“What you focus on determines what you miss.” —Brian McLaren (via widely-beloved former PSU professor, Don Mihaloew)

A few things about virtual appointments:

It’s been interesting to see etiquette develop after the onset of COVID-19 forced everything that could be virtual to be so. Now that we find ourselves navigating an ever-fluctuating hybrid life of in-person and online, it can be tricky to determine best practices for our interactions; overall, everything seems to have shifted to the more casual, and as with anything, there are upsides and downsides to this. One big upside for virtual therapy (aside from convenience), is that clients can (arguably) take better care of themselves during sessions. Fidget objects and (quiet) pets are welcome, as is eating/drinking (as long as it’s not disruptive), excusing yourself if you need to see to something, and keeping your body physically comfortable. Please be mindful, however, of not doing things that compromise your focus, safety, and/or confidentiality (driving during session, participating from a public place) and/or would be inappropriate if we were meeting in-person (e.g. multitasking, being partially clothed, being under the influence of recreational substances). You can expect the same from me.

Insurance (no one’s favorite thing) and payments:

Through Alma, I am in-network with Aetna, United, and Cigna. Alma takes care of checking those clients’ benefits and billing their insurance.

I am independently in-network with Regence BlueCross, PacificSource, and Oregon Health Plan (OHP/Medicaid), and bill them directly. I check these clients’ benefits myself, and also usually ask clients to double-check and confirm on their end.

I cannot bill Medicare, Kaiser, Providence, or other insurances not named here. I can provide you with receipts or super-bills for reimbursement if you have out-of-network benefits or are using an HSA/FSA.

I do not take insurance for couples or relational counseling; this type of therapy is private-pay/out-of-pocket only. Almost without exception, insurance will only cover couples counseling if one of the individuals is the “identified client” who must carry a diagnosis for which couples counseling is an appropriate intervention (there is no billable diagnosis for relationship problems only). In my experience, this creates imbalances in the dynamics between everyone involved, no matter how much we try to maintain equal status among clients. There is also a higher degree of scrutiny and possibility of claim denial for couples counseling, and while clients tend to already feel protective of the content of their individual counseling, this is only more true about relational counseling.

My private-pay/out-of-pocket rate is $170/50-minute session, whether the session is individual or relational (couple, family, etc.). I do not charge more for the first session/assessment. Alma allows for clients who have insurances they work with to store a card with them to use for auto-payment of co-pays. Venmo is what most of my non-Alma clients use to pay co-pays or out-of-pocket fees; I can also take payment through Zelle.