FREQUENTLY ASKED QUESTIONS
1) Why is your insurance panel so limited?
I could talk at length regarding the problems consumers and providers face in dealing with insurance. There are many reasons why I no longer credential with many insurance carriers. I face the same challenges with my own family insurance. And it feels unfair to pay for services while also paying insurance premiums and deductibles! The nation is in crisis. Both in the availability of services provided and in offering fair reimbursement rates to providers. While the cost of overhead (testing office, administrative staff, billing and credit card processing fees, electronic health record system, insurance, licensing fees, etc.) and testing materials has risen, the rates for providers have been cut. It is no longer sustainable to provide comprehensive testing services while being paneled with most insurance companies. I had to make the hard decision to value my years and cost of education, experience, and time over insurance. Here are some benefits of not using your insurance:
Article: Here's why I don't take Insurance by Margie Ryerson
2) Do I have to pay it all up front?
The amount is due on the day services are rendered. We do require you keep a valid credit card on file with us. In general, we will process payment on the day of your session and provide you a superbill. For testing, we break the payments into several chunks (2-3). We are happy to work with you on a payment plan if needed.
3) What is a superbill?
A superbill is an itemized form which details services provided to you. A superbill does contain confidential information: along with demographics, it also states the diagnosis and billing code. While your payment is due up front, you can submit your superbill to your insurance company for reimbursement. Not all insurance carriers will reimburse you and the percentage of reimbursement will vary. Recently, for clients with out-of-network benefits, we have heard of reimbursements ranging from $100-$155, and, in general, have heard of a 40-80% reimbursement rate.
What Is a Superbill for Therapy?
4) If I call my insurance company to check benefits, what should I ask?
5) Why is it so hard to find a therapist or get testing?
Again, I could talk at length on this subject. Mental health is undervalued and underpaid in our culture. Like medical doctors, psychologists spend years in school studying psychology, participate in research, write dissertations, and accrue clinical hours. We then apply for year-long internships and, in most states, then move on to a 1-2 years post-doctoral position. Many of these positions are unpaid or underpaid, and actually cost money, which, of course, is a deterrent to recruiting future providers. Also, because there is such a high demand and insurance has so much say, many providers are burnt out, especially following COVID. Some have chosen to retire, cut their hours, or pursue a different career. There is a massive shortage of providers in the Eugene area.
6) Why are you still doing telehealth?
Truthfully, it fits my lifestyle. I get to spend more time with my family, I have lunch with my daughter, and I get to pick up my son from school. Also, I found during COVID that telehealth was just as successful as in-person therapy and my no-show or cancellation rate actually decreased because clients found it more convenient as well. You save on commute time and can still come if you don't have childcare or have a cold. In addition, I have two young children and a high-risk father, so we are still COVID-cautious and avoid indoor gatherings and wear masks.
7) Why do we need to talk on the phone before starting therapy?
Prior to taking on a therapy client, we will speak over the phone for approximately 15 minutes. This is so I can get an idea of what brings you to therapy, and we can both assess if our interpersonal styles are a match. It is important that as psychologists we practice within our competencies. There are some areas of psychology, such as eating disorders, psychosis, acute trauma, and personality disorders, that are not ethically within my competency level. I will do my best to offer you community referrals.
8) What will my first session look like?
After our phone conversation, we will both assess if it seems like a good therapeutic match. Remember, the number one predictor of therapeutic success is the therapeutic relationship. If it's a go, we will schedule the first session, called an intake or initial assessment. I like to gather background information so I have an idea of who you are. Often, I start from the beginning, such as, "Where were you born and raised? What was your home life like? Siblings? Parents? Friends?" and we build a timeline up to where you are today. Of course, this could take the course of several sessions. As a psychologist, my style is supportive, interpersonal, and validating, so clients usually are able to open up, even if they were very nervous about talking. The timeline then leads us to questions such as, "What is going on now?" and asking specific questions about what symptoms you may be experiencing.
9) How much does therapy with you cost?
10) Can you read my mind?
No
11) Can I email you?
We welcome emails to admin@silvermanpsych.com and phone calls/texts to 541-293-3029. Jennifer is my billing specialist and administrator. You may email me for scheduling purposes only. DO NOT EMAIL OR TEXT IF YOU ARE EXPERIENCING A CRISIS.
12) Who should I call in a crisis and you're not available or it's not business hours?
13) Why aren't you answering your phone?
During business hours, I am usually in session with clients or in a meeting. Jennifer works part-time and is most available Monday-Friday from 3PM-6PM; however, she may be on another call or unable to answer the phone. She will return your call as soon as possible, and can also reply to texts and/or email correspondence. We will try to get back to you as soon as we can but we are a small, solo practice so please understand!
14) Can we be friends?
Due to my therapeutic approach and style, our interactions will hopefully be safe, comfortable, engaging, friendly, and productive. It can take on the feel of talking to a good friend. However, there are very strict boundaries set forth by the Oregon Board of Psychologist Examiners forbidding personal relationships between psychologists and their clients. As such, we cannot get together outside of our therapeutic work and I will not accept social media friend/follow requests.
15) What if I see you out in the community?
Because of HIPAA, laws, and ethics, the fact you are a client is 100% confidential, along with any information you have shared with me. I cannot release any information without your permission, so when I see a client in public, I do not acknowledge them because people may deduce you are in therapy with me. However, I am very open to you approaching me- just know this compromises your confidentiality, especially if I'm with my family and/or friends.
16) Speaking of, what is my confidentiality?
This is determined by several factors including if I take your insurance, you are a minor, and if you pose any safety threats. In general, what you say in session stays in session. There are a few exceptions. I am able to consult with your other care teams (for example, your primary care doctor) regarding your treatment. If you are seeing me through PacificSource, you have agreed to sharing of information to them for billing and treatment purposes. In cases where there is concern regarding child/elder/dependent abuse or suicidal/homicidal intent, I can break confidentiality to ensure your safety and may contact a support person (parent, partner, etc.) or police/CAHOOTS. However, I cannot release or discuss information with anyone else without your consent. In the event you want information to be shared, you complete an ROI (Release of Information) granting permission. In psychological testing cases, multiple ROI's are needed for parents, significant others, teacher, etc.
17) Where are you? I'm on Zoom and you haven't started the meeting yet.
There may be a transitional time between sessions. I often see clients back-to-back and may be running over time or taking a quick break. I also allow 5-7 minutes in case you may be running late. At that point, I may telephone you or send you an email checking in. You can call or text 541-293-3029 if you are late or need to cancel, or reply to my Zoom invite.
18) Do you write emotional support animal (ESA) letters? No. Why not? ESA letters are based on psychiatric disability and should include a full evaluation. The term disability is a legal concept based upon 6 federal laws. A forensic psychologist with legal expertise and an animal behavior specialist should be involved in this evaluation to determine your psychiatric disability, how your animal specifically relates to your disability-related need, and evaluate the behavior of your animal. An ESA evaluation should not be completed by your treating therapist.
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