Good Faith Estimate
Good Faith Estimate for Services with Kari Wolman Killianey Psy.D.
Serving Clients Online and In Person in Redwood City, CA
Brief explanation for new and continuing patients: The following is an estimated list of expected charges for psychological services. The estimated costs are valid for 12 months from the date of this Good Faith Estimate, unless I send you an updated estimate.
The estimate below is a range for the cost of sessions for three different scenarios. Typically, patients meet with me on a weekly basis. Depending on the individual’s needs and Dr. Kari’s observations, there may be an adjustment to the frequency of sessions. For example, rather than weekly sessions an individual may change to bi-weekly sessions over time. Frequency will be evaluated and personalized on an ongoing basis.
Individual Therapy
The cost per session is $300 ( 50 minute sessions).
Some client concerns–like specific or temporary problems or questions for consultation–can be addressed in just a few sessions:
~4 weekly sessions Total estimated cost = $1200
Many clients are able to meet their therapy goals in more like 3-6 months, gaining understanding for causes of symptoms and problem solving and learning skills to cope:
~12 - 24 sessions Total estimated cost = $3,600 - $7,200
Often, clients come to me looking to unwind patterns and habits that have been developing or maintained over years and decades; these clients benefit from stable ongoing therapeutic support for a transformative growth process.
Yearly = ~45 sessions Total estimate cost = $13,500
Ketamine Assisted Psychotherapy
KAP usually includes at least 2 preparation sessions, a half day medicine session, and integration sessions as needed. Most clients begin with about 6 medicine sessions with appropriate preparation and integration before re-evaluating and deciding if more sessions would improve outcomes.
There is also an intake process that includes meeting with a medical provider who will prescribe the ketamine. Cost of the ketamine prescription is not included in this estimate and is not covered by Dr. Kari.
2 Preparations sessions ($300 each) = $600
6 Half day sessions with Ketamine Assisted Psychotherapy ($1200 each) = $7,200
3 Integration Sessions ($300 each) - $900
Total Estimated Cost: $8,700
If you have questions about this estimate, please contact Dr. Kari Killianey by email at : kari.killianey@gmail.com
Disclaimer
This Good Faith Estimate shows the costs of services that are reasonably expected for the expected services to address your mental health care needs. The estimate is based on the information known to [us/me] when [we/I] did the estimate.
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
If you are billed for $400 more (per provider) than this Good Faith Estimate (GFE), you have the right to dispute the bill.
You may contact Dr. Kari Killianey at the contact listed above to let her know the billed charges are at least $400 higher than the GFE. You can ask her to update the bill to match the GFE, ask to negotiate the bill, or ask if there is financial assistance available.
You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this GFE. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
To learn more and get a form to start the process, go to:
www.cms.gov/nosurprises or call CMS at 1-800-985-3059.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call CMS at 1-800-985-3059.
This GFE is not a contract. It does not obligate you to accept the services listed above.
Keep a copy of this Good Faith Estimate (GFE) in a safe place or take pictures of it. You may need it if you are billed more than $400 than the estimate provided above.
