The services I provide are not be covered by Japanese National Health Insurance.

I do not bill insurance directly and am considered an out-of-network provider. Clients are responsible for full payment at the start of each session.

If you wish to seek reimbursement from your U.S. insurance provider, I can provide a monthly invoice. These invoices are processed once per month and delivered at the beginning of each month. Invoices include specific diagnostic and service codes required by insurers to describe the nature and focus of counseling.

Important Notes:

• Direct Communication: Clients are responsible for communicating with their insurance provider. I will not communicate directly with insurance companies on your behalf.

• No Guarantee of Reimbursement: Reimbursement decisions are made solely by your insurance provider. Receiving reimbursement once does not guarantee future approvals.

• Late-Cancellation Fees: Fees for missed or late-cancelled sessions are strictly non-reimbursable, and I do not provide insurance invoices for these charges.

• Potential Denial or Reversal: Insurers may deny claims or demand repayment if:

  • My documentation does not meet their specific administrative standards.

  • They disagree with the frequency, duration, or necessity of therapy.

  • Claims are submitted past their filing deadlines.

  • The reasons you are seeking therapy fall outside your plan's coverage.

Privacy & Third-Party Involvement Involving an insurance company introduces a third party into our work together, which can impact your care in several ways:

• Indefinite Records: Insurers often require specific clinical details to be included in your file, which may remain in their systems permanently.

• Audits & Session Notes: Insurance providers retain the right to request session notes, audit treatment plans, or limit coverage. If you deny them access to records, they may deny reimbursement or demand repayments.

• Impact on Therapy: Knowing an insurance company could review details of your care can sometimes influence what you feel comfortable discussing, how often you attend, or the focus of our work.

Recommended Steps Before Starting Therapy Never pay more out-of-pocket than you can afford, as reimbursement is never guaranteed. If you plan to submit invoices, submit them regularly so you are quickly aware of any claim denials and can accurately assess your ongoing costs.

Contact your insurance provider directly prior to our first session to verify your coverage. Here are key questions to ask them:

• What percentage is reimbursed for an out-of-network, Master’s-level, Licensed Marriage & Family Therapist (LMFT)?

• What is my out-of-network deductible, and how much of it has been met?

• Is there an "allowed amount" or maximum fee cap per session?

• Is there a limit on the number of sessions allowed per calendar year?

• What specific documentation or coding do you require for reimbursement?

• Is a mental health diagnosis required?

I am a TRICARE Overseas Program (TOPS) provider and also contracted with a few Employee Assistance Programs (EAP) in Japan. Please let me know at the beginning of our work together what coverage you currently have. Please let me know if your coverage ever changes.

Important things to know and consider before using insurance:

• Insurance/EAP reimbursement requires that certain information about your situation be documented and stored in their records.
• This information may be kept indefinitely and could affect you in ways that are difficult to predict.
• Insurance companies may request access to session notes or summaries, meaning they could review sensitive details about our work together.
• Involving insurance introduces a third party into the therapy process, which can influence how often you attend, what we focus on, and what you feel comfortable discussing, knowing that records might be reviewed.
• If you have any concerns about privacy, the involvement of insurance, or how this could affect our work together, please bring them up so we can talk through your options.