Mark A. Koenen, M.D., J.D.
General & Forensic Psychiatry

1200 5th Avenue
Suite 2010
Seattle, WA  98101
(206) 623-1949
Copyright © 2009 by Mark Koenen

Home.Dr. Koenen.FAQs.Directions.
Q:  What can I expect in our first session?

A:  Since no two individuals are alike, no two sessions are alike.  However, generally for our
first session we meet for 75 minutes or so so that I can take a complete psychiatric, medical,
social and developmental history of the patient.  This can give me at least a superficial
understanding of the issues involved, and the patient and I can decide how to proceed.  
Sometimes we decide to proceed with medication management of the patient’s problems and
schedule follow-up accordingly.  At other times, we can decide on a program of psychotherapy
and make preliminary arrangements regarding the frequency and duration of treatment.  
Occasionally, a patient’s history suggests that there may be a medical cause of their symptoms,
and I will refer them for laboratory testing (generally blood tests) or possibly radiological
studies or sleep studies at an offsite location (typically the University of Washington,
LabCorp or some other testing facility).  

Q:  How long are the sessions and how frequently do you meet with patients?

A:  That depends entirely on the patient and the problems they want treated.  I offer 50 minute
psychotherapy sessions and 25 minute medication management visits.  The frequency of visits
is tailored to the patients individual needs and preferences.  This can range from weekly (or
even biweekly) psychotherapy sessions to meeting a few of times per year for medication

Q:  What is the procedure for making a first appointment?

A:   Call my office at (206) 623-1949.  Typically we will speak by telephone for a few minutes
so that I can get an initial history and determine if I am an appropriate psychiatrist for you
(and so that you can get an idea of whether you will be comfortable working with me).  
Assuming it is a good fit, we will settle on a time that is mutually convenient for both of us
to meet at my office for the initial evaluation.     

Q:  Do you take insurance?

A:  No.  I require payment by cash or check at the time of service.  I do not bill insurance
companies, Medicare, Medicaid or any third party payor, nor do I deal with them directly.  I
will generate a statement and mail it to you shortly after any session.  This statement will
contain any information necessary or you to submit a claim and receive reimbursement
directly from the insurance company.  However, as I am out of network, the reimbursement
by your insurance provider may not cover all of my costs.  

Q:  What if my HMO requires additional forms for reimbursement?

A:  Yes.  Some managed care plans require additional forms that they will supply.  My policy
is to fill out any such forms during our session so that you will be aware of what information
I am conveying to the managed care company.  Please note that if there is a maximum
Number of covered sessions by the insurance provider, you will be responsible for keeping
track of authorizations as well as the number of sessions used and requested.   

Q:  Are our sessions confidential?

A:  Yes.  The fact that you are seeing me and what you say to me is kept under the strictest
confidence.  However, under some circumstances I may be required by law to report
disclosures during our session.  These situations include when the patient threatens harm to
himself or others.  I am under a legal obligation to protect the intended victim.  This can
include warning the possible victim as well as contacting appropriate authorities.  In addition,
I am required to notify Child Protective Services of any ongoing child abuse situations about
which I become aware.  Finally, I can be required to release information in response to a
summons or court order.  

Q:  Will you release medical information if I want you to?

A:  Certainly.  I will provide medical information if you provide written consent.

Q:  My spouse/parent is paying for my session, will you release information to them?

A:  Not without the express written consent of the patient.  Who is paying for the session is

Q:  When are you available for appointments?

A:  That depends on when I already have patients scheduled.  As a general rule, I am usually
willing to make appointments anytime between 7:00 AM and 7:00 PM Monday through Friday
depending on availability.  

Q:  I ran out of my prescription, how do I obtain a refill?

A:  If you need refills, please remember to obtain prescriptions at the time of your session.  
If you need a refill prior to your next session, contact the pharmacy and have them call my
number for refill authorization.

Q:  How do I contact you after hours?

A:  Routine messages, questions, or requests can be left on my answering machine
(206) 623-1949.  In case of emergency, please call my office number and follow the voice
mail instructions to reach the psychiatrist on-call.

Q:  What is your cancellation policy?

A:  Since your appointment time is reserved exclusively for you, please cancel any appointment
that you are unable to attend.  You will be charged for cancellations with less than 24 hours
notice or for missed appointments.

Q:  What is a forensic psychiatrist / forensic psychiatry?

A:  Forensic psychiatry is a field that deals with the interaction of psychiatry and law.  Forensic
assessments come into play in a variety of legal matters.  In criminal law, forensic assessments
typically concern competence to stand trial and/or criminal responsibility.  However, psychiatric
issues are common in many civil cases such as those involving testamentary capacity, capacity to
make medical decisions, insurance and disability claims, damages in tort litigation, medical
malpractice cases, civil commitment, dangerousness assessment, child custody, etc.  In such
cases, forensic psychiatrists are typically called upon to evaluate the individuals involved and
produce reports for use by an attorney or by the court.        

Dr. Koenen.