FAQ

My office is at 6205 Old Keene Mill Court Suite A in Springfield, Virginia close to Planet Fitness and Trader Joe’s.  The office is on the second floor and there is no elevator in the building. Parking is available in the office complex parking lot. 

Counseling is also available online via the Sessions client portal. Clients are welcome to avail themselves of either in-person or online counseling or a blend of both, depending on your convenience and preference.

Both!  I offer in-person appointments at my office in Springfield, Virginia near the intersection of Old Keene Mill Road and Rolling Road and online appointments through the secure, HIPAA-compliant service provided by Sessions Health.

Not directly, no. I am not considered an in-network provider with any insurance companies and do not directly bill them. I can, however, provide you with a “superbill,” which is a receipt for clinical services that includes all of the information the insurance company would need to process an out of network claim. Superbills are easily accessible to you (and downloadable) through the client portal on Sessions Health.

Many clients find that their policies offer some out of network benefits that can defray a substantial portion of the session fees. If you are concerned about forgetting to file for reimbursement or you just don’t want to deal with the hassle, check out Thrizer, a company that will serve as your biller for a percentage-per-transaction fee. You can also check your in-network benefits on Thrizer’s site.

Determining out of network benefits is the responsibility of the client. Please either check your benefits through Thrizer or call your insurance company in advance of your first appointment to help avoid unpleasant surprises.

Some questions that may be helpful to ask your insurance company representative:

• Do I have mental health insurance benefits?
• What is my deductible and has it been met?
• How many sessions per year does my health insurance cover?
• Are distance counseling sessions (video, phone, email) covered under my plan?  (The location of services — if your insurer asks — is 02 for distance services.)
• What are my mental health benefits for out-of-network providers?
• What is the coverage amount per therapy session?
• Is approval required from my primary care physician?

Your insurance provider may ask you some questions in return about what service you are receiving.  You will want to provide them with some specific CPT codes (these are the codes that identify to the insurance company that you are receiving some kind of mental health treatment and how long the session last) to ensure they are covered.

*Please note that these codes typically refer to in-person and video sessions, not email or phone sessions, which are much less likely to be covered.

• 90791   Psychological Diagnostic Interview (typically just the first session)
• 90834   Individual Psychotherapy, 45 Minutes
• 90837   Individual Psychotherapy, 55-60 Minutes

Note that healthcare flexible spending is another option for reimbursement.

Session fees are $195 for 55 minute sessions. If you are interested in shorter sessions, please let me know as 45-minute sessions are available on request.

Credit cards are the preferred form of payment. 

Please note that registration with the client portal includes supplying a current credit card that can be securely kept on file. This credit card may be used for automatic billing if that is your preferred method of payment or in the event that you have a late cancellation, it may be used for a missed session.

The client portal allows you to make, change, and cancel appointments up to 24 hours before your scheduled time. If something comes up last-minute, please email me directly.

I request that you give me 24 hours of notice whenever possible, but also recognize that illnesses, snow days, and last-minute work meetings don’t happen on a predictable schedule. In my practice policies, I reserve the right to charge a $50 cancellation fee if cancellations become a frequent occurrence.

The decision to submit your receipts to your insurance company is one you should weigh carefully.

The Pros

• Cost. If your insurance provider will pay for part or all of your therapy fees, it can help keep costs down.
• Monitoring. Your insurance company requires that your therapist stay current with paperwork and document progress and have the ability to audit records to ensure compliance.
• Easy Referrals. Your insurance company  maintains a list of area providers that are within theirnetwork.

The Cons

• Diagnosis. To access your insurance benefit, your assigned therapist is required to assign you a mental health diagnosis, which will become part of your MIB profile. MIB is the Medical Information Bureau and is the centralized clearing house for health insurance usage – performing essentially the same task as the credit bureaus do for your financial information. Note that even if your therapist is “out of network” and you want to use out of network benefits, this requires a diagnosis on file. If this concerns you or you have any question about how I approach diagnosis, please talk with me. I want you to be informed and comfortable.
• Loss of confidentiality. The insurance company may require ongoing information from your therapist regarding why you are going to therapy and what progress you are making. They can audit your therapist’s files and request clarification from your therapist regarding your issues.

* Please note, however, that your therapist will only offer them the basic information to which they are entitled.  If you have any questions about that, please ask.

• Limited choice. Seasoned clinicians often choose to stay out-of-network rather than joining insurance panels due to the cons listed above. Your choice of therapists within-network may be limited.
• Potential issues with seeking life insurance coverage. Depending on the diagnosis that your therapist assigns to you, some life insurance companies may see you as a heightened risk, choosing to raise your rates or deny you coverage altogether. It is a good idea to secure life insurance in advance of beginning therapy for this reason.

* Please note that this information is not intended to scare you from using your insurance coverage or to scare you from seeking help when you need it.

While the “cons” are important considerations, we have many clients who do opt to seek reimbursement from their insurance companies and have not reported negative consequences.

It can feel anxiety-producing to talk with someone you have never met about highly personal issues.

New clients often have questions:

What should I talk about?

Where should I start?

There’s no right or wrong way to begin talking about the issues that are important to you. I will help to get you started by providing you with information about how I work, asking you questions, and beginning to collaborate with you on getting what you need out of the counseling session. If you have worked with a therapist in the past and have things you liked or didn’t like, please feel free to share your observations, experiences, and preferences.

It can be very helpful to clients to jot down notes during the week or to create a running list of things they want to talk about in session. This can help focus our work together and ensure that we address your most important concerns, but is up to you. Likewise, it can be helpful to keep notes of what you discussed in therapy, even if it’s just a few words to jog your memory. Many clients report liking being able to see their documented changes and progress over time.

It’s common to feel doubt or despair about the possibility of getting help, especially if you feel like you have tried everything already.  It can be helpful to think of therapeutic change as happening in a spiral, rather than a straight line. When we have emotional issues or situations, rather than getting past them and never having them happen again, we re-visit them, but hopefully each time we circle around a little faster and at a higher plane. The therapists at Nova Terra have worked with many people who have started out feeling hopeless but are later thankful that they gave therapy another try.

Clients can help their symptom alleviation significantly by doing a few things:

1. Being willing to practice new skills or ways of thinking outside of therapy.
2. Doing some pre-planning for the session i.e. coming in with specific issues you’d like to discuss or observations you’d like to share.
3. Writing down notes from each session.

Therapy content is a bit like the stuff of dreams: it can feel so vivid and real that you’re sure you will never forget that particular insight or realization but then — in the process of getting on with regular life — it can suddenly be hard to recall.

Writing will help you solidify what you are learning and give you a record to come back to later. It can also serve as a reminder of how far you have come.