9550 Warner Ave, Ste. 250-08, Fountain Valley, CA 92708
Phone: (714) 403-4166
jackie.harlan@hotmail.com

​​​Dr. ​​​Jacquelyn M. Harlan

Licensed Marriage and Family Therapist

Rates: 
 

$150 per 50-minute initial intake session

 

*The initial intake session is our first session together. I will go over all of your signed paperwork with you, answer any questions you may have, and then ask you a lot of questions to get to know you and your situation. At the end of the intake session we will each decide if we feel we are a good fit for each other. If so, we will schedule our next session. If not, I will give you some referrals for other therapists who may be a better fit for you.

 

$150 per 50-minute therapy session​



Insurance: 
I currently accept Cigna, Blue Shield, Magellan (MHSA), Affiliate West, Tri-Care, and HMC.

I also accept some EAPs.

 

While I am not a preferred provider for some insurance carriers (PPOs), your sessions may be covered in full or in part by your health insurance or employee benefit plan. I will provide a superbill for you to submit to your insurer. However, you will be required to pay for your session at the time of the appointment. You would then submit the superbill to your insurance for reimbursement.

 

Prior to our first session, please check your coverage carefully by asking the following questions: 

  • Do I have mental health insurance benefits? 
  • What is my deductible and has it been met? 
  • How many sessions per year does my health insurance cover? 
  • What is the coverage amount per therapy session? 
  • Is approval required from my primary care physician? 

 


Payment: 
Cash, checks, Venmo, and credit cards are accepted. Payment is required at time of service.



Cancellation Policy: 
If you do not show up for your scheduled therapy appointment, and you have not given at least 24 hours notice, you will be required to pay the full cost of the missed session. If you have insurance, I will not bill them for the missed session. It is your financial responsibility.



Effective 1/1/2022:

Your Right to a “Good Faith Estimate”
 
You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a “Good Faith Estimate” for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a “Good Faith Estimate” before you schedule a service. 

If you receive a bill that is at least $400 more than your “Good Faith Estimate”, you can dispute the bill. Make sure to save a copy or picture of your “Good Faith Estimate”. For questions or more information about your right to a “Good Faith Estimate”, visit www.cms.gov/nosurprises. 

 

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