The purpose of this document is to let you know about your protection from unexpected medical bills. This notice is to remind you that our providers/facility is not in your health plan's network. This means our providers and this facility do not have an agreement with your insurance plan.
You are seeking service ( s ) from Foothills Psychiatry, Inc. Heather Dietz, PA - C, and Heidi Ritchie Lossmann, PMHNPC, MSN, who are out-of-network providers with your insurance company/plan. You are responsible for paying ( the prices listed below ) at the time of service. You are voluntarily choosing an out-of-network provider.
You have the right to receive service ( s ) at a participating facility or by a participating physician or provider within your insurance company's network in order to obtain full benefits under your health coverage. If you have questions or would like to locate an in-network provider, please contact your insurance company's customer service at the telephone number/website listed on your insurance identification card or ask for assistance.
$130 for 10-15 minute Medication Management Appointment
$160 for 25 minute Medication Management Appointment, supportive appointments
$175 for 35 minute Medication Management Appointment, supportive appointments
$200 for 45 minute Medication Management Appointment, supportive appointments
$280 for 1 hour New Patient Diagnostic Appointments
Additional services for medical records, emergent on-call services , family collaboration, and / or paperwork are billed according to provider time spent.
$130 for 10-15 minutes
$160 for 25 minutes
** Appointment length is subject to change based on the provider's observation of the patient and/or patient circumstances at the time of service but will still follow the times and prices listed above. Appointment times may be over the face-to-face time due to electronic medical record input, and collaboration with other providers/family members on the patient's behalf.
Appointments may be conducted by the following options:
• In Person • Zoom (telehealth) • T/C ( teleconference )