Investment

Individual Counseling:

Intake/Assessment: $225

50-minute Session: $175

80-minute Session: $250

110-minute Session: $325

EMDR Intensive*: Inquire within for rates.

*EMDR Intensives are scheduled according to need and can take place over the course of days or a week, with sessions often lasting longer than 2 hours in length.

Payment Forms:

We are private pay.

We accept cash, credit cards, debit cards, and HSA/FSA cards.

All payments are due at the time of service.

Insurance:

Insurance companies often enforce limitations of care that do not benefit the client or the clinician, including limiting the number and length of sessions.

Private pay benefits you as a client. It allows for the maximum level of privacy, as your healthcare information will not be shared with any third parties (insurance companies) and a diagnosis is not always necessary.

Therefore, we choose to not work directly with insurance.

However, our counseling services may qualify for OUT-OF-NETWORK reimbursement, for health insurance policies including this benefit. We will gladly provide you the documentation necessary for you to submit for reimbursement, per your request. Please contact your insurance provider for their reimbursement policies and rates.

Cancellation Policy:

Life happens! Schedule changes can be made free of charge if your counselor is given a minimum of 48 hours notice.

To honor your and your counselor’s time, late cancellations (less than 48 hours notice) or missed appointments are charged the full session rate.

Sliding Scale Rates:

We know that not everyone can afford the current market prices for counseling services. It is important to us as practitioners to provide affordable and accessible counseling for all.

We provide a limited number of sliding-scale rates for those who qualify. Please inquire within.

Additionally, you may qualify for sliding-scale rates through Open Path Collective at https://openpathcollective.org/clinicians/shannon-kratky/.

No Surprises Act**:

**Information regarding the No Surprises Act and Good Faith Estimates are required to be listed on our website, in our offices, and within our paperwork completed at intake. Please note: As far as we can see at this point, none of the requirements within the "No Surprises Act" will not impact what we have actually been doing and will do in our counseling sessions. We fully anticipate that we will be able to continue without any interruptions.

In December 2020, Congress passed the "No Surprises Act." On September 30, 2021, Congress passed revisions for the "No Surprises Act." It was mainly intended to reduce unexpected medical bills for patients (as example: you have emergency surgery that is covered by your insurance and then receive a large bill from the anesthesiologist, who turns out to be out-of-network for your plan). This law went into effect January 1, 2022. Some information about this law and requirements and how they relate to private practice psychotherapists just became widely available on December 31, 2021. Our professional associations, did not even realize the implications until the last week of December (2021). It is apparent that most of the hundreds of thousands of therapists and counselors affected across the country, myself included, only found out about this law via Facebook and/or word of mouth! Please note that this Act and the requirements within are still a work in progress for therapists and counselors in private mental health counseling practices, such as Courageous Story Counseling, PLLC and the counselors within.

The basics requirements of the "No Surprises Act" are already in place here at Courageous Story Counseling, PLLC, as we both follow and exceed the American Counseling Association Code of Ethics (2014), which includes the following ethical standards:

• Inform clients of fees before the commencement of treatment (all fees for services are listed in our "Informed Consent" and on our website for additional transparency).

• Make it clear that clients with health insurance have the option to seek counseling services with providers who are in-network with their insurance company, often at a lower fee (in-network providers can be located through your health insurance company).

• Allow clients who choose to work with a counselor who is out-of-network (such as Courageous Story Counseling, PLLC and the counselors within) to receive a Superbill, which can be submitted for possible out-of-network reimbursement (partial, full, or none), solely at the discretion of your health insurance company and the policies of your individual plan). Superbills also contain diagnostic codes, which are another requirement of this Act.

Some requirements of this new legislation are expanded from the above. According to the "No Surprises Act," we are directed to provide clients with a diagnosis before commencing treatment, which is in direct contradiction with the ethical standards of our counseling profession. Our ethics would never allow us to diagnose someone without seeing them, as diagnosis typically does not occur, if it occurs at all, until after the first 1-5 sessions. Undoubtedly, this requirement would make more sense for something such as setting a broken bone. However, counseling does not work like that. We may have an idea about what the trajectory of treatment looks like for a particular issue, based on experiences with other clients and our training; however, we cannot possibly know what exactly might lie beneath the tip of the iceberg that initially brings someone to counseling or what other concerns might arise during the course of treatment.

Similar to most counselors in private practice, we submit charges for each session on the morning of your scheduled appointment and we have a very clear "no-show," late-cancellation (less than 48 hours' notice), and late-arrival (considered a "no-show" if you arrive more than 15 minutes late to your scheduled appointment). As a reminder, "no-show," late-cancellation, and late-arrival fees are charged at the full session rate based on the originally scheduled appointment. We can estimate a length of time for certain conditions; however, due to complexity of the specialized care that we provide here at Courageous Story Counseling, PLLC, the duration, frequency, and overall length of counseling sessions varies based on many factors, including, but not limited to, the your schedule and life circumstances, counselor availability, ongoing life challenges, the nature of your specific challenges and how you address them, and your personal finances. To determine the cost over the course of 1 month or 1 year, we could simply multiply the fee per session by the estimated number of sessions.

Implementation of the "No Surprises Act" seems to be a gray area at the moment. At best, there are contradictory interpretations of several aspects of the Act within, by therapists, counselors, attorneys, professional associations, and so forth. There remains conflicting information about what the requirements are before December 2021, January 2022, March 2022, and/or December 2022 (some of the dates that have surfaced in terms of requirements). There are also likely to be challenges to the inclusion of counselors and therapists in the way this legislation was intended. In fact, on December 9, 2021, the American Medical Association, American Hospital Association, and other provider associations filed lawsuit against the US Department of Health and Human Services and other federal agencies over implementation of the "No Surprise Act. " The Texas Medical Association previously filed lawsuit as well in October of 2021.

As far as we can see at this point, none of the requirements within the "No Surprises Act" will impact what we have actually been doing and will do in our counseling sessions. We fully anticipate that we will be able to continue without any interruptions.

Good Faith Estimate**:

Effective January 1, 2022, this ruling (the “No Surprises Act") went into effect called the which requires practitioners to provide a “Good Faith Estimate” (GFE) about out-of-network care. The GFE works to show the cost of items and services that are reasonably expected for your health care needs, based on the item or services, diagnosis, and reason for therapy. The estimate is based on information known at the time the estimate was created. The GFE does not include any unknown or unexpected costs that may arise during treatment (i.e., “crisis” sessions). You could be charged more if complications or special circumstances occur, and you will be provided with a new GFE should this happen. If this happens, federal law allows you to dispute (appeal) the bill if you and your therapist have not previously talked about the change and you have not been given an updated GFE.

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 with an insurance plan/coverage or a Federal health care program, or not seeking to file a claim with their plan/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 GFE of expected charges.

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 possible reimbursement).

Timeline requirements: Practitioners are required to provide a GFE of expected charges for a scheduled or requested service, including items or services that are reasonably expected to be provided in conjunction with such scheduled or requested item or service. That estimate must be provided within specified timeframes:

• If the service is scheduled at least 3 business days before the appointment date, no later than one business day after the date of scheduling;

• If the service is scheduled at least 10 business days before the appointment date, no later than 3 business days after the date of scheduling; or

• If the uninsured or self-pay client requests a GFE (without scheduling the service), no later than 3 business days after the date of the request. A new GFE must be provided, within the specified timeframes if the patient reschedules the requested item or service.

**Information regarding the No Surprises Act and Good Faith Estimates are required to be listed on our website, in our offices, and within our paperwork completed at intake and intermittently throughout receiving counseling services. If you have additional questions or concerns, you may review those in session with your counselor at intake or by phone prior to your scheduled intake appointment.