Like any sort of medical procedure or intervention, there are sometimes risks and side effects that can be associated with engaging in care.

Like with any medical interventions, some clients never experience any adverse impacts from therapy, while others experience some difficulties along the way.

Because of this, you will sign an informed consent form before starting services, like you would when you go to the doctors office, outlining the possible risks and benefits of engaging in therapy.

Change is often uncomfortable, and can take time, which can then also lead to some frustration.

Think of it like working out or exercising.

After a work out, you may experience physical discomfort, like your muscles aching, you may feel tired, you may find going back challenging, and you may have emotional reactions like feeling frustrated if you don’t make the gains (or losses) you would like to as quickly as you would like, if you started off seeing a lot of change and then plateau, or if you hit a barrier, like an injury (even one you may get from working out) or illness, which makes going harder and may even result in regression or loss of progress.

Also, when you start working out you may experience great change quickly, even with some of the discomforts, or you may experience discomfort with change that comes slowly or not exactly as you were expecting. But, if you keep going, you will often eventually see SOME sort of results, even if it isn’t exactly what you had in mind, and may only be a part of what you set out to achieve.

Working through the challenges, making adjustments, and sticking with it over longer periods of time will give you more of the results you were looking for.

Similarly to what you may experience with working out, some of the discomfort you may have in therapy will be emotional, and other times you may notice it physically, like aches in your body (yes! its true), or feeling drained or tired.

While engaging in therapy, other, less common, adverse experiences clients may have during the process are symptom increase, re-experiencing negative past thoughts or feelings, or new issues arising as the change process occurs.

This is all to say, just like getting started with a new exercise routine, when you start therapy, uncomfortable experiences are not uncommon, and are not necessarily indicators that therapy isn’t working, this includes some of the less common more adverse experiences some clients have.

Instead, discomfort in the process can be a sign that therapy IS working, but may also mean that adjustment to what we are doing, or how we are doing it, or additional interventions/referrals may be needed to provide the support you need.

Rebekah knows and understands that you likely came to therapy because you noticed something in your life that was creating discomfort and you wanted to address it, so additional discomfort can be especially unnerving.

Rebekah is committed to your safety and wellbeing throughout the process and will her best to stay attuned to you, check in on how you are doing, and provide care, practical skills development, and guidance so that you can feel supported and confident as you celebrate your progress or navigate any challenges or set backs you may experience along the way.

Rebekah encourages you to ask any questions you may have about any care you are receiving, and communicate any adverse experiences you may have, so that she adjust your services or provide additional supports as needed.

As mentioned in “Risks” - just like any sort of medical procedure or intervention, there is not always an assurance that you will achieve the anticipated outcome, or that you won’t ever experience what you recovered from again.

Some clients may notice changes right away, while others may not see any changes or improvements for extended periods of time, sometimes clients reach plateaus, sometimes client's experience that things seem to get worse before they get better, and some clients experience regression during the process, and sometimes even after.

Struggles during the change process are not uncommon, and do not mean it is hopeless or impossible to meet your goals. Rebekah is committed to sticking with you throughout the whole journey, including during times that are difficult, and will work with you to try to uncover what needs may be behind a particular struggle, so that we can strategize a way to work through it or around it.

Discomfort, symptoms increase, lack of progression, plateaus, and regression may be indicators that :

• the treatment is working because change, even desired change, can be uncomfortable - and Rebekah can help you develop skills to manage this new discomfort

• we need to reassess our approach

• we need to add new goals or work on/address a particular goal before moving on to others

• we need to consider a referral for medical or psychiatric assessment to rule out possible biological or mental health conditions that need additional intervention, like medication management (and Rebekah will help in any way she can if this is needed)

• we need to explore if changes in intervention or additional interventions would be helpful

• and, if nothing else helps, discuss the possibility of referring out to another provider for a specific intervention Rebekah may not be skilled in, or even just for a fresh approach

Rebekah honors that this space is YOURS, that you should get what you need from it, is able to be comfortable in the discomfort so she can support you though it, and is committed to making sure you get the best care possible.

Coming soon

Coming Soon

Pros:

Reduced Costs of Care - Utilizing insurance benefits to access mental health care and offset the costs of services is a fantastic resource that can help clients who have both In-Network (INN) or Out-of-Network (OON) benefits. Clients who are INN will only be responsible to pay their co-payment, co-insurance, or deductible rate, according to their plans. Clients who are OON with OON benefits may have OON copays, reimburse plans, or other benefits when they access care with a provider that is OON.

Eliminating Costs for Care - Some insurance plans that are INN with Rebekah require ZERO co-payment - meaning clients with these plans can get access to services at NO financial cost! Also, there may be some companies with OON benefits that will reimburse for full out of pocket costs.

Cons:

Privacy - When you use insurance they will require validation for services, meaning they will want to know your diagnosis, and to see evidence of the necessity for therapy.

Can create other Limits to Accessing Care and Services - Insurance companies may limit the number of sessions you can have, how long a session can last, what kinds of issues/diagnosis they will pay to treat, or how long you can have access services.

Co-Payments/Co-Insurance/Deductibles - sometimes your co-payment, co-insurance, or deductibles will be so high, you might as well be paying out of pocket for services.

Summary: utilizing insurance benefits, both In-Network and Out-Of-Network can really help offset the financial burden of accessing services for some clients, though there are other costs to consider such as copayment/coinsurance/deductibles that can still create some financial barriers to accessing care.

Utilizing insurance also has downsides that include requiring your provider document and share information with them that validates your care, such as diagnosis and treatment codes, and they can request to access treatment plans and progress notes to ensure your services are “medically necessary”.

What your plan is willing to pay for may also limit the kinds of services or treatment you can access, and may also impact the number of sessions you can have or how long you can be in a session.

PROS

Privacy:

Choosing to access care through self-pay sessions enhances your privacy, as no information has to be shared with anyone, or any entity, outside of sessions; unless requested by you, or required by law.

Customized Client Care & Ability to Utilize Best Practice:

Self-payment also opens the door to less restrictions on sessions, as insurance will limit how much time, and how often, you are allowed to be in a session.

Best practice for both EMDR and Couples work recommends 90 minute sessions, and sometimes there is need for intensive work, multiple sessions a week, or combination of session types (for example: individual and couples sessions in the same week).

Self-payment can make accessing recommended services more effective and less prohibited.

CONS

Financial Burden:

Sometimes accessing the best care or treatment for your particular needs is made difficult due to the financial costs for these services.

Therapy can be expensive, especially specialized treatment or care that requires more time in sessions or intensive care.

Please talk with Rebekah if the financial cost of services is the only thing getting in the way of you accessing care.

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A Superbill is a document made for insurance companies that details the services an Out-of-Network (OON) therapist or health care provider performed for a client. It is essentially a receipt for your visit and contains vital information, like diagnosis and procedure codes, needed for insurance payers to reimburse you for the services after you’ve paid for. Insurers use the Superbill “receipt” to reimburse clients instead of paying the provider directly.

Usually, when you see an out-of-network provider, you pay them out of pocket for their services. Then, they provide you with a Superbill detailing those services and their costs. To get your Superbills reimbursed, you or your provider has to file an out-of-network claim with your insurer. Your insurer will review the claim and reimburse all, some, or none of the services depending on their assessment. In the event that not all of the claim is reimbursed, you then have the option of fixing the rejected parts and refiling the claim. 

Rebekah is signing up with Thrizer to make this process simple and streamlined for clients, that will guarantee reimbursement for services based on their OON benefits.

Based on your insurance carrier’s policies and your plan, several factors determine how much you may be reimbursed. These factors include:

The amount allowed for a therapy service based on what your insurance company would pay for an in-network therapist

Your out-of-network benefit level

Whether you have met your out-of-network provider deductible for the year

Your coinsurance rate for out-of-network providers (the percentage of charges your insurance company expects you to pay)

Using insurance to offset the cost of therapy can come with its benefits, but it can also have limitations as well other downsides (which you can find in Pros and Cons of using insurance in FAQs), and since they are paying for your treatment, insurance companies require a documented diagnosis, documentation of ongoing issues that validate services, a treatment plan, and documentation of progress, including evidence of ongoing need for care - all of which they can have access to when they need to validate paying for services. This goes for both In-Network (INN) clients AND Out-Of-Network (OON) clients who wish to use OON benefits, ie - requesting to use superbills - as some information like treatment code and diagnosis will need to be included for any possible reimbursement.

However, anyone who pays for services Out of Pocket as a Self-Pay client, even if they have INN or OON benefits, and does not use any INN or OON benefits with an insurance company or other third party payer, will not have any of their treatment information shared with anyone, including any insurance company or payer, without their expressed written consent. (of course with the exception of mandated reporting items, safety concerns, or in any other circumstances outlined in the Notice of Privacy Practices.)

If you are a client who has a plan that is INN with Rebekah, but you wish to not utilize your benefits, for any reason, including not wanting to share your treatment information with your insurance company, you can OPT OUT of using your insurance benefits at any time. (You can can also OPT back IN if you change your mind.)

If you wish to OPT OUT of using your insurance benefits, please let Rebekah know you would like an Insurance OPT OUT form, and to discuss other ways to pay for services.