Appointments

Please visit an individual therapist’s web page to make an appointment.

• Meredith Gardner

• Madeline Cramer

• Amber Utter

• Judy Gardner

• Marjie Ruhl

For your first appointment, please arrive 15 minutes early. If you haven’t already registered, we’ll ask you to provide some information. You may wish to provide some background on your area of concern, any treatment you have received and a list of medications you are taking. You will also need a photo ID and a method of payment. Forms can also be downloaded here and brought completed to the appointment.

We’re honored that you have chosen us to serve you and look forward to meeting you.

Contact us

If you would like to make an appointment, please schedule with one of the individual therapists listed above. If you have a non-appointment related question, you can send an email using the form below or call the specific therapist at their number on their individual page.

Billing

Payment for services is due at the time of the session. For your convenience, we accept cash, checks, most debit and credit cards, Flexible Spending Account (FSA), and Health Savings Account (HSA) cards.

Understanding your financial options for counseling services

We do not participate in insurers’ approved networks (also called insurance panels). However, we can provide documentation for clients to submit claims on their own.

We don’t want you to have any surprises, so please understand that filing a claim with your insurer does not guarantee reimbursement. Your benefits reflect the contract between you and your insurer. If you have not done so, make sure you understand your coverage including copays, deductibles and coinsurance. We recommend contacting your insurer before your first session to determine your out-of-pocket responsibility.

You almost always have a deductible. This is the amount you are expected to pay out-of-pocket before your insurance covers anything. Make sure you know what it is. If your deductible is high, you might be able to self-pay for several therapy visits before your deductible is met.

Your insurance may not include mental health benefits. If you do have coverage, you may have an entirely different policy or insurance provider for mental health. Make sure you speak with the right company in order to get accurate information.

Pros and cons of using insurance for counseling

It’s natural to want to maximize the use of your insurance. After all, you pay for some or all of it. However, the reality is not quite as simple. We want you to have all the facts and to be an informed consumer.

When you start your search for a mental health provider, you’ll quickly find that many counselors, and a growing number of psychiatrists, do not participate in insurance referral networks (they are not on insurance panels). You owe it to yourself to consider why some of us avoid managed care.

Third-party involvement

Whenever there is third-party involvement, confidentiality is out of the control of the therapist. Information about the content and progress of treatment is required on every claim. The insurance company does not spell out how they will communicate that information or protect you. Once information enters the company computers, others have access to your personal information.

Every insurance claim must include a diagnostic code. That is like saying everyone who sees their general practitioner must be diagnosed with a cold, at least, when they may or may not have one. Therapists use the Diagnostic Statistic Manual for Mental Diagnosing (DSM). Though the DSM provides guidelines for diagnosis, coding by the practitioner is somewhat subjective. We collaborate with our clients when giving a diagnostic code, but not all providers discuss the diagnosis with their clients. Since you generally don’t see the complete filing of your claim, you might want to ask about the diagnosis before it becomes part of your permanent record.

Limiting therapy

Insurance companies often limit the number of sessions they will cover. This cutoff may occur before you are ready to end therapy. People are different and there is no cookie-cutter plan for everyone. It’s better for individuals – not insurers – to decide when to conclude therapy.

Documenting a diagnosis

When managed care (insurance) is involved, a diagnosis could be less or more severe than if the client self-pays. Therapists usually know which diagnostic codes insurance covers and which are more questionable. Though all clinicians use the DSM for diagnosis, the use of a specific code is still somewhat subjective.

Most insurance policies do not cover couples counseling. This is considered a V-Code, which is generally excluded from the list of covered services. Most of us know that poor relationships contribute to anxiety or depression. However, this is excluded from most policies.

Potential conflict of interest

A therapist on an insurance panel is working for both the client and the insurance company. This is a potential conflict of interest. When therapists receive referrals from the insurer, they need to remain in good standing and work within the parameters of managed care. Occasionally, even out-of-network providers are asked about a client’s treatment.

In addition, it is difficult for therapists to maintain a quality practice based on the low reimbursement that insurance companies usually set for counselors. Instead of spending time and energy on the extensive reporting required to file insurance claims, we prefer to be caring for you directly or investing in ongoing professional development.

We hope this information has been of value as you consider therapy options.

Additional considerations

If you are considering using your insurance for psychotherapy (counseling), it may be useful to ask your insurer or human resources department to clarify policies regarding managed care, coverage for therapy, and how confidentiality is preserved.

Counseling is a long-term investment in yourself. As you weigh the cost, it is important to consider the life goals you have not yet reached. These may include your goals as they relate to work, relationships, or simply day-to-day quality of life. Because psychotherapy can help you make choices that will affect your entire future, it can be thought of as an investment in yourself that is on a par with education or other forms of self-development. The positive effects of counseling last a lifetime. Only you can decide whether the potential gains will compensate for your investment in money and time.

Managed care companies prefer you to work with their approved providers. However, many managed-care policies will allow you to use an out-of-network therapist. Usually, insurers reimburse you at a different rate for approved providers versus out-of-network providers. Using an out-of-network provider may be an option for you; just understand that your reimbursement may be lower.

There are several reasons many people pay for counseling services out-of-pocket rather than using insurance coverage:

• Insurers limit services to the minimum “necessary” treatment (and they define what this means).

• Confidential and privileged information must nearly always be given to the insurance company in order to have services approved.

• Counseling can be delayed or interrupted due to insurance decisions.

Insurers often initially deny payment for counseling, even when the use is fully legitimate. Approval is based on “medical necessity,” which they define and determine. The client and counselor are then required to prove there is a need for counseling that is directly related to the client’s health. Although there is an appeal process, it can be tedious, time-consuming, and stressful for the client.

Insurance payments for counseling nearly always require assigning a diagnosis of a mental health disorder. Many appropriate uses of counseling do not involve an actual mental health diagnosis. For example, counseling for family problems, marital difficulties and adolescent angst are often not covered by insurance unless the behavior becomes serious or is considered part of a more severe mental health disorder. When a legitimate mental health disorder is diagnosed, it becomes part of the client’s permanent medical record and may have future implications (difficulty changing insurance, ineligibility for certain jobs, denial of life insurance, etc.) This is especially concerning when it involves children or adolescent clients.

If you need or want to change insurance companies in the future, your rates may be higher (or you may be denied insurance) due to your medical record showing a history of using insurance for treatment of a mental health disorder.

No Surprise Act

In 2021, Congress and the Departments of Treasury, Labor, and Health and Human Services issued a host of new rules that aim to improve healthcare cost transparency and encourage consumer agreement. Click here to learn more about the No Surprise Act.