What is a Virtual Business?

Bloom Behavioral Health is a virtual business meaning all counseling services by Megan Neitling, LMHC, CST are provided online via TeleHealth.

All therapy sessions are held virtually from the comfort of your home or your work office using a secure and HIPAA compliant video platform. 

What is Online Therapy? 

Online Therapy can involve providing a range of services including Mental Health Therapy (individual therapy, marital therapy, group therapy), Sex Therapy, or Sexualities Education. Online Therapy involves direct interaction between a Mental Health professional and the client through an online video platform.

What are the Benefits to Online Therapy?

• Convenience & Scheduling Flexibility: If you’re too busy to maintain traditional in-person therapy sessions, Online Therapy is the solution! If adding one more appointment on the calendar feels too overwhelming or just impossible, virtual therapy alleviates that barrier to care.  With Online Therapy, there is no more commuting to the office, no more rushing around in traffic, no need to take a longer lunch break to squeeze in your therapy session, no need to arrange a babysitter or childcare, and no time wasted sitting in a waiting room.

• Couples Counseling Benefits: You and your partner/spouse no longer need to be in the same physical space for therapy! You can be in your own personal spaces (work, home, office, etc.) and call into the same HIPAA compliant TeleHealth Video session.  Virtual, or Online, Therapy is great for Couples that want to work on their relationship but can’t be together in the same space.

• Increased Privacy: Online Therapy eliminates the possibility of someone you know seeing you in the waiting area of therapy office or leaving the office.

• Provides a Safe Space: Online Therapy allows therapy to be conducted in any private location (home office, private work office, bedroom, car, living room, etc.) When therapy is utilized in your own space, clients report feeling more comfortable which improves their ability to discuss and process sensitive or difficult topics.

• Access to Specialized Therapy: Online Therapy can be conducted from anywhere within the state of Indiana. People over the state of Indiana have access to Mental Health Therapy, Sex Therapy, and Sexualities Education. Since there are so few Certified Sex Therapists in the state, more folx can receive treatment.

• Same-level of Care: No client outcome difference was found between online appointments and face-to-face office visits. Online Therapy provides the same same clinical skills, clinical knowledge, resources, and expertise as an in-person session provides.

• Some Cost Reduction: Nearly all research suggests that Online Therapy saves money when compared with traditional in-person approaches to Mental Health care. For clients, this often means lower transportation costs, less time missed from work, and less money spent on child care expenses.

• Accessibility:  Anyone living in the state of Indiana can become a client at Bloom Behavioral Health with virtual services. Online Therapy is also an option for people experiencing limitations with reliable transportation or access to specialized care. Online Therapy allows accessibility for people with chronic illnesses or physical disabilities. Accommodations to TeleHealth can be made for clients that are hearing impaired, visually impaired, or deaf.

Is Online Therapy Effective? 

Research has extensively studied the effectiveness of video-based therapy. There is no difference between online therapy versus traditional in-person therapy. When Megan began providing Online Therapy, they quickly realized clients were more comfortable during video sessions than they were in the office. Online therapy allows clients to feel safe and secure from the comfort of their own home or office, which often increases the rate of the client’s emotional growth. This personal growth often results in meeting their therapy goals! Also, when sessions are held from your home, your pets get to join the session to provide emotional support!

How Much Does an Online Therapy Session Cost?

Online Therapy provides clients the same clinical skills, clinical knowledge, resources, and expertise as an in-person session provides. Thus, Online sessions are the same rates an in-person AASECT Certified Sex Therapist and Doctoral level clinician charges in Indiana. You can find my Rates listed on this F&Qs page.

Is Online Therapy Secure? What Can I Do If I’m Concerned About Privacy?

Bloom Behavioral Health assures clients that all video sessions are held to the highest possible level of confidentiality. For this reason, Bloom Behavioral Health uses a secure video platform that protects clients information. Once your appointment is scheduled, a unique video link is sent to you. This link will open the video session that is HIPPA compliant, meaning that the video platform has the highest standard of protection in the healthcare field.

To protect privacy, Bloom Behavioral Health recommends having a private space available to use during your online sessions. Other options to help increase your privacy are: 1) use a headset instead of the phone or computer speakers, 2) utilize a white noise machine outside of the room you’re in [If you have an Amazon Alexa or Google Home, ask it to “play white noise”], 3) Sit outside if the weather is nice or sit inside your car.

How Do I Know If Online Therapy is Not Right For Me?

That is truly a personal choice to determine if Online Therapy is the right fit for you. However, Bloom Behavioral Health asks clients to try Online Therapy for the first session. Then, if we decide it is not a good fit, referrals can be made to in-person therapists. Many clients that were initially hesitant about Online Therapy discovered they felt comfortable having therapy online and found it more convenient for their schedules. However, Online Therapy is NOT an appropriate treatment method for clients with chronic suicidal or homicidal thoughts or clients that are in a crisis situation.  Any client that is in immediate crisis should call 911 to receive immediate help or go directly to the nearest emergency room

Online Therapy (TeleHealth) in Indiana 

An Executive order was made in Indiana that stated all licensed mental health professionals within the State of Indiana are permitted to conduct their work via TeleHealth. Executive Order 20-05.

As added by P.L.185-2015, SEC.25.

http://iga.in.gov/legislative/laws/2019/ic/titles/027#27-8-34

Session Length

Sessions are 50 minutes in length.

Extended sessions times are available upon request for an additional pro-rated fee. 

*Please Note: Some Out Of Network Insurance Benefits do not reimburse for extended therapy sessions (60+ minutes), and as such, it is typically considered an out-of-pocket expense.

Business Hours

*Monday, *Tuesday, *Wednesday,  *Thursday or *Friday 10am to 2pm 

*Indicates a rotating schedule. Clients will be notified 4-6 weeks in advance which days of the week are available for scheduling services.

Please Note: 2:00 pm is the latest available session time each business day. 

Just like when scheduling with other Healthcare or Mental Health Specialists, clients may need to adjust their own schedules to receive Sex Therapy or Sexualities Education during Bloom Behavioral Health’s regular business hours. 

Rate Per Session

Phone Consultation [15-Minutes]: FREE

Intake Session* [50-Minutes]: $210

Therapy Session [50-Minutes]: $185 

Clients pay the full session rate at the time of service.

*For Individual therapy, the 1st session will be charged at the Intake Rate.

*For Couples/Partners therapy, up to 3 sessions may be charged at the Intake Rate. The 1st session is the couples/partners Intake. If the Couple agrees to have Individual sessions as a part of the Sex Therapy Intake process, the  2nd and 3rd sessions will be charged at the Intake Rate. Then, the 4th session, or subsequent sessions after the Intakes are completed, will be charged at the Standard Rate.

Bloom Behavioral Health’s rates are commensurate to AASECT Certified Sex Therapists, Sexuality Educators, and Doctoral level clinicians. Bloom Behavioral Health is unable accept rates below the usual, customary, and reasonable (UCR) rate for these specialty mental health services. 

Accepted Payment Methods

Bloom Behavioral Health accepts Credit or Debit (Visa, MasterCard, American Express, Discover),  Health Savings Account (HSA), and Flexible Spending Account (FSA). 

What is a “Good Faith Estimate” (GFE)?

Effective January 1, 2022, a ruling went into effect called the “No Surprises Act” which requires practitioners to provide a “Good Faith Estimate” (GFE) about out-of-network care.

The Good Faith Estimate works to show the cost of items and services that are reasonably expected for your health care needs for an item or service, a diagnosis, and a reason for therapy.

Under Section 2799B-6 of the Public Health Service Act (PHSA), health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request, or at the time of scheduling health care items and services to receive a “Good Faith Estimate” of expected charges.

• Please Note: The PHSA and GFE does not currently apply to any clients who are using insurance benefits, including “out of network benefits” (i.e., submitting superbills to insurance for reimbursement).
• If you plan to submit a Superbill, or use Out Of Network benefits for any services rendered by Bloom Behavioral Health, you can disregard the GFE.

How Do I Download My GFE?

Click here to download your GFE from Bloom Behavioral Health.

*The GFE will open in a new window.

How Do I Complete My GFE? 

To complete your GFE from Bloom Behavioral Health, download the GFE using the link above.

Then, carefully read the GFE and fill in all of the required fields with a red asterisk (*).

Once completed, your GFE is ready to keep on file for your records.

How To Request An Appointment

Send an appointment request via email using the “Contact” feature below or through the “Contact” page on the website.

Please note, there is a high demand for Sex Therapy services. Availability for services is not guaranteed upon request. If Megan is not currently accepting new clients, referrals can be provided. 

Expecting A Response from Bloom Behavioral Health

Please check your spam or junk folder to ensure you don’t miss an email response. 

Megan will reply to your email during Bloom Behavioral Health’s business hours.

*It may take up to 5-7 standard business days to receive a response. Megan only replies to emails when in the office.

Scheduling Via Phone

Megan offers free 15 minute phone consultations for potential new clients. This call must be schedule via email as Megan is not readily available for phone calls during, or outside of, business hours. 

*Please note: Phone calls do not typically exceed 15 minutes. Phone calls will consist of the following: discuss what is bringing you to therapy, review session fees, review accepted payment methods, and discuss the required intake paperwork. Then, we will discuss how to schedule your initial session.  

All therapy sessions are confidential. Confidentiality means that protected information about a client, including the information a client shares in therapy, cannot be disclosed to others without written consent from the client.

There are exceptions where the clinician must break confidentiality:

1. Suspicion and/or knowledge about any form of child, elder, or dependent adult abuse. [This includes currently or previous viewing, storing, taking, or distributing child pornography or engaging in non-consensual sexual activity.]

2. Threatening to harm other person(s).

3. Threatening to harm yourself.

4. If there is perceived danger to the health of others if the client is a carrier of a communicable disease. This means, if the client engages repeatedly in a behavior that transmits a dangerous communicable disease or indicates a careless disregard for the transmission of the disease to others [defined by by the state department IC 4-22-b].

If any of these exceptions to confidentially occur while a client is in treatment or requesting treatment, confidentiality will be broken and appropriate measures will be taken to ensure the safety of the client and others.  

No, We Do Not Accept Insurance 

Bloom Behavioral Health does not work with, or bill, insurance companies directly because Megan Neitling, LMHC, CST is a Specialist in Sex Therapy and Sexualities Education. Session fees are due in full at the time of service. 

Bloom Behavioral Health believes you should know 10 potential risks to using Insurance for therapy. So, if you are curious to know more about the reasons we do not accept insurance, and the 10 risks, please read below. 

1) As an AASECT Certified Sex Therapist, Megan does not wish to label or diagnose sexual concerns, gender, or mental health as “dysfunctional” or “pathological”. If Megan were to accept insurance or submit claims directly to insurance a mental health diagnosis, or sexual health diagnosis, is required.

2) Often, when Couples seek Sex Therapy, they are trying to improve their sexual health or sexual relationship. In order to use Insurance, one person in the relationship must have a “diagnosis” or “disorder”. In Couples Therapy, when there is a “diagnosis”, the Insurance requires the therapist to treat the “diagnosis”, not any other concerns. In Sex Therapy, we are not just treating a “diagnosis”.

3) Any “diagnosis” given would stay in your medical history indefinitely as a pre-existing condition. A mental health or sexual health diagnosis may impact the ability to obtain life insurance, obtain health insurance, or to get certain jobs that require background checks or medical records.

4) Insurance companies can limit the number of therapy sessions you are allowed to receive and the length of time each sessions lasts.

5) Insurance companies can determine the type, or method, of treatment that is “covered” to treat the “diagnosis”. The insurance companies preferred treatment method is directly tied to the diagnosis provided. This limits the therapists’ ability to provide specialized care to the client.  Megan wants to work directly with the client(s) to determine the best treatment options and not have insurance, or a third party, involved in the process. 

6) TeleHealth is not covered by all insurance plans. Thus, insurance companies may not allow all clients to have access specialized therapy services. 

7) Your insurance company determines what Therapy treatment is “medically necessary”. This means Sex Therapy, Couples Therapy, or Sexualities Education may not be a covered “medically necessary” service. 

8) You likely have a deductible that needs to be met before the insurance company will pay for some of the session fee. This means you will likely be paying out of pocket for Therapy until your deductible is paid for the year. 

9) If an Insurance service claim is denied, the client is still responsible for the fee of the service. Folx can be surprised when they receive a large bill for hundreds of dollars after having 4-6 sessions denied by Insurance. This large bill occurs because Insurance takes 3-6+ weeks to process a single claim and return the payment information to the Therapist. Haven’t you received a large, or unexpected, medical bill in the mail weeks or months after going to the doctor or ER? The same principal applies here with Therapy and backed up Insurance claims. However, being self-pay allows clients to pay at the time of service and know exactly what you will pay for each session. 

10) When you use insurance, including submitting a Superbill for Out of Network reimbursment, there are increased risks to the confidentiality of your clinical notes, treatment plan, diagnosis, and therapy records. The insurance company will have access to your entire therapy record, if requested. Since Sex Therapy and Sexualities Education is sensitive and private in nature, Megan has chosen to not accept insurance to protect the client’s confidentiality.  

Superbills

Knowing the risks to submitting claims to Insurance, clients can request a Superbill. 

A superbill is a detailed receipt of the client’s Therapy session.

Clients will submit the SuperBill directly to their Health Insurance Company. If the client has Out-Of-Network Insurance benefits, they may be reimbursed directly from the Insurance Company for a percentage of the session fee, based on what their plan allows, if applicable. 

Your Out Of Network Benefits may require a deductible to paid before any reimbursement begins. Once your deductible is paid in full, the insurance company may reimburse a rate different than Bloom Behavioral Health’s full session rate, which is called the “allowable amount”.  Some companies may reimburse 80-100% of mental health services, which means the client will pay for any portion of the session fee your insurer does not reimburse.  Contact your insurance company by phone to ask about your Out of Network benefits.

When you call to verify your Out of Network benefits with your Insurance carrier, you may want to ask: 

• How much is my Out of Network deductible? How much of the Out of Network deductible have I met this year? 
• Verify, do you cover CPT codes 90847 and 90837?
• What percentage, or dollar amount, is allowed for reimbursement per session for the CPT codes 90847 (Couples/Family Therapy) and 90837 (Individual Therapy)?
• Do you reimburse for the diagnostic code Z63 (Relational Distress with a Spouse/Partner)?
• Do you reimburse for TeleHealth sessions (Modifier 95: TeleHealth & Location 02: TeleHealth)?
• Is there a limit to how many sessions are allowed per year?
• Do I need a prior authorization, or a referral, from my Primary Care Physician or other professional?
• What is the process of submitting the Superbill to obtain Out of Network reimbursement from my Insurance?

Reasons for Denied Out Of Network Benefits

You do not have Out of Network benefits for your Insurance plan. 

You have not yet met your Out of Network deductible for the year. This means you will pay out of pocket and continue submitting your Superbills. Once you have paid your deductible, your Insurance may begin reimbursement, if allowed. 

Some services, including Couples/Partners Therapy, Sex Therapy, or TeleHealth may not be covered by Insurance as a “medically necessary” service when claiming Out Of Network Benefits.

Additionally, insurance may not cover the DSM Diagnostic Code Z63.0 (“Z63.0: Counseling for Marital and Partner Problems”). Most often, it is the Diagnostic Code that causes a claim to be rejected or denied for reimbursement. Bloom Behavioral Health will only use a diagnosis that fits the client’s presenting clinical concerns. Bloom Behavioral Health will not engage in unethical or fraudulent insurance billing. As a result, services may be considered an out-of-pocket health-care expense and may not eligible for reimbursement from your Insurance company.

Clients are liable to pay the full session fees at the time of service and clients are required to pay for services rendered, regardless of Out of Network Benefits.