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Fees/Insurance Information

kh-pp-stick-figures-blue-therapy-couch-consultation-dollar-photoInsurance Information for Gay Men’s Therapy

What insurance plans do you take?

Therapy or counseling is an investment in your life, health, relationships, career, family, and future.  I run a small, boutique-style practice as a specialist in working almost exclusively with gay men, as individuals or gay male couples for over 24 years as a gay, HIV-positive (26 years) person myself.  I sometimes see other adults, such as women, lesbians, and straight men, but LGBT or gay-affirmative therapy has been my specialty in my clinical work, research, writing, speaking, and teaching (I’m an Adjunct Assistant Professor at USC School of Social Work, part-time, teaching advanced clinical practice and psychotherapy technique in their graduate MSW program).

Currently, as the most experienced gay men’s specialist therapist in Los Angeles, I offer you an in-depth knowledge of gay men’s mental health that even the most well-meaning straight therapist, male or female, cannot provide.  Even other gay male therapists who are generalists who work with everyone don’t have my specific expertise in working almost exclusively with gay men and gay male couples, or my long experience in this work for over 24 years.  Plus, being a gay man myself, living and working in Los Angeles/West Hollywood for over 30 years, I “walk my talk” of living in the gay male community.  I’m also in a long-term (14 years) relationship with my husband; we were one of the first 13,000 same-sex couples to be married in California in 2008.  And for those living with or concerned about HIV, I have been living successfully with HIV, healthy and active, for 25 years, since 1990.  I am proud that I live in the same community in which I work.  I “get you” in a depth of gay men’s cultural understanding that other therapists can’t offer in the same way.

Because of this experience and specialization, I work on a private-hire basis only.  I’m not an in-network provider with any of the corporate health insurance “HMO”/managed care plans, and I don’t bill insurance plans directly.  You simply pay your session fee at the time of each session (cash, check, having debit/credit card on file, Venmo, or PayPal), and I provide you with a completed claim form for you to submit to health insurance plan to seek reimbursement as long as you have a PPO plan with “out-of-network” benefits.

Speak with your health plan’s customer service representative (at the number on your health plan membership card) if you’re not sure if you have an HMO or a PPO plan, or whether they cover “out-of-network providers” for “outpatient psychotherapy”.  You might also ask if you have a deductible to meet for the calendar year, which is the amount you are responsible for, before your insurance benefits apply.  If you are budgeting for your therapy, we might have to have a session and you submit a claim form before your insurance will reveal how much they will reimburse you; usually, they will not reveal the actual dollar amount they reimburse you before you submit a live claim, but they might give you an estimate, such as “50 percent of average fees for your geographic area”.  However, they will not reveal what they consider the “average” or “reasonable and customary” fee until you submit an actual claim; they consider this information their corporate intellectual property.  After they process your claim, I will work with you and discuss your situation and do my best to make something work for us.

What is your session fee?

Session fees vary per person, based on a “sliding scale” linked to your annual income.  We re-assess your ability to pay and adjust your fee periodically to discuss what you can manage if your circumstances change.  Please feel free to ask to discuss your personal circumstances and we can identify some options to try to make therapy with me possible for you.  We would need to discuss your income level, other resources, or any financial hardships you have that might affect your ability to pay.  Reduced-fee appointments are usually offered in the weekday afternoons.  I can also refer you to my clinical associates, who work under my supervision in my office certain weekday mornings and weekends, and they offer lower fees.  If you need a very low fee, I can provide you with some referrals to low-cost counseling resources and programs in the community.

What types of payment do you accept?

Cash or check are always accepted, but I also ask to put a credit card on file for occasions where you might forget to bring cash or check, or to cover your fee if you have to cancel without giving 48 hours’ notice, or if you have a session via phone or via webcam.  I use Square, the secured/encrypted iPhone app for processing credit card transactions, and I cover the fees to use this service myself, at no additional cost to you.  You can also use a card that is for pre-tax, flex Healthcare Savings Accounts.  You can also use the PayPal or Venmo apps to pay for sessions on the date of your appointment.

Considering the Value of Therapy

I encourage you to consider the value of therapy to you, especially in comparison to the other things that you spend money on in the course of the month, and the intrinsic value that therapy/coaching offers in improving your life in many ways that can’t be quantified. If you ever feel that you are not getting value for the money you spend hiring me privately, we can talk about that, and see how I can be more attentive to your needs and make your investment in sessions more valuable. But hopefully your investment in therapy is helping you to earn more in your career, get more satisfaction from your relationships, support your health, improve your mood and outlook, and solve the problems that bother you the most. I think you’ll find that’s worth it.

How can I help?  Call/text 310-339-5778 for a no-charge, 15-minute phone consultation, or to ask questions about our services.

HOW TO UTILIZE INSURANCE FOR THERAPY
1. Contact your insurance company and ask how much they reimburse for “out of network, outpatient psychotherapy”.
(Often, this will vary from 40 percent to 70 percent of the total fee.)
2.  Ask your insurance company if there is a separate “out of network” deductible you need to meet for the year, of if you’ve already met all (or part) of it .
3.  Ask if they have any paperwork that they need you to submit in addition to the receipt I will provide you after each appointment.
4.  When we meet you will pay the full fee for the service and I will give you a receipt with all the information your insurance company needs to process your claim for a reimbursement check to be sent directly to you.
Usually, it takes about 4 weeks for you to receive a reimbursement check.  If you want to pay for your visits by credit card, that’s fine.  I use the “Square” app for smartphones for credit card processing, and there is no additional fee to you for using this (I cover the 3% fee myself).
When you talk with your insurance provider, they may request information regarding my practice to determine your eligibility for reimbursement.  Here is the information they might ask you for:
TYPE OF CONTRACT: No contract. Out of Network Provider
TYPE OF PROVIDER: Licensed Clinical Social Worker (California License LCS18290)
TYPE OF DEGREE: MSW, Mental Health Concentration, special sub-concentration in Chronic/Persistent Mental Illness (NSWE-accredited program, University of Southern California, School of Social Work)
TYPE OF SERVICE: Individual Psychotherapy 60 minutes (CPT Code: 90837; NOT 45 minutes, Code 90834, due to providing in-depth sessions), Conjoint (couple) Psychotherapy (CPT Code: 90847), Diagnostic Interview (CPT Code:  90801)
ADDRESS OF SERVICE PROVISION:
566 S. San Vicente Boulevard, Suite 103
Los Angeles, CA 90048
OFFICE PHONE:  310-726-4357
OFFICE EMAIL:  Ken@GayTherapyLA.com
(No current FAX number)
NATIONAL PROVIDER IDENTIFIER NUMBER: 1295753291
UNIQUE QUALIFICATIONS OVER OTHER PROVIDERS IN THE AREA:
Over 24 years experience as a specialist working almost exclusively in therapy with gay men, either individuals or gay male couples.  Academic appointment as an Adjunct Assistant Professor in the graduate MSW program of the USC School of Social Work, over 4 years, teaching advanced courses in Clinical Practice in their Mental Health Concentration in the Department of Adults and Healthy Aging.  Perspective in working with gay men who are living with HIV from over 26 years of successfully living with HIV and 9 years as Chair of the Los Angeles County HIV Mental Health Task Force.  Published in academic journals and books regarding homelessness, mental illness, gay men’s mental health, HIV mental health, and healthy aging.  National-level speaker on these issues.  Expert witness experience on gay men’s mental health legal cases.  Over 18 years experience supervising California MFT Interns and Associate Clinical Social Workers in private practice, as well as experience as a Field Instructor for the MSW programs of USC, UCLA, and California State University  – Long Beach.