San Diego Psychotherapy

FIRST VISIT FORMS

Below are the forms you will need to complete and bring with you to your first session.  You can click on the link to print out the client advisement and intake forms. You do not need to print or bring the rest to your session. The consent and HIPAA forms are for you. Please make sure you have read and understood them, and bring any questions when you come to your first visit. Alternatively, the forms can be left in the waiting room for you to fill out at your first visit.  If you prefer that option, please let Dr. Shea know.

• Client advisement form

• HIPAA

• Consent form

• intake form

Payment and Reimbursement

Payment in full is expected at time of services, and can be made by check, to “San Diego Psychotherapy” or “Shoshana Shea,” via major credit card, or through a health savings account (HSA).  At this time, Dr. Shea is not an “in-network” provider for insurance panels.  Often insurance reimbursement can be sought for plans that have a Preferred Provider Option (PPO) or Exclusive provider option (EPO).  If you choose to seek reimbursement from your insurance company, a superbill can be provided (i.e., a receipt) with all the necessary information, that can be submitted.  Calling ahead to your insurance company before the first visit is strongly advised.  The following questions can be used as a template: 

1) What do they (e.g., your insurance plan) reimburse for the first visit with a procedure code of 90791 (initial consultation/evaluation) for an out of network provider?
2) What do they reimburse for subsequent visits with a procedure code of 90834 (45 min) and/or 90837 (60 min) for an outside provider?
3) How do I (e.g., you) get reimbursed for these visits (e.g., form on their website)?

If you have any further questions or concerns, Dr. Shea is happy to discuss them with you. 

Parking

There is limited parking in back of the office, and is “first come, first served.”  You can access the parking lot through the alley off of Robinson or University.  There is usually free street parking; you may just have to walk a block or two. And if no other options are available, there is metered parking out on University.