Frequently Asked Questions about Therapy and Insurance
How do I know I’m ready to begin therapy?
Everybody’s reasons for seeking out a therapist are different. If you’ve come this far reading through my website, you’re likely more than ready to take action. While some people may seek help for conditions causing an interruption in their lives, such as anxiety and depression, others may need to deal with trauma from childhood or a specific event. There’s no right or wrong reason to go to therapy or even when to begin. Most people turn to a therapist when they’re in crisis or have not found a solution on their own, or they’ve tried a variety of things and therapy is their last resort.
Working with a therapist is a privilege – and an emotionally intimate relationship unlike any other. It can provide you with the awareness, insight, and strategies to deal with every type of challenge you may face. It can also help you live a life you couldn’t have imagined for yourself or didn’t even know existed.
I know that therapy is beginning to “work” when the initial crisis has resolved and the intensity of the presenting issue that brought us together is over. Therapy provides an opportunity for you to build a new relationship with yourself, regain a sense of choice in your life, and build self-awareness towards a more complete and whole version of yourself.
Are there some things I need to know about therapy?
Sometimes you will start to feel “worse” after beginning therapy. These feelings are often associated with us uncovering and revealing parts of your life that have been pushed down, cut off, or which you’ve kept very well hidden. Sharing these parts of yourself can be scary and unsettling, even overwhelming. Please know this is part of the process. You and I will work together to ensure you are safe and have methods in place to handle emotions when they arise. As you begin to transform, it’s possible the environment around you will react. At times, this causes conflicts with friends, family, and loved ones, because the way you show up in their lives may start to change. This is normal and again, something we will make sure you have the support you need and tools to adapt to as the need arises.
How long does therapy take to be effective?
Many clients begin to feel relief immediately simply because they’ve taken a giant step in taking care of themselves and being heard.
The therapeutic process and our relationship are based on what you’re seeking and needing from therapy. While some people are looking for shorter-term work around a specific issue, others may be looking to heal from deep wounds and understand patterns, and they want the opportunity to discover parts of themselves that have gone unknown. Many of my clients remain with me for several months and many have stayed in the relationship for years. Some clients want a supportive person to help them navigate the ups and downs of their lives without a set time frame.
We’ll discuss what you’re hoping to get from engaging in a therapy relationship. As we continue to work together, what you need or want may change, and we’ll communicate regularly and consistently throughout treatment to make sure your goals are being met and that your needs are addressed.
What does Gestalt therapy look like?
Therapy is a unique process for each individual that’s based on the relationship we form together. The therapeutic relationship is co-created and dependent upon your needs and how you show up with me. I invite you to take time to get to know yourself, to be seen and heard, and reclaim space in the world that is solely for you. You are not a passive onlooker to the therapeutic process, but rather, I’m a passenger on the journey with you, at times serving as a guide but never taking the driver's seat. During a session, I’ll set up “experiments” – experiential opportunities to work through parts of you that show up, which sometimes look like role-playing with a twist. (While Gestalt therapy is most widely associated with the “empty chair experiment,” that’s just one technique we “experiment” with.)
What is a Discovery Call (also called a consultation)?
The Discovery Call session is 20-30 minutes in duration. Think of this call as a “meet and greet” or “getting to know you” discussion. I take you and your therapy very seriously, and the therapeutic relationship, for both the therapist and the client, is a commitment. You're going to be transforming and changing over time, and this requires that I simultaneously be transforming and changing along with you.
There will be times that come up in our relationship when you’re going to want to bail out. It’s my job to help identify these moments and sit with you in the discomfort of what’s present and lean in. This is when the magic of therapy happens. Most people in your life will avoid what’s uncomfortable. By contrast, as your therapist, I’m not going to short-change you by avoiding what needs to be addressed. You deserve a therapist who dares greatly to show up with you; someone who sees you and remains present, constant, and consistent, and who operates from a place of willingness and awareness. The initial discovery call is an opportunity for us both to find out if we want to schedule a formal session, and for me to understand if I can be of help to you.
What does my commitment to therapy look like?
Engaging in therapy weekly, especially at the beginning of treatment, is most effective for our work together. Session frequency has an important impact on the delivery of successful therapy, and weekly sessions allow us to build our therapeutic relationship, which requires a foundation of safety and trust. Duration of the therapeutic relationship is open-ended and may change as your goals are met and new needs emerge.
How do I check my insurance benefits?
You can check online. Look for your “Summary of Benefits” on your insurance provider’s website. While reading through your plan summary, look for phrases like “out-of-network deductible” and “coinsurance” or “copayment.” Your out-of-network deductible is how much you have to pay before you can access your out-of-network benefits and be reimbursed. For example, you may have an out-of-network deductible of $500. Once you pay that amount, your insurance company will cover 100% of out-of-network service fees. You’ll have met your deductible after you pay $500 and will be eligible for reimbursement. This means that if you spend $1,000, you’ll be responsible for $500 of that and then your insurance company will reimburse you for all or a portion of the remaining $500. This normally comes to you in the form of a check and is mailed directly to you after you submit a claim. Your deductible will most likely reset at the beginning of each calendar year.
“Co-insurance” is the portion of the service fee that you will have to cover. If the session fee is $300 and your co-insurance is 50%, you are responsible for $150 and your insurance will reimburse you the other $150. Your co-insurance will not kick in until you reach your deductible. If your insurance company has an “allowed” amount, this means there’s a max that they will pay out to reimburse you. For example, if the “allowed” amount is $150 for each session, your co-insurance is 50%, and the session fee is $300, then the reimbursed amount will cover a maximum of $75.
Call your insurance company. Locate the phone number on the back of your insurance card for “Member Services” which may also be listed as “Customer Service.” If there is a separate number for “Behavioral Health,” this is the number you will need to call. Listen carefully to the options and choose the option that best fits “check benefits” for “outpatient behavioral health” or “mental health” office visits.
Sometimes mental health benefits are contracted out to another company, so your insurance company may give you another number to call or transfer you straight to that company. Once you connect with the right company and department, you may follow this script to verify out-of-network benefits after you reach a live representative on the phone:
- Do I have out-of-network coverage for mental health/behavioral health services provided through telehealth? (If the answer is “no,” then you will not be eligible for any reimbursement when you see an out-of-network provider). If yes, proceed.
- What is my annual deductible? How much of the annual deductible has been met this year?
- How many sessions per year does my plan cover?
- How much does my insurance plan reimburse for an out-of-network provider for CPT code 90837?
- What is my copayment or co-insurance (if applicable)?
- Do I need a referral from my primary care physician?
- What is the home and mailing address you have on file? (It’s important to ensure checks are issued to the correct address.)
- How do I submit a superbill? Is there an online portal or fax number, or do I need to mail in a copy?
- What is the time limit to submit a “superbill”?
Is there a fee for the discovery call?
There is no charge for the discovery call.
What is a “superbill”?
A “superbill” is a document, much like an invoice, that outlines the services you received with your therapist. If you request one, I will provide you with a superbill; it will then be your responsibility to submit it yourself in an attempt to draw on an out-of-network benefit. I provide superbills upon request at the end of each month if you are wanting to attempt to use an out-of-network benefit through your insurance. Beyond providing a superbill, Gestalt Therapy PLLC does not communicate or provide any additional information to any insurance company for any reason at any time before, during, or after our therapeutic commitment to one another.
Why does Gestalt Therapy PLLC not accept insurance?
This is a question with several layers of answers. The primary reason I don’t accept insurance is that insurance companies often restrict the kind of therapeutic work we can do, and I don’t want those kinds of restrictions dictating your care, my practice, or my best clinical judgment. The healthcare system views people as “sick,” suggesting there is something diseased that must be diagnosed and treated. This perspective boxes us both in, labels and stigmatizes everyone, and doesn’t take into consideration the many facets that health encompasses. I want to do the work I love, with love, and without having to worry about time constraints, the stress of whether or not insurance will cover certain services or diagnoses, or whether insurance will reimburse at all for mental health treatment.
Do you take insurance?
Gestalt Therapy PLLC does not have “in-network” or “out-of-network” provider status with any insurance companies. This doesn’t mean you cannot still use your insurance, as you may be able to use out-of-network benefits. While you’ll be responsible for paying your session fee upfront to me directly, you may be able to get some portion of reimbursement from your insurance company. Please be aware when checking your insurance benefits, as benefits are NOT a guarantee of payment. You will have no way of knowing for sure what a benefit looks like until you submit a superbill that gets processed by the insurance company. Gestalt Therapy can provide a superbill to you as a courtesy and upon request, however, Gestalt Therapy does not engage in any communication or correspondence with insurance companies.
How does payment work?
Clients are responsible for payment in full at the beginning of each session. Payment is processed either by ACH bank draft, debit card, or credit card, which is stored securely in a HIPAA-compliant point of sale (POS) platform. All major credit cards, including AmEx and FSA/HSA cards, are acceptable methods of payment, and upon request, I provide a receipt for all fees paid. Personal checks, bank checks, or money orders will be accepted if arranged prior and sent one month in advance of sessions. All clients are required to keep a credit card on file, regardless of payment arrangement.
What are some benefits of virtual therapy?
Whether you’re on a time crunch, have scheduling conflicts, or facing unforeseen crises, virtual therapy is a safe alternative for those living and traveling abroad, people with fast-paced lifestyles, and folks who otherwise don’t have access to high-quality mental health care. The virtual format allows for access to mental health care from the comfort and safety of your home, workspace, or otherwise private space, without interruptions to your personal journey of healing due to life circumstances or the lifestyle you want and need to live. There’s no time spent driving to an office, money spent on gas, more wear and tear on a vehicle, or damage to the environment. In my years of practice, I’ve found the virtual therapy format to be highly effective and beneficial in providing space for creativity within the therapy experience.
What are your rates?
Therapy requires a commitment on your part as well as mine. It is an investment of time, energy, and money in you. The nature of the work I do as a Gestalt psychotherapist is demanding on my body, mind, and spirit. By carefully selecting the number of clients I choose to work with at any given time, I’m able to provide each client with a very personal approach and the highest standard of care.
Individuals:
$300 per 50-minute session
Couples:
$375 per 75-minute session
Groups:
$75/group session
Can I get a Good Faith Estimate?
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 health care 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.
