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RATES
My current rate for all my clinical and coaching services: $250/hour.
I do not accept insurance. But if we agree on a long-term therapeutic relationship, I can consider a long-term rate that reflects regular and ongoing work together. That said, I am unable to alter my rates for first-time or infrequent sessions. Additionally, down below is information on how you may be able to use insurance either through a Single Case Agreement or a Superbill.
Because I care deeply about economic justice, I’d like to be transparent about my rate structure. My fees reflect my experience, the cost of my education, professional licensing and accruing credentials. Though it is my foremost goal to lower the barriers to a healthy and pleasurable life for people across all economic strata, I must nurture and maintain my practice in order to do so. That is why I have set my rates as they are—so that I can afford to work with anyone and everyone in a variety of ways. My fees allow me to volunteer my time or take reduced rates for grassroots organizations.
As someone who is deeply connected to socio-economic justice, I am acutely aware that not everyone has access to income that makes makes certain services affordable. That’s why, if my rates are currently out of your budget, I am happy to:
Curate a 1-time salon for you and a small group of friends. We can collaborate on the topics and you and your friends can split the cost.
Connect you with a trusted and qualified therapist from my professional network. Additionally, Wombat Mental Health Services, is a great resource for indigenous-centered therapy and for finding sex positive/LGBTQ+-friendly therapists.
ADDITIONAL INSURANCE INFORMATION & SINGLE CASE AGREEMENTS
Finding ways to afford to work with me are possible. There’s a great deal of information below but please take the time to read it to see if it can help.
Many insurance companies will reimburse you for a portion of your therapy sessions. Prior to starting treatment, you may want to call them to determine the exact amount your insurance company will reimburse you.
Common Questions to ask your insurance company:
What is the reimbursement rate for an out-of-network provider?
Do I have an out-of-network deductible? If so, how much is it? Have I met any of it?
Do I need approval from my primary care provider?
How many sessions per year do I have coverage for?
What form(s) do I need to submit so that I can be reimbursed?
When you speak with your insurance company, tell them that you are seeing an “out-of-network-therapist” and ask them what the “reimbursement rate” is for each session. They may ask for my NPI number, which is: 1851750590
To help you determine the reimbursement rate, here are some common codes. You will need to provide your insurance company with one procedure code, one diagnostic code, the length of the session and the actual cost of the session.
The Length of Therapy Sessions:
50-60 minutes long
Procedure Codes:
90791 Psychiatric Evaluation (used at first appointment only)
90837 Individual Counseling
90847 Family Counseling (this includes couples counseling)
90853 Group Therapy
Diagnostic Codes: For the purposes of insurance I will use a diagnoses that addresses your symptoms but, ideally, will not feel stigmatizing. I always discuss a diagnoses with a client before you submit to insurance.
Single Case Agreements
Adapted from [https://www.theprojectheal.org/single-case-agreements]
WHAT IS A SINGLE CASE AGREEMENT?
A Single Case Agreement (SCA) is a one-time contract between an insurance company and an out-of-network provider so the patient can see that provider using their in-network benefits. It is essentially an exception to the network so that the patient will only have to pay their routine in-network co-pays for sessions after meeting their in-network deductible (if any). The fee per session that will be paid by the insurance company is negotiated by the insurance company and the provider as part of the SCA.
SCA’S CAN BE JUSTIFIED WHEN:
The outpatient provider/treatment program has a clinical specialty, which is not available among any in-network provider
The in-network provider does not treat people of your age, gender, or religious preference
The geographical location of the patient does not have any in-network providers
A patient who has recently changed their insurance plan or is stepping down to a different level of care at the same facility (continuity of care)
All in-network providers are full and have no availability
There is proof that the available in-network providers are inappropriate or would cause harm (e.g. the patient is transgender and they need a provider with expertise in transgender expertise)
If a plan does have out-of-network benefits, the deductible, out-of-pocket max, and/or co-pay may be too costly financially.
HOW DO I SET UP AN SCA?
SCAs are typically negotiated directly between your healthcare provider and your insurance company. When you first reach out to your healthcare provider for treatment, you can ask them whether they would be willing to negotiate a SCA with your insurance company. Be prepared to provide details about your medical history and whether you have received eating disorder treatment in the past. The stronger your case is that your chosen provider is the best care for you, the more likely your insurance company will agree to a SCA.
HOW LONG DOES AN SCA LAST?
SCAs typically last for the length of your treatment. However, if you complete treatment with your provider and decide to resume treatment at a later date, you would need to negotiate a new SCA with your insurance company.
STEPS TO SET UP AND ADVOCATE FOR AN SCA
Start by contacting Member Services at your insurance company (will often be on the back of your insurance card) to request a list of in-network (INN) providers for all the specific concerns that you have (ie. sex therapy, trauma management, gender exploration).
If there are no INN providers available, ask if you have out-of-network (OON) benefits. Many insurance plans do not have OON benefits, so it is important to check. A Single Case Agreement can be requested if you have OON benefits to be paid at an INN rate.
While on the phone with your insurance company, ask to be assigned a Behavioral Health Case Manager, if you do not already have one. This is a free enrollment within your policy. Tell the representative on the call this is URGENT and contingent on you finding immediate treatment – this will hopefully get you a Case Manager to contact you sooner rather than later. If you haven’t heard back in 1-2 weeks, do not be afraid to call back and be a squeaky wheel!
Your Case Manager will be your advocate from within the insurance company and your main point of contact going forward. They will help connect you to INN and OON resources.
If you do not have OON benefits, let your Case Manager know you are in need of a Single Case Agreement, and ask them if it is possible within your insurance plan. Inform your Case Manager you have “exhausted all resources” and “there are no known therapists INN” with your plan that meets your needs. They will help guide you on next steps once it is determined that a SCA is possible.
If you are starting a Single Case Agreement, once you have spoken with your Case Manager, call Fire and Flow Therapy. We will work with your Case Manager, or the appropriate contact provided, to work with you through next steps in the process.
If you have other outpatient providers (psychiatrist/PCP), it may be helpful to get clarity on your symptoms and diagnosis. This may be helpful in gathering more information for insurance to meet “medical necessity criteria” for a SCA.
APPEALING INSURANCE DENIALS
You, as the member, can also send a letter in addition to the provider’s letter to further advocate for yourself.
LINK FOR SAMPLE LETTERS FOR APPEALS AFTER A DENIAL
https://www.nationaleatingdisorders.org/sample-insurance-letters
(You will need to adapt the language for your specific concerns)