Fees & Insurance
Finances can be a particularly difficult portion of therapy as you are sharing highly personal information with me during our sessions. And my financial policies may impact our therapeutic relationship.
While my goal is to help you, I am also running a business and have to ensure I am earning an income in order to support myself.
I understand you may have some discomfort when I enforce these policies. I’m happy to discuss any of my policies with you in advance or at the time of enforcement.
It is important for us to reach a clear understanding about how our relationship will work. And what each of us can expect.
I may choose not to enforce any of these agreements at any time solely at my own discretion without explanation.
Private pay fees
My current rates are:
- $150 per 50-minute session
There are additional fees for longer phone calls, emails, document preparation, and court attendance. Longer sessions can be arranged.
I periodically review my fees and can change them at any time. I’ll provide current clients at least 30 days’ notice prior to any fee changes.
I require clients to keep an active credit card on file with me at all times. Which will be used to charge any fees you are responsible for.
If you use an FSA or HSA card, this card cannot be used for missed or late cancelled appointments. You would need to have a backup card on file as well. Your client portal will include any invoices that you need to submit to your FSA/HSA for coverage.
If you prefer not to utilize a credit card, please discuss this with me.
You are responsible for informing me of all insurance coverage that may apply to you and immediately informing me of any changes to your insurance coverage. Please know that there are potential legal consequences for me, depending on your coverage, regardless of whether or not you informed me of that coverage.
I am no longer in network with United and Cigna. And will no longer be in network with CCHA Medicaid as of May 2021.
I do not have a date set for terminating with Anthem, but plan to do so later this year. And also plan to stop taking new Colorado Access Medicaid clients later this year.
If you’d like to learn more about the reasons for my decision or would like more information to help you decide whether you would like to use your insurance, please see the section below.
If I do not accept your current insurance, I am considered out of network. I will not work directly with your insurance company. I agree to provide any documentation that you may need to submit in order utilize your FSA, HSA, or out of network benefits. Such as invoices or Superbills.
Here are the questions you can ask your insurance provider to learn about your out-of-network reimbursement benefits:
- Does my plan provide reimbursement for out-of-network mental health care with a Licensed Professional Counselor?
- If so, is there a separate deductible?
- What percentage of out-of-network costs does my plan cover?
- Do I need pre-authorization for out-of-network services?
- Is there a limit to the number of sessions that will be reimbursed per year?
- How do I submit for out-of-network reimbursement?
Cancellation / Reschedule policy
I reserve your time slot specifically for you. You must cancel or reschedule sessions at least 24 hours in advance via text. Do not provide notice via email. If you do not give at least 24 hours’ notice, you will be responsible for the full cost of your session.
If you repeatedly cancel or reschedule your appointments, I may decline to schedule your appointments in advance. And request that you to contact me 24 hours before you would like to attend an appointment in order to see if I have availability. I may also decline to provide further services.
At times, I may contact you to inquire whether you are able to change your appointment time. You can always decline my requests.
Please provide notice via text that you will be arriving late before the scheduled start time of your session. Do not provide notice via email. I may choose to contact you or wait for you if you have not arrived at your scheduled start time. But I am not responsible for doing so. If you are late for a session, the session will still end at the scheduled time.
If you are utilizing insurance- If you are more than 7 minutes late or leave more than 7 minutes early, you will be responsible for the cost difference between the service that can be billed to your insurance and the service that would have been billed to your insurance if you had attended the full scheduled time. I cannot bill your insurance for services that you did not use.
You may choose to receive email and/or text reminders of your appointments. These are a courtesy. You are responsible for cancellations or late arrival fees even if you did not receive a reminder. Do not respond to reminders as the message will not get to me.
Medicaid / Health First Colorado
I will no longer be in network with CCHA Medicaid as of May 2021. I also plan to stop taking new Colorado Access Medicaid clients later this year.
You are not legally allowed to private pay for services. And nobody can private pay for services for you, unless those services would not be covered by your insurance. Medicaid members will not be charged any fees and cannot elect to pay for cancellations or late arrivals.
If you are more than 5 minutes late or leave more than 5 minutes early for 3 sessions, this will count as a late cancellation. Arriving more than 20 minutes late or leaving more than 20 minutes early will count as two late arrivals or early departures.
You will be referred to another provider after two late cancellations or rescheduled sessions.
Understanding how utilizing insurance impacts your treatment
You get to choose whether or not you utilize your health insurance for therapy. Here are some factors to consider:
PrivacyIn order to utilize your insurance benefits, you have to agree that your insurance company can access any information they want about your treatment at any time. Which includes your diagnosis, dates of service, and everything you talk about. I can take some care in what I document. But if they decide to challenge your need for treatment, I have to share enough with them in order to convince them that they should continue to pay for your services. I can no longer promise confidentiality in the same way that I can when you pay for your own services.
In order to utilize your insurance benefits, you have to meet medical necessity for care. More simply, this means that you have to have a mental health diagnosis that is severe enough to require ongoing treatment. And the diagnosis has to be one that your insurance company has decided qualifies for coverage.
That means I have to give every client a diagnosis if they want to use their insurance benefits. Or in cases where the client’s symptoms don’t meet DSM criteria for a covered diagnosis, I have to explain to the client why their insurance won’t cover their services.
In my opinion and in research, the DSM is made up of meaningless labels of clusters of symptoms and is politically and societally determined. For example, homosexuality was a mental health diagnosis in the DSM until recently. Developmental trauma does not have a diagnosis in the DSM even though it is often a focus of treatment.
For some people, having a diagnosis is helpful. And it helps them to understand why they are feeling how they feel.
Diagnoses can help determine medication treatment as well.
For me, your diagnosis has nothing to do with how I treat you or what might help you to get better. At the best, it gives us a shorthand to label a set of things you are experiencing. And it helps to categorize your improvements, which we can do without officially giving you a diagnosis. Diagnoses become part of your medical record. And can impact your future employment, particularly in careers that require security clearance or background checks.
Control of treatment
Your insurance company decides how frequently you can come to therapy and how long those sessions can last. They do this by refusing to pay for additional sessions or refusing to compensate therapists for additional time.
I once had to explain to an insurance company that the client had come to therapy on a Thursday and the following Monday because they were questioning why she had two sessions so close together. Also had to justify why she needed individual and couples therapy.
If I don’t sufficiently justify why you needed treatment on a certain day, they can come back later and take back the money they paid me for the session. And you can become financially responsible for that session.
Many therapists refuse to take insurance for couples therapy because justifying treatment becomes so much more difficult. And it significantly impacts how the session is run. We can’t provide services because you are having difficulties in your relationship. We can only provide services if your mental health is impacting your family. Or so we can teach your family how to better support you with your mental health.
Time and money
Insurance companies make it very difficult for us to update our information in their directories. So they waste your time by giving you wrong addresses, phone numbers, websites, or availability. I have to spend more time telling prospective clients that I am not available.
I have to spend more time on your insurance and billing. This is time that I don’t get to spend checking in with you between sessions. Or researching better ways to help you.
I have to spend more time outside of our sessions and during our sessions making sure that I document things in a way that your insurance company will want to pay for them. This takes some of my attention away from you.
I have to spend more time submitting claims, documenting payment of claims, checking your benefits, collecting copays and coinsurance, and following up on denied claims. More time calling them to give detailed information about your treatment. Or giving them copies of your records in order to convince them to pay.
We have to spend more of our time together talking about money and your insurance. There are more chances that you will get an unexpected bill later if they choose not to cover a session. Or I will have to refund money to you because your costs change throughout the year.
It also increases the chances that I’m going to be frustrated and not at my best when I arrive to your session.
They determine what I get paid and who I am allowed to see and where and by what means.
I am not allowed to turn down prospective clients based on what their insurance pays for a particular service. I have to agree to see any client with any insurance I am contracted with who approaches me when I have an opening. Or I have to terminate my insurance contracts.
They determine whether a particular address, such as a home-based office, is a location I can use to see their clients. They determine whether they will cover telehealth via video chat or phone call or require us to meet in person.
I hope this helps you to understand more about why I ethically disagree with how insurance companies handle mental health treatment. And why I am making the choice to stop taking insurance.
I am happy to answer any questions or concerns that you might have about this.
Serving the Denver Metro Area, Colorado Springs, Fort Collins, Boulder, Grand Junction, Greeley, Pueblo and the entire state with online therapy in Colorado. I do not see clients at my home-based office located in Brighton, CO.