Tracy G. Bell, MA, LMHC
1417 NW 54th Street, Suite 407
Seattle, WA 98107
My fee for a 50-minute individual therapy session is $150.
Unless prior arrangements have been made, payments are
to be made by cash or check at the time of your appointment.
During our first meeting, I will ask you to read, complete, and
sign the following forms. You may download them here if you
would like to save time by reviewing, completing, and signing
them in advance.
"Perhaps everything that
frightens us is,
in its deepest essence,
something precious that
wants our love"
© copyright 2008-2009 Tracy G Bell, MA, LMHC
Fees, Forms and Insurance
Disclosure Statement: this document describes my practice and explains my policies with regard to confidentiality, privacy, scheduling, fees, and cancellations. When you sign this statement, you are stating that you consent to my services and policies as described in the disclosure statement. RCW 18.130.180: Washington state law requires me as a counselor to provide clients with a copy of the acts of unprofessional conduct, along with contact information for the department of health should you have any complaints against the services I provide. New Client Information Form: I would appreciate having this basic information about you as a foundation for our psychotherapy work together.
First Choice Health Network: I am a network provider for FCHN. You will pay me only your coinsurance amount and I will bill FCHN directly for the balance. You are responsible for any amount not covered by FCHN for any reason.
Other insurance (Premera, Regence, Aetna, Group Health, etc.):
Most insurance plans have mental health benefits for out-of-network providers. We can work together to understand the amount your insurance will cover. You will pay me up front for sessions. Upon request, I will provide you with a statement at the end of each month which you can then submit to your insurance company with a claim for reimbursement.