Frequently asked questions

Have questions? We have answers!

General Questions

  • All new clients have one intake session prior to the first therapy session and or to the administering of any assessments/test(s) (approximately 25-50 min). This intake session, is to check documents, make sure we fully understand client’s issues, and to introduce the therapy process.

  • Couples and family therapy is different from individual therapy because the focus of the work will be on the relationship(s). Both members of the couple, or all members of the family, will be present in the first session so the therapist can get to know all of you at the same time. The therapist will help identify the goals for the relationship(s), and will work towards meeting those goals, together.

  • Online Session, Telehealth Session, and Video Session are all the same terms. We made it easy to use. A web link will be sent to you in email. Click the link and a browser based video session will be started. You can use most smart phones and or personal computers with a webcam. It is similar to face time. Allowing you to see and converse with your provider from the comfort of your home or whatever space you feel comfortable in.

  • On rare occasions the Therapist assigned would be out of network with your insurance provider. Or, we simply do not have an in network provider available.

    We always offer the Client the best use case scenario and the client is never obligated to proceed.

    In network usually means you are fully covered for treatment. There can be co-pays and deductibles on your insurance plan. Check with your insurance provider.

  • We verify insurance benefits and find ways to accommodate the client. We will check benefits and offer you service based on your coverage - Takes on average 2-5 business days.

  • The differences between a Licensed Professional, an Associate, and a Practicum Student lie primarily in their level of education, licensure status, and ability to work independently. Here's a breakdown:

    1. Licensed Professional

    • Qualifications: Fully licensed mental health professional (e.g., LMFT, LCSW, LPCC, Licensed Psychologist) who has completed:

      • All educational requirements (master’s or doctoral degree).

      • Required supervised hours.

      • Licensing exams specific to their field and jurisdiction.

    • Scope of Practice:

      • Works independently without supervision.

      • Can diagnose and treat clients, administer psychological testing (if appropriately trained/licensed), and bill insurance directly.

      • May supervise Associates and Practicum Students.

    • Responsibilities:

      • Accountable to their licensing board for ethical and professional conduct.

      • Maintains continuing education to retain licensure.

    2. Associate

    • Qualifications: Post-graduate clinician working toward licensure (e.g., Associate Marriage and Family Therapist [AMFT], Associate Professional Clinical Counselor [APCC], or Psychological Associate [PA]).

      • Completed all educational requirements but has not yet accrued all supervised hours or passed licensing exams.

    • Scope of Practice:

      • Provides therapy or psychological services under the supervision of a licensed professional.

      • Cannot work independently; all work must be reviewed by a supervisor.

      • May perform assessments and therapy, but their work is overseen to ensure competence and adherence to professional standards.

    • Responsibilities:

      • Accrues required supervised hours for licensure (e.g., 3,000 hours for LMFT/LPCC or Psychological Associates in CA).

    3. Practicum Student

    • Qualifications: Graduate student enrolled in a clinical program (e.g., psychology, social work, counseling) completing a required practicum placement as part of their degree.

      • Has not yet graduated or begun post-graduate supervised work.

    • Scope of Practice:

      • Provides basic therapy or assessment services under close supervision.

      • Works within the limited scope allowed by their training program and placement site.

      • Not yet qualified to diagnose independently or conduct advanced interventions without significant oversight.

    • Responsibilities:

      • Gains foundational clinical experience.

      • Completes hours required for their academic program, which count toward graduation but not licensure.


    Summary:

    • A Licensed Professional works independently and is fully credentialed.

    • An Associate is in the process of gaining the necessary experience and supervision for independent practice.

    • A Practicum Student is in the early stages of clinical training, focusing on foundational skills under close supervision.

  • We can assign a Therapist within 36hrs. Or, client can initially pay with this method and get a statement (known as a superbill) that can possibly be used for reimbursement by your Insurance provider. It is always best to speak with your insurance provider concerning reimbursements and coverages.

Pre-Authorization for Testing

  • Pre-authorization, also known as prior authorization, prior approval, or precertification, is a process used by health insurance companies to determine whether they will cover a specific medical service, procedure, or medication. This process requires healthcare providers (like us) to obtain approval from the insurance company before delivering certain treatments to ensure that the proposed care is medically necessary and cost-effective.

    The primary purpose of pre-authorization is to control healthcare costs and ensure patient safety by preventing unnecessary or potentially harmful treatments. It allows insurers to review the medical necessity of a proposed service and confirm that it aligns with current medical guidelines and the patient's health plan coverage.

    It's important to note that pre-authorization does not guarantee payment. Even if a service is pre-authorized, other factors, such as plan limitations or changes in coverage, can affect the final decision on payment.

    "It's important to note that the prior authorization process can sometimes lead to delays in receiving necessary care. A 2024 survey by the American Medical Association found that physicians and their staff spend about 12 hours each week requesting prior authorizations, which can result in delays for patients accessing necessary treatments.
    - Harvard Health

    To navigate this process effectively, consider the following steps:

    1. Consult Your Healthcare Provider: They can determine if a test requires pre-authorization and assist with the submission process.

    2. Contact Your Insurance Company: Verify coverage details and understand any pre-authorization requirements specific to your plan.

    3. Follow Up: Stay proactive by checking the status of your pre-authorization to ensure timely approval and address any issues promptly.


    By adhering to these steps, you can help ensure that your mental health testing proceeds without unnecessary interruptions or unexpected costs.

    Recent Discussions on Prior Authorization Challenges" 

    New York Magazine

    'Delay' and 'Deny': The Outrage Over Prior Authorization

  • Obtaining pre-authorization for certain mental health tests is crucial for several reasons:

    • Ensures Insurance Coverage: Without prior authorization, your health insurance may not cover the cost of specific tests, potentially leaving you responsible for the full expense.

    • Prevents Delays in Care: Securing pre-authorization helps avoid postponements in your evaluation and treatment, facilitating a smoother healthcare journey.

    • Saves Time and Money: By confirming coverage beforehand, you can prevent unexpected costs and reduce administrative hurdles, making the process more efficient.

  • What are the steps for Pre-Authorization? 

    Navigating the pre-authorization process is essential to ensure that your medical services or medications are covered by your health insurance. The typical steps involved are:

    1. Verify Insurance Requirements: Before scheduling a procedure or filling a prescription, confirm with your healthcare provider or directly with your insurance company whether the proposed service requires pre-authorization and obtain the Pre-Authorization Form. This step helps prevent unexpected denials.

    2. Gather Necessary Information: Your healthcare provider will compile relevant medical records, treatment histories, and any other documentation that supports the medical necessity of the proposed service. Accurate and complete information is crucial for approval.

    3. Submit the Pre-Authorization Request: Your provider submits the required forms and documentation to your insurance company. This submission can be done electronically, by fax, or through other specified channels, depending on the insurer's procedures.

    4. Await the Decision: The insurance company reviews the request to determine if the service is covered under your plan and if it's deemed medically necessary. This review can take from a few days to several weeks, depending on the insurer's policies and the urgency of the request.

    5. Receive Notification: Both you and your healthcare provider will be informed of the decision. If approved, you can proceed with the service. If denied, the notification will include reasons for the denial, and you may have the option to appeal the decision and/or pay out of pocket for the service. 

    6. Schedule the Service: Once approved, coordinate with your healthcare provider to schedule the procedure within the authorization's validity period. Be mindful of any time limits associated with the approval to avoid the need for reauthorization.

  • Not all assessments or tests require pre-authorization. To avoid unexpected costs or delays, it's advisable to contact your insurance provider to confirm the specific requirements of your plan.

  • The duration of the pre-authorization process can vary based on factors such as the urgency of the request, the complexity of the case, and the efficiency of communication between healthcare providers and insurance companies.

    Typical Timeframes:

    • Standard Requests: Generally, standard pre-authorization requests are processed within a few days to several weeks.

    • Complex Cases: For more complicated cases or when additional information is needed, the process might extend up to 60 days.

    • Urgent Requests: In situations where there is a medical urgency, healthcare providers can submit an expedited request, which may result in a decision within 72 hours.

  • We typically handle the submission of pre-authorization information to your insurance company on your behalf.

  • If your pre-authorization request is denied, it means your insurance company has determined that the proposed medical service or procedure isn't covered under your current plan or isn't deemed medically necessary based on the information provided. Here's what you can do next:

    1. Understand the Reason for Denial:

    • Review the Denial Notice: Carefully read the communication from your insurer to identify the specific reasons for the denial. This will help you address any issues in your appeal.

    • Contact Your Insurer: If the denial notice lacks clarity, reach out to your insurance company's customer service for a detailed explanation.

    2. Discuss with Your Healthcare Provider:

    • Consult Your Provider: Share the denial information with your healthcare provider. They can offer insights and may suggest alternative treatments that are more likely to receive approval.

    • Obtain Supporting Documentation: Request that your provider supply additional medical records or a letter of medical necessity to strengthen your case.

    3. Initiate an Appeal:

    • Review Appeal Procedures: Familiarize yourself with your insurer's appeal process, including deadlines and required documentation. This information is typically outlined in the denial notice or available on the insurer's website.

    • Submit a Formal Appeal: Prepare a comprehensive appeal letter that includes:

      • Patient Information: Your full name, policy number, and contact details.

      • Service Details: A clear description of the denied service, procedure, or medication.

      • Supporting Evidence: Medical records, test results, and a letter from your healthcare provider explaining the medical necessity.

      • Relevant Guidelines: References to clinical guidelines or studies that support the requested treatment.

    • Maintain Records: Keep copies of all correspondence and send your appeal via certified mail to confirm receipt.

    4. Explore Alternative Options:

    • Alternative Treatments: Work with your healthcare provider to identify other treatment options that may be covered by your insurance.

    • Financial Assistance: Inquire about payment plans or financial assistance programs offered by healthcare providers or pharmaceutical companies.

    5. Stay Informed and Proactive:

    • Know Your Rights: Familiarize yourself with your health plan's policies and your rights regarding appeals and coverage.

    • Seek Support: Consider reaching out to patient advocacy groups or legal advisors specializing in healthcare to assist with the appeals process.

    Remember, a denial doesn't necessarily mean the end of the road. Many initial denials are overturned upon appeal, especially when additional supporting information is provided. Persistence and thorough documentation are key to navigating this process successfully.

Testing Steps

  • Psychological assessments differ from standard psychotherapy sessions. They are conducted to aid in diagnosis, inform treatment plans, and monitor progress. For adults, the typical process involves:

    Step 1: Initial Interview

    • Conducted online via video session.

    Step 2: Test Administration

    • Most assessments can be completed online.

    • If in-person testing is necessary, sessions are scheduled in 90-minute increments.

    • Additional appointments may be required, depending on the specific tests.

    Step 3: Feedback Session

    • Receive your test results during a phone session with your therapist.

    This structured approach ensures a comprehensive evaluation tailored to your individual needs.

  • Psychological assessments for Child/Adolescent differ from standard therapy sessions , as they focus on diagnosis, treatment planning, and progress evaluation. The typical process includes:

    Step 1: Parent/Caregiver Interview

    • Conducted via video session; may require one or two appointments.

    • May be asked to provide any other documentation (i.e. IEP, psychological testing results, medical documents) that will aid in the determination of assessments.

    Step 2: Parent/Caregiver/Teacher Assessments

    • Questionnaires sent via email to be completed online, gathering information on the minor's developmental, medical, social, and academic history.

    Step 3: Child/Adolescent Assessments

    • Many tests are administered through video sessions.

    • If in-person testing is necessary, sessions are scheduled in 90-minute increments, with additional appointments as needed based on the specific assessments.

    Step 4: Child/Adolescent Interview

    • Conducted via video session.

    • For children under 12, the interview is held in person and lasts approximately one hour.

    Step 5: Feedback Session

    • Parents receive the assessment results during a phone session with the therapist.

    This structured approach ensures a comprehensive evaluation tailored to the minor's individual needs.