Crisis & Emergency Support

Syzygy is an outpatient practice and does not provide crisis or emergency services.

If you are in immediate danger or experiencing a mental health emergency, call 911 or go to the nearest emergency department. In the U.S., you can also call or text 988 to reach the Suicide & Crisis Lifeline.

If you are experiencing a crisis, please call:

National Suicide Hotline at 1.800.273.8255

Crisis Clinic in Seattle at 206.361.2222

LGBTQ+ issues contact the Trevor Lifeline at 1-866-488-7386.

If you need support in challenging psychedelic experiences please call or text the Fireside Project at 623-473-7433.

Insurance & Payment

Billing varies by provider.

All Syzygy psychotherapists are out-of-network and do not bill insurance directly. Payment is due at the time of service. Upon request, your therapist can provide a superbill that you may submit to your insurance company for possible out-of-network reimbursement.

Our psychiatric and nutrition providers accept insurance.

Jenia Malysh, DNP, PMHNP-BC currently accepts Premera, Aetna, and Cigna.

Julia Hollenberg, RDN, CD is currently in-network with Regence, Blue Cross Blue Shield, First Choice, BridgeSpan, Kaiser PPO, and United Healthcare. She is out-of-network with Premera and can help clients use eligible out-of-network nutrition benefits when available.

Coverage varies by plan, so we recommend confirming your specific benefits before beginning care.

Out-of-Network Reimbursement

If your plan includes out-of-network mental health benefits, you may be eligible for partial reimbursement for psychotherapy. Your therapist can provide a superbill containing the information typically needed to submit a claim.

You may want to ask your insurance company:

• Do I have out-of-network outpatient mental health benefits?

• What is my deductible, and has it been met?

• What percentage or dollar amount is reimbursed after the deductible?

• Is my provider’s license type covered?

• Are telehealth sessions eligible for reimbursement?

• Do I need a referral or preauthorization?

• What documentation is required to submit a claim?

Common psychotherapy billing codes include 90791 for an intake and 90837 for psychotherapy sessions of 53 minutes or longer.

Your insurance company determines reimbursement, and Syzygy cannot guarantee that a claim will be covered.

Private Pay Psychotherapy

Private-pay therapy allows you and your therapist to make decisions about the focus, frequency, and length of treatment without those decisions being determined by an insurance plan.

It may also offer greater privacy because your therapist is not routinely submitting a diagnosis and treatment information to an insurance company.

Your provider can discuss fees, payment policies, and possible out-of-network reimbursement with you before beginning care.

Intake & Paperwork

Before beginning treatment, you will receive intake and consent forms through the secure client portal. These may include informed consent documents, payment information, practice policies, and questionnaires relevant to your care.

Please complete all required paperwork before your first appointment. Your provider will let you know if anything additional is needed.

Questions about paperwork or scheduling should be directed to your individual provider.

Cancellation Policy

Appointments are reserved specifically for you. Please provide at least 48 hours’ notice if you need to cancel or reschedule.

Appointments cancelled or rescheduled with less than 48 hours’ notice may be charged the full session fee. Exceptions may be made for emergencies or serious illness at your provider’s discretion.

Because each clinician operates an independent practice, individual cancellation policies may vary. Please refer to your provider’s disclosure statement for their specific policy.

Confidentiality & Communication

Syzygy providers use secure systems for clinical records and sensitive communication whenever possible.

Standard email and text messaging are not fully secure, so we recommend limiting personal or clinical information sent through those methods. Please use your provider’s secure client portal for sensitive information whenever available.

Email, text, and social media should not be used for emergencies or urgent clinical concerns.

Privacy & Your Health Information

Syzygy providers protect your health information in accordance with applicable federal and Washington state privacy laws.

Because each clinician operates an independent practice, you will receive a privacy notice from your individual provider as part of the intake process. This explains how your health information may be used or shared, your privacy rights, and how to ask questions or raise concerns.

Scope of Care

Syzygy is an outpatient practice and is not designed to provide crisis stabilization, emergency services, intensive case management, or a higher level of psychiatric care.

Each provider practices under their own professional license or credential and is responsible for determining whether their services are appropriate for your needs.

During consultation, intake, or at any point in treatment, a provider may determine that another clinician or level of care would better support you. When possible, we will offer referrals or recommendations for appropriate resources.

Providers may also decline or discontinue in-person services when someone arrives intoxicated, threatening, or unable to participate safely in treatment.

Couples Therapy Scope

Couples therapy can support relationship distress, recurring conflict, betrayal, affairs, intimacy concerns, and major ruptures.

Our couples therapists do not provide treatment for high-conflict separation or divorce matters involving custody disputes, litigation, or court-involved relational work. We also assess whether conjoint therapy is appropriate when ongoing coercion, intimidation, or violence makes open participation unsafe.

Good Faith Estimate

Under the No Surprises Act, clients who are uninsured or who choose not to use insurance have the right to receive a Good Faith Estimate of the expected cost of care.

You may request a Good Faith Estimate before scheduling or at any point during treatment.

Individual providers are responsible for supplying estimates related to the services they provide.

Social Media & Professional Boundaries

Syzygy providers maintain professional boundaries with current and former clients on social media and do not accept personal friend or follow requests when doing so could create a dual relationship or compromise confidentiality.

Syzygy’s public social media accounts are intended for general information and practice updates. They are not secure and should not be used to discuss your care, schedule appointments, or communicate urgent concerns.

Please contact your provider directly through the communication methods they have established for clinical care.

In-Person & Telehealth Care

Syzygy providers offer a combination of in-person and telehealth services. Availability varies by clinician.

For telehealth appointments, you must be physically located in a state where your provider is legally authorized to practice and should join from a private location with a reliable internet connection.

If you are experiencing a contagious respiratory illness, fever, or other symptoms that could put others at risk, please contact your provider about meeting by telehealth instead.

If you are unsure whether you should attend in person, contact your provider before arriving.

Independent Providers

Syzygy is a collective of independently practicing clinicians.

Each provider practices under their own professional license or credential, operates an independent private practice, establishes their own fees and policies, and is responsible for the care they provide.

Although our approaches differ, we share a commitment to thoughtful, collaborative care that respects the complexity of the people we work with.

Questions?

For questions about fees, insurance, scheduling, or finding the right provider, please submit a new-client inquiry through our website. We’ll review your information and help direct you toward the provider or service that may be the best fit.