrative Therapy can help

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Step 2

Fill out our contact form and a member of intake will reach out to you to get the scheduling process started

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Step 3

The Pacific Integrative Therapy is a paperless practice. After scheduling your appointment, our intake coordinator will email you our online intake form. Please fill out the intake form at least 48 hours before your first appointment on any tablet, smartphone or computer.

Sessions cannot start without intake form being completed.

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Cancellation Policy

We prioritize our clients by holding space for each person we see. When clients cancel an appointment, our clinicians offer that space to other clients who need an appointment that week. When clients cancel within 24-hours or no show, other clients miss out on an opportunity to be seen.

If you would like to cancel an appointment, we ask that you do so with your provider with at least 24-hour notice. Anyone canceling an appointment with less than a 24-hour notice will be charged the full session fee. Insurance does not cover no shows and late cancellations, so is the client’s responsibility to pay.

Your Rights and Protection Against Surprise

Note: the following document is a Federal form required by the No Surprises Act. The NSA attempts to protect consumers from surprise medical bills that can result from being treated by an out of network provider. The first section applies to individuals receiving treatment at a facility, and the second is more applicable to outpatient psychotherapy, but I am including both to be comprehensive. The right to a Good Faith Estimate currently applies to clients and potential clients who are paying for services out of pocket or out of their insurance network. If you have any questions, please don’t hesitate to ask.

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 healthcare 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.

Information about California’s legislation regarding surprise medical billing can be found at: https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm

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 directly.

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.