FAQS

Nix Baker Wellness & Therapy is a boutique practice designed to provide high-quality mental health services and an elevated customer experience with a mental health provider.

You can expect:

• A free 15-20 minute initial phone or video consultation where we discuss your concerns and what you are looking for in therapy. This is a great time to ask questions and ensure we are a good fit.

  For Couples: The clinician will need to receive a call/text/email/online contact request from both partners. Each partner should expect an individual free 15-20 intake call with the clinician.

• If you choose to schedule, we will pick a time during the initial phone or video consultation. The clinician or other office staff will send you our paperwork via our client portal. This needs to be completed at least 24 hours before your first appointment, or your appointment may be canceled.

• Our first meeting in -person or by telehealth will typically be 1 hour to 1 hour and 15 minutes. This first session is about getting to know you better, understanding your history, and really digging into your concerns and goals. This session may not feel incredibly productive, but it is an important part of building a strong, lasting therapeutic relationship necessary for significant progress. Many of our clients leave this first session feeling heard, seen, lighter, and hopeful, having a safe and non-judgmental space to share their stories. During this first session, your clinician will review confidentiality and relevant practice policies and clarify billing. You will also discuss any relevant impressions and recommendations about frequency and treatment.

  For Teens: The first session is almost always a parent sessions

  For Couples: Typically, the first session is with both partners, unless otherwise discussed with your therapist. We obtain individual and relationship histories, discuss concerns, and create shared goals. Confidentiality, practice policies, and billing are reviewed. Your clinician will provide you with recommendations about frequency and treatment. Please note that individual sessions may be recommended in an effort to gain each person’s perspective.

  Discernment counseling has its own treatment trajectory. You can check out more information on Discernment therapy here——> Discernment Therapy Info

• After the initial assessment, you will schedule regular appointments with your clinician on a “semester” basis. You and your therapist will decide on the frequency and length of your sessions. In the initial stages, more assessment may be necessary to really understand the initial concerns. You and your therapist will work towards building that strong therapeutic relationship. Sometimes, there is homework or activities outside of the appointment time. Sometimes you and your therapist are looking at building insight or noticing patterns of behaviors that are helpful or unhelpful. Through the activities, insight, and building of coping skills, we hope to help you move toward the happiness you want and deserve. Some types of therapy provided by Nix Baker Wellness do have more strict treatment plans. if this is warranted, your clinician will discuss this with you individually.

Clinicians are eclectic and integrative therapists, meaning that they have training in different kinds of therapy to provide you with a dynamic and individualized treatment plan based on your specific goals and needs. Clinicians tend to be more active in sessions to help you reach your goals.

Depending on your goals, concerns, or diagnosis, different forms of therapy may be helpful. For example, Exposure and Response Prevention is the gold standard treatment for OCD and is provided to clients diagnosed with OCD.

How long you attend therapy is completely dependent on your concerns, goals, and needs. Your clinician will make recommendations after your initial assessment and over the course of therapy. The goal is not to be in therapy for forever. We want you to learn coping skills, build insights, shift thoughts and behaviors, and empower you to live the way you want without us!

We do have some clients who attend therapy in different forms on a more long-term basis. However, some clients attend therapy on a more short-term basis.

Client attending Exposure and Response Prevention Therapy, Cognitive Behavioral Therapy, and other therapies for Anxiety, OCD, and Phobias typically come in for 17-30 sessions and depends on individual goals and progress over time.

Discernment therapy for couples is typically 1-5 sessions.

Supportive Parenting for Anxious Childhood Emotions (SPACE) is typically a more short therapy. Parents may attend 10-30 sessions based on goals and progress over time.

Nix Baker Wellness & Therapy is not like other therapy practices. We mean it when we say we want to meet you where you are in your life and growth. Your clinician will make recommendations regarding frequency based on your initial consultation, initial assessment, and ongoing assessment throughout your time together.

Typically, it is recommended to meet weekly in the beginning to build a strong relationship. Having a good relationship with your therapist is key, and time together can help to strengthen the relationship. However, meeting weekly may be challenging in your life for many different reasons, so if you would like to meet at a different frequency, please discuss this request with your clinician. It is important to know that progress and growth towards your goals are often slowed if you space sessions out or come to therapy less frequently. There may be additional risks to attending therapy less than what is recommended. Your clinician can talk with you about your individual treatment plan and associated risks specific to your treatment.

Attending therapy sessions more frequently may be recommended by your clinician or you may desire to attend therapy more frequently for a time period. Discuss this with your clinician! We work hard to be flexible and dynamic to meet your needs.

Over time, clients often taper to less frequent sessions. You and your clinician will talk about this throughout your time in therapy and work together to determine the appropriate frequency based on where you are with your treatment goals.

Couples

Couples have different options for frequency. Based on your needs, your clinician will recommend frequency and discuss options for session length and frequency. We do require that clients plan for sessions that are at least 1 hour in length (versus 45 minutes for individual sessions). Couples may opt to meet once per week or bi-weekly. It is important for the couple and the therapist to build a strong relationship. This may take longer if sessions are less frequent.

We also provide options to meet at different frequencies but for longer periods of time. An example may be 1.5-2 hours every other week. Talk to your clinician about your needs! We will try to work with your schedule.

Certain types of couples therapy or counseling have more strict guidelines around frequency, session length, and amount of sessions. An example of this is discernment therapy. Please discuss these guidelines further at your consultation call so that you know what to expect.

Groups

Groups typically have a required commitment to sessions that are scheduled on a weekly, bimonthly, or monthly basis. The commitment and group meeting times will be predetermined and communicated once you have committed to the specific group.

Nix Baker Wellness and Therapy is an “Out-of-network” provider. The practice does not accept any insurance. Nix Baker Wellness & Therapy accepts credit cards, HSA, flex spending accounts, cash, or checks. Telehealth appointments require a credit card on file. If requested, your therapist can provide a detailed invoice of services received. 

We can (and will) assist with helping you receive reimbursement from your insurance by providing you with the documents and codes necessary for you to utilize these benefits that are associated with many health plans. Many of our clients who need or want reimbursement often receive 50-100% reimbursement for sessions. There may be a deductible associated with your out-of-network benefits that you must meet. We encourage you to contact your insurance to understand your benefits, deductible, and reimbursement rates. Our clinicians can assist you with this information upon request.

Nix Baker Wellness & Therapy wants our clients to make informed decisions about their treatment and care. Our clients are a top priority, and we like to explain why we are a self-pay practice to help you make the right decision for your life.

WHY DO WE PREFER SELF-PAY AS A COUNSELING PRACTICE?

At Nix Baker Wellness and Therapy, we focus on our client's well-being! We encourage our clients to consider self-pay because insurance is not always the best option. Therapy is an investment in yourself, and our clinicians want the treatment journey to reflect your investment and focus on you. Below are a few of the more critical considerations that are often not discussed when billing insurance:

1. YOU COULD BE SACRIFICING CONFIDENTIALITY 

Your therapist must provide a diagnosis and treatment notes to the insurance company for them to pay for sessions. Privacy is an essential aspect of the therapeutic relationship. We aim for you to feel that the information you provide to us is confidential so that you can be open in your therapy session. The ability to be open is essential to see the most significant benefit. Providing this information to the insurance company weakens your privacy. In addition, it is unclear who sees this information, how it is used, and how it is stored for future use. 

2. INSURANCE OFTEN REQUIRES CLINICIANS TO INPUT A DIAGNOSIS (WHETHER NEEDED OR NOT) AND WE DO NOT KNOW HOW THIS DIAGNOSIS IS USED LONG TERM.

Insurance companies operate on a medical model. When working with insurance, a therapist must assign you a diagnosis even when there may not be a diagnosis that fits your situation. A therapist will also have to prove "medical necessity". This model does not allow for the following common reasons for treatment: relationship issues (couples or family therapy), developmental/attachment trauma, existential issues, life transitions, personal development, or self-improvement. Since the diagnostic manual (the DSM-V) does not include these common reasons for treatment, a therapist may have to give you a less accurate diagnosis that becomes part of your medical record. As mentioned before, we do not know how this information is stored or used in future considerations of your healthcare. 

3. INSURANCE INFLUENCES YOUR TREATMENT PLAN SIGNIFICANTLY

Insurance companies try to dictate treatment by setting or limiting the number of sessions, how often you meet with your therapist and the type of care provided for the client. At Nix Baker Wellness& Therapy, we strongly believe you and your counselor should make these choices. When you self-pay, you have the flexibility you need for your care to seek the most significant benefit. 

Our clinicians acknowledge that our clients' concerns, stories, and lives are unique and unpredictable. We want to be able to cater our treatment to individual needs and goals. For example, an individual may begin counseling to address recent feelings of anxiety but suddenly lose a family member; in this scenario, we would shift our treatment plan to include grief to suit your present needs. 

SO, WHAT ARE THE BENEFITS OF SELF-PAY?

No labels or unnecessary diagnosis- You do not need to carry an unnecessary and possibly inaccurate diagnosis on your medical record. 

Confidentiality- Your therapy is between you and your counselor. As our privacy policy states, you choose whom to share information (if anyone at all), and your session notes remain private and unshared. 

Autonomy- You are in charge of your treatment. You and your therapist will determine how many sessions, how often, and the goals you want to accomplish without outside pressure or influence.

Quality personalized care and attention- The back and forth between the therapist and the insurance company is time-consuming. Without this obligation, we can focus more on you and your treatment and be more available to answer your questions and phone calls between sessions. 

SELF-PAY and Reimbursement

Self-pay clients typically prefer to keep their information confidential. However, you can ask for reimbursement for your sessions using out-of-network benefits. As mentioned previously, please call your insurance to confirm your benefits. If requested, Your therapist can provide you with a"superbill" that you can use to ask for reimbursement. This will provide you with all the information insurance needs for reimbursement. Many insurance companies require dates of service, diagnostic codes, length and frequency of sessions, and may even ask for therapy notes. Again, keep in mind your tolerance for potential lack of privacy and confidentiality. 

Ultimately, we want you to make informed decisions about your mental health care. We are very happy to help you navigate your benefits, so reach out!!!

Nix Baker Wellness has a 48-hour cancelation policy. If you cancel your appointment within the 48-hour window or no-show your appointment, you will be charged the full fee for your appointment.

A late cancel or no-show appointment impacts you, your therapist, and another client who may need an appointment. Therapy sessions are scheduled typically by semesters, allowing the therapist and client to reserve a regular appointment that is mindful of your time and the therapist’s time. When a session is canceled without adequate notice, we cannot fill this time slot.

Clinicians are accessible by text, call, email, and client portal and try to respond to all requests in a timely manner during typical business hours. If you have an emergency, please contact your clinician immediately.

The only exception to our policy is in the event of serious or contagious illness. Other examples of an emergency may include a death, car accident, or extreme illness in your family. In these instances, telehealth can be an option for services if it is needed or appropriate for you. We offer one “no-fee cancelation” for these events in a 6-month period. Examples that may not be included in our exception include work-related scheduling issues, extracurricular-related scheduling conflicts, childcare conflicts, or forgetting about your appointment. We want to provide grace and understanding, so please contact your clinician if there is an issue regarding your appointment. Communication is key in navigating scheduling!

You will receive reminders 48 hours before your session and 24 hours before your session.

Clinicians are people too. There are times when emergencies arise for clinicians as well. We will try to provide you with the same courtesy regarding cancelations as we are asking for you. Sometimes this may be challenging, but we will do our best (as you would) to communicate as quickly as possible regarding any scheduling issues.

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. MY PLEDGE REGARDING HEALTH INFORMATION:

I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:

• Make sure that protected health information (“PHI”) that identifies you is kept private.

• Give you this notice of my legal duties and privacy practices with respect to health information.

• Follow the terms of the notice that is currently in effect.

• I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures, I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.

For Treatment Payment or Health Care Operations: Federal privacy rules (regulations) allow healthcare providers who have a direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any healthcare provider. This, too, can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the clinician in the diagnosis and treatment of your mental health condition.

Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers, and referrals of a patient for health care from one health care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

Psychotherapy Notes. I do keep     “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any     use or disclosure of such notes requires your Authorization unless the use or disclosure is:

a. For my use in treating you.    

b. For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.

c. For my use in defending myself in legal proceedings instituted by you.

d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.

e. Required by law and the use or disclosure is limited to the requirements of such law.

f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.

g. Required by a coroner who is performing duties authorized by law.

h. Required to help avert a serious threat to the health and safety of others.

Marketing Purposes As a Psychotherapist:

I will not use or disclose your PHI for marketing purposes unless you provide specific and distinct permission to do so. If you voluntarily leave a review or comment on an external website (Google, psychology directories, Yelp, etc). I also have social media. If you choose to follow those social media accounts, others may see your name or other personal information about you.

You are opening yourself up for privacy disclosure by leaving comments, reviews, or following social media accounts. I do not take responsibility in the event that you voluntarily engage in these behaviors.

Sale of PHI as a psychotherapist:

I will not sell your PHI in the regular course of my business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION.

Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:

1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.

3. For health oversight activities,     including audits and investigations.

4. For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.

5. For law enforcement purposes, including reporting crimes occurring on my premises.

6. To coroners or medical examiners, when such individuals perform duties authorized by law.

7. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.

8. Specialized government functions, including, ensuring the proper execution of military missions such as: protecting the President of the United States, conducting intelligence or counter-intelligence operations, or, helping to ensure the safety of those working within or housed in correctional institutions.

9. For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers’ compensation laws.

10. Appointment reminders and health-related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other healthcare services or benefits that I offer.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

Disclosures to family, friends, or others:

I may provide your PHI to a family member, friend, or another person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

1. The Right to Request Limits on uses and disclosures of Your PHI.

   You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.

2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full.

   You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

3. The Right to Choose How I Send PHI to You.

   You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and I will agree to all reasonable requests.

4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes”.

   You have the right to get an electronic or paper copy of your medical record and other information that     I have about you. I will provide you with a copy of your record, or a     summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost-based fee for doing so.

5. The Right to Get a List of the Disclosures I Have Made.

   You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an     Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request.

6. The Right to Correct or Update Your PHI.

   If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.

7. The Right to Get a Paper or Electronic Copy of this Notice.

   You have the right to receive a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. This notice is also available in your client portal at all times.

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.  Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.  

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.

You can ask your healthcare provider and any other provider you choose for a Good Faith Estimate before you schedule a service.  

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. 

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

Nix Baker Wellness and Therapy provides a Good Faith Estimate to all clients, as we are out-of-network providers. This can be provided to you at the time of scheduling. All fees are shared transparently in our practice paperwork and require acknowledgment and signature from clients and those responsible for billing.