Frequently asked questions

---

Yes, I exclusively offer online (telehealth) therapy sessions. This is done through a private, safe, and secure online platform, which is HIPAA-compliant. In addition, I ensure I'm in a private and confidential location to provide you with privacy. However, I cannot guarantee confidentiality from your location and it will be up to you to ensure you are in a private location.

Exceptions to confidentiality:

• If a client threatens or attempts to commit suicide or other grave bodily harm;
• If a client threatens grave bodily harm or death to another person;
• If there is a reasonable suspicion of neglect, abuse, or abandonment to children under the age of 18 years old;
• If there is a reasonable suspicion of neglect, abuse, or abandonment of an elderly person;
• If there is a reasonable suspicion of neglect, abuse, or abandonment of anyone unable to care for themselves;
• If a court of law issues a legitimate subpoena;
• If a client is in therapy by order of a court of law;
• If a client's insurance provider requests information to process a claim.

Online (telehealth) therapy is shown to be as effective as face-to-face counseling sessions (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5723163/ ).  Here are a few other advantages:

• Convenience. Attend therapy from home, work, car, or anywhere you feel comfortable. Cut down on driving time and the extra gas expense. Sessions can be scheduled for a lunch break.
• Accessibility. Therapy is easily accessible for those with medical and/or physical difficulties getting to an office. All you need is an internet connected device (computer, laptop, tablet, phone) and webcam. Note: Stable internet connection recommended.
• Availability. Those who live in remote or rural areas now have access to therapy without the need to go to the nearest big city. 

While online therapy does have its advantages, there are some disadvantages such as:

• Reimbursement. Some insurance companies will not reimburse for telehealth therapy sessions or they require the first session to be in person before allowing continued telehealth sessions.
• Technology Issues. Having an unstable internet connection, loss of internet service, power loss, et cetera can cause issues completing a telehealth session. For that reason, there will be clear instructions to help overcome those in the event they occur.
•  Seriousness of Issues. There are some cases where it is best to be seen in person. For example, someone with a high suicide risk would be better suited to more frequent, in person sessions.

How long you continue in therapy depends on a lot of different factors.

1. At first you may not feel comfortable talking to me or you may feel comfortable immediately.  It can sometimes take a few sessions to begin feeling comfortable enough to talk about sensitive subjects.
2. Some situations are deeply rooted after years of built-up feelings, behaviors, and/or traumatic events. It may take longer to process these and some may spend years in therapy to work through everything. Those with less severe issues may find short-term therapy (2-6 months) more beneficial for them and will progress more quickly.
3. You may feel like therapy is too hard, you don't want to do more than talk in session and be done, or it may bring on intense feelings which make you want to quit.  These are all normal feelings!  However, those who are willing to work through these feelings outside of their sessions, and are ready to implement the changes discussed will spend less time in therapy than those unwilling to put in the work.

I require all new clients start with weekly sessions to give you time to become comfortable with the me and to begin processing through your issues.  The frequency of sessions are often reduced to biweekly, then monthly once you begin seeing progress.

Yes, I do accept insurance on a limited basis for Florida and New Mexico clients only through a partnership with Headway. Unfortunately, I am unable to accept insurance for those who reside in Massachusetts. Please check your insurance for out-of-network benefits. I can provided you with a superbill to request reimbursement.

The following commercial plans are currently accepted for those who reside in FL:

• Aetna
• Cigna
• Oscar Health
• Oxford
• United Healthcare
• Carelon Behavioral Health
• Quest Behavioral Health

The following commercial plans are currently accepted for those who reside in NM:

• Aetna
• Cigna
• Carelon Behavioral Health
• Quest Behavioral Health

Note that Medicaid and Medicare plans are not accepted. 

If using insurance benefits, please note that you will be required to register with Headway. They will be responsible for processing your insurance claims, collecting copays and deductibles. You will be required to have a card on file with Headway for this reason, as well as a card on file with our office for no show and late cancellation fees.

If you are not covered by any of these plans or reside in Massachusetts, you may still be able to use out of network benefits to get reimbursed for any out-of-pocket costs. 

With this option: You pay me for the scheduled sessions, and monthly I provide you with a receipt called a superbill, which you can then submit to your insurance company.  If you have mental health benefits and do not have a deductible, the insurance company will send a check to you directly for reimbursement once the claim is accepted. Please be aware that I do not have any control over your insurance company, whether they accept or decline your claim, nor the reimbursement amount.

Using in- and out-of-network benefits will require a diagnosis by your insurance company. Not all diagnoses are covered and even those that should be covered may not be. They have the right to decide your diagnosis is not covered at any time. In addition, your insurance company may not reimburse for telehealth sessions. Please check your policy coverage with your insurance company prior to seeking reimbursement. 

NOTE: Superbills are provided upon request only.

Another payment option: Use a Health Saving Account (HSA) or Flexible Spending Account (FSA), which allows you to use pre-taxed money.

Please be aware a debit/credit card is required to be on file to schedule a session and payment is due at the time of service.

If you plan to use your in-network or out-of-network benefits for reimbursement, it is important to be proactive and contact your insurance company prior to seeking counseling so you understand what is or is not covered so there will not be any surprises.

What questions should I ask my insurance company about my mental health benefits?

1. Do I have in-network or out-of-network mental health insurance benefits?
2. Do my in-network or out-of-network mental health benefits cover telehealth sessions?
3. What is my deductible and has it been met? What is the deductible amount that I will need to pay before getting reimbursed?
4. How many sessions per year does my health insurance cover?
5. Do I need prior authorization to see an out-of-network therapist?
6. What is the reimbursement rate per therapy session?

Your insurance company may need a billing code when you call. 

In most instances this is 90791 for the initial intake session with a 95 modifier and continuing sessions are either 90834 or 90837 with a 95 modifier. 

90834 is used for individual therapy sessions that are 45-52 minutes in duration and the 95 modifier indicates the session was a telehealth session. If your session exceeds 52 minutes, a code of 90837 will be used with the same modifier.

Not everyone wants to or can use their insurance for mental health counseling sessions. There are many reasons for this:

• Their insurance does not cover mental health counseling, has a high deductible (meaning they would be paying in full anyway), and/or only allows for a few sessions.
• Insurance companies require a formal diagnosis and proof that the therapy sessions are "medically necessary" in order to use their benefits.  This means that you must have an issue that affects your daily life and wellbeing. Unfortunately, there are many reasons for going to therapy, but very few that are considered diagnosable. Some diagnoses not covered on their own include: relationship issues, experiencing a life transition, and managing stress. 
• The diagnosis provided will become part of their permanent record as a pre-existing condition.
• The insurance company may require their treatment plan and the progress notes about each session resulting in a loss of confidentiality.
• They have a security clearance, a high-profile or government job, or other positions where their mental health diagnosis could be detrimental to getting or retaining that clearance and/or position.
• They don't want any surprise costs later down the road. Insurance companies often say “a quote for benefits does not guarantee payment…” For example, you may be told you only need to pay a $25 copay for each session. However, after 5 sessions the insurance company comes back and states your claims have been denied and you need to pay all 5 session in full, which could amount to $500 or more. 

The solution for many is to waive their use of their insurance benefits for mental health care and pay for sessions privately. Please note: For informational purposes only. Your decision to use or to not use your out-of-network insurance benefits is a personal decision. Only you can decide which is best for you based on your own needs and experiences. 

I have very limited reduced fee spots available, so they may not always be available. 

At this time all reduced fee spots are currently full. 

I don't want to add more stress or anxiety onto those who are already experiencing anxiety in their lives, so the truth is that I may not be the best option for everyone. Therapy is an investment in you, but that does not need to be accomplished with me as your therapist. Please let me know if you need help finding a referral for a therapist who fits with what you are able to afford.

 Yes!  You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. 

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items  or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. 
• Make sure your healthcare provider gives you a Good Faith Estimate in writing at least 1 business      day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or 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 or call 1-800-985-3059.

If you have any other questions not answered here, please send me a message with your question(s).

• If you are ready to schedule an appointment, click the button below and it will bring you to scheduling. 
• Choose "I'm a New Client" and follow the directions to schedule a free consultation.
• Once you have chosen a day and time, I will be able to accept or decline the appointment. If I need to decline the appointment for any reason, I will provide an explanation and offer an alternative day and time.
• Please make sure to complete the required consultation form prior to the scheduled appointment.
• You will receive an email with a link to get into the therapy room at your scheduled time. 
• I will be online at the scheduled appointment time.
• The first counseling session can be scheduled at the end of the free consultation. 
• Required documentation will be sent out and must be complete prior to the initial counseling session.  You will receive reminder notifications with a link for your scheduled session appointment.  A debit/credit card is required to be on file for session payments and payment will be charged immediately after each session.  
• If all documentation and information required is not complete prior to the first session, the appointment will be rescheduled.