FAQs

  • You will leave the first visit with your diagnosis.

    Diagnoses may be adjusted as I get to know you better.

    Some diagnoses like ADHD and Autism may need information from caregivers in different settings (like school, extra-curricular activities, etc). See our ADHD and Autism page for more information.

    You will leave the first visit with your treatment plan. Your treatment plan may include:

    Medication, if you want to try medication and it’s indicated.

    Referrals if you are interested and they are indicated. Referrals can include counseling, Speech Therapy, Occupational Therapy, Medical Specialists, and more.

    Preliminary guidance and information on patient tailored parenting techniques, learning support, and more.

  • ·       New Evaluations take between 90 minutes and 2 hours.

    ·       Follow-up visits take between 20-40 minutes.

    ·       Some patients are more complex and may require additional time.

    o   For these patients, we can schedule a post- visit phone call or sooner follow-up visit.

    o   We also have options to schedule complex follow-up visits.

  • The following information is VERY HELPFUL to have ready for your first visit:

    o   Past records of previous developmental, academic, or mental health supports. This can include:

    • developmental evaluations

    • past psychiatry evaluations/progress notes

    • psychological evaluations

    • school testing

    • IEPs or 504s

    o   List of any past or current medications (medical or psychiatric) or supplements and description of any good or bad responses.

    o   History of family mental health diagnoses (parents, siblings, aunts, uncles, grandparents, first cousins, no further)

    o   History of psychiatric medications that have been helpful or not well tolerated for family members.

    o   If you suspect your child to have ADHD, Teacher Vanderbilt forms completed by teacher or structured caregiver (eg coach, day care worker, Sunday school teacher, etc) and Parent Vanderbilt forms completed by you. 

  • Yes. The patient must attend every scheduled follow up visit unless we have discussed and agreed upon scheduling a visit without your child.

    Why?

    o   It is important that I can visualize your child for diagnostic and medical assessment purposes.

    o   Some medications by law cannot be prescribed without in-person visit with your child at least every 3-6 months.

    o   Your child’s involvement and investment in their care are important. I try to help even the youngest children feel comfortable with their care plan.

    Privacy and sensitivity…

    o   Some issues are best discussed not in front of your child. If you are concerned about the need for more private discussion around your child’s needs, consider…

    • Much can be communicated in SPRUCE messaging prior to visits.

    • Plan to bring another caregiver if your child cannot be left unattended in the waiting room for private conversation if needed.

    • Minor children can be brought to visits by other caregivers than Legal Guardian, and Adolescent clients may come to appointments without their legal guardian, but…

    o   If the legal guardian is not present for visit of a minor client, Legal guardian should be available by phone during time of visit.

    • We make treatment goals from the start. If medication is needed, we will meet monthly to monitor any medication changes.

    • If you are doing well and no treatment plan changes are needed, we can spread out visits to every 3-6 months depending on your needs.

    • Sometimes, care can be transitioned back to your primary care provider if they agree and you feel comfortable.

    • Patients should see me at least annually to check in and stay connected. Patients that have not been seen annually may require new intake to re-establish care.

    • With SPRUCE text messaging, it’s easy to get in touch with me. My administrative coordinator or I will respond to your message within 24-48 business hours.

    • See my contact page for more information.

  • I decided not to contract with insurance companies to allow me to provide better care…

    I can spend more time on direct patient care.

    o   Instead of going back and forth with insurance companies, I can focus on staying in touch with you.

    o   I am still responsible for getting your medications authorized according to your individual pharmacy benefits.

    Transparent pricing for my patients

    o   If you have a high deductible insurance plan, with providers who bill insurance, you often pay more before co-insurance is eligible.

    o   Medical billing is too often complex and insurance specific, resulting in higher-than-expected bills. With my care, there are no surprises on what you pay.

    o   I provide you with a superbill (receipt of services) at the end of each session. You can submit this to your insurance company to apply towards your deductible and for out of network reimbursement (not guaranteed).

    o   You can use your FSA funds to pay for your care. (document administrative fees and no show fees do not apply. See pricing page for more information).

    Privacy Perks

    o   My office is housed with a small private counseling office.

    o   As a solo practice, there’s no phone tag with multiple staff. Through the spruce messaging app, you communicate directly with me and my administrative coordinator only, and get responses to your care needs quickly.

    o   It is possible to keep your sessions at a higher level of confidentiality if you choose not to submit to insurance companies.

  • A psychiatric mental health nurse practitioner (PMHNP) is an advanced practice provider trained to diagnose and treat mental health conditions using both medication management and supportive therapy. Like psychiatrists, PMHNPs evaluate symptoms, prescribe medications (including controlled substances), monitor treatment response, and collaborate with other providers when needed.

    In the state of Virginia, PMHNPs have full practice authority. This means they can provide comprehensive mental health care independently, including developing and managing treatment plans, prescribing and adjusting medications, ordering and interpreting lab work, and supporting long-term mental wellness.

    Nursing-based care is grounded in a holistic model. PMHNPs are trained to consider physical health, emotional well-being, environment, relationships, and life context when developing treatment plans.

    In some cases, care with a psychiatrist or higher level of specialty hospital based outpatient team may be more appropriate—for example, when there are complex medical conditions, a need for residential treatment, or when interventions such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) are being considered.

  • Much of my treatment process involves supportive therapy. I have training in modalities including CBT, DBT, PCIT, ERP, motivational interviewing, positive parenting models, collaborative problem solving, and family therapy.

    Counseling is weaved into our conversations, but in-depth counseling requires longer and more frequent visits best performed by a counseling expert in the area of your needs. I make personalized referrals to many wonderful therapists in the area with whom I collaborate frequently.

  • Check Your Insurance Plan

    Call the member services number on your insurance card and ask:

    • Do I have out-of-network benefits?

    • What is my out-of-network deductible?

    • What percentage will be reimbursed?

    • Do I need a specific claim form?

    If you don’t have out-of-network benefits, reimbursement usually isn’t available.

    Complete a Claim Form

    Most insurers require a Member Claim Form (also called a “Medical Reimbursement Form”).

    You can usually find it on your insurance company’s website, for example:

    • Aetna

    • Cigna

    • Blue Cross Blue Shield

    • UnitedHealthcare

    Fill it out completely. Be sure to include:

    • Your member ID

    • Provider information

    • Reason for visit (if required)

    Attach Required Documents

    Typically you’ll need:

    • The superbill

    • Proof of payment (receipt, credit card statement, etc.)

    • The completed claim form

    Make copies for your records.

    Submit the Claim

    You can usually submit by:

    • Uploading through your insurer’s online portal

    • Fax

    • Mail (address listed on claim form)

    Online submission is usually fastest.

    Track Reimbursement

    Processing usually takes 2–6 weeks.
    You’ll receive an Explanation of Benefits (EOB) showing:

    • Amount billed

    • Allowed amount

    • Insurance payment

    • Your responsibility

    Reimbursement is typically sent via check or direct deposit.

    Helpful Tips

    • Submit claims within your insurer’s deadline (often 90–180 days from service date).

    • Keep copies of everything.

    • If denied, you can file an appeal (your EOB will explain how).