It can be hard to decide to come in for therapy and harder still to select a therapist. And, common sense and research tell us that “fit really matters,” so finding someone with whom you feel comfortable sharing and exploring difficult and private issues is important. It’s also important that you find someone who is competent to help with the particular issues you are trying to address. For these reasons, I’m glad to offer a complimentary 10-15 minute phone call to allow for an initial exploration of the fit between what you are seeking and what I can offer.
If, based on our phone call it appears that it make sense to set up an appointment, we will use the first 1-3 sessions to further explore your concerns. You will have a chance to bring me up to speed on important background information, describe current concerns, and establish clarity about how you hope to make use therapy. I will identify and share how I believe I might be helpful, if I think I can, or I will be glad to offer you recommendations and/or referrals if I don’t think I am the right therapist to meet your needs…
Prior to beginning treatment: It is a good idea to verify that your insurance plan will cover my services. You should check your insurance benefits and coverage by phone, website or handbook and seek answers to the following questions:
- Is Dr. Sheila Gardner in my plan’s network of providers?
- Do I have a deductible to satisfy?
- What is my co-payment per visit?
- Do I need to ask for a “pre-authorization” prior to my first visit? (If so, obtain call for an authorization number).
- What are the limits of my mental health benefit (ie. number of sessions allowed per year, or dollar limits)?
Insurances for which I am credentialed:
- Blue Cross/Blue Shield
- United Behavioral Health
Implications of Using Insurance for Mental Health Services
Most people choose to have their insurance pay for mental health services if they have a benefit for it. However, if you chose to use your insurance, there are several implications of doing so that you should be aware of. Some insurance plans will pay for mental health services with very few questions asked. These companies typically ask for a diagnostic code and a treatment date. Others will pay for 8-12 sessions with no questions asked, after which they will want some additional information in order to determine if continued treatment is “medically necessary.”
When insurers ask providers to submit a “treatment authorization request” for continuing services, typically this will include a disclosure of the following types of information:
- Your specific symptoms, their severity, and duration.
- Risk factors such as suicidal/homicidal tendencies or significant substance abuse.
- Level and description of functional impairment.
- Specific treatment goals and indications of progress made toward those goals.
- Psychotropic medications taken or reasons why medications are not appropriate.
When information like this is requested by your insurer, I make every effort to minimize the disclosure of sensitive information. The only sure way to completely prevent information from being disclosed to an insurance company is to consider a self-pay arrangement with a therapist.