George Jackson, M.D.
Process of Treatment: The initial appointment will involve at psychiatric evaluation followed by a recommended treatment plan. The plan will include recommendations for psychotherapy, medication management or a combination of the two. The therapist may be myself or someone else at Rainier Behavioral Health based upon individual needs. Psychotropic medication may be recommended or continued to help treat the presenting symptoms. Please Note: If you are currently prescribed medications, I may not recommend continuation of them, nor prescribe the medications for you.
Appointments and Cancellations: All sessions are arranged by appointment only. Sessions are either 15-minute medication management or 45-minute therapy appointments. You have the option to receive a reminder via telephone call, text or email approximately 48 hours prior to the appointment. Cancellations must occur at least 24 hours in advance or you will be charged a $75.00 fee. Please be aware that this fee is the patient’s responsibility and insurance companies do not reimburse for missed or late cancelled appointments.
Telephone Calls and Emergencies: Telephone calls to the office are answered by the office staff during the workday. All calls during non-workday hours are directed through our answering service. Calls requiring a response will usually be returned within 24 hours. If the call is emergent and requires immediate attention, please call 911 or go to the nearest emergency department. A consultation fee may be charged for telephone calls in special circumstances.
Legal Issues and Documents: Please understand that I do not perform evaluations that concern legal matters, social security disability, psychological reports or service animals. A fee will be charged for certain documentation based upon the required time needed to complete. You will be informed of the fee and payment is required prior to completing the documentation.
Payments and Billing: You are expected to pay the co-pay at the time of each appointment. Arrangements for paying the fee can be made in special circumstances. The co-pay for mental health treatment can be different than other medical visits. If you are uncertain about your co-pay, please contact your insurance company. It is recommended that you pay 20% of the appointment fee if the co-pay amount is unknown. If you have insurance coverage, we will bill your insurance company. However, you are responsible for the account and expected to pay the bill whether insurance pays a portion or not. Payments are expected to be made at the time of billing. If payments are not made within 90 days, your account may be sent to collections. Any collection fees, legal fees or other costs needed to collect unpaid balances are your responsibility. If there are questions or concerns about your account, please ask to speak with our billing office.
Insurance: Please complete the insurance portion of the “Patient Information” form in addition to providing a copy of your insurance card at the initial appointment. I am a contracted provider for many, but not all, local insurance companies. Prior to the initial appointment, please check with your insurer to make sure that I am a provider for your plan. Additionally, please check if (1) a referral or preauthorization is needed, (2) there is a separate annual deductible or (3) there is a yearly maximum number of visits or dollar amount for mental health benefits. The intake office can assist you in obtaining this information.
Office Policy: Changes to these polices may occur over time. A concerted effort will be made to inform you of any relevant changes.
Informed Consent: Your signature below indicates that you have read the information in this document and agree to its terms throughout your treatment at Rainier Behavioral Health.
*I acknowledge that I have read the financial policy above and I am responsible for all charges, regardless of insurance coverage. I understand that delinquent accounts may be assigned to a credit reporting collection agency and agree to pay for all legal costs and expenses including reasonable attorney fees. (By signing this acknowledgement, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.)