FAQ

On 2/27/24 Indiana law (SEA 480) went into effect. This law precludes providers from being able to provide referral information to medical providers (surgeons, HRT doctors etc.) for minors. To follow the law, as we are obliged, we will pause referrals for transition related medical care for minors. We are continually consulting with attorneys who have expertise and knowledge about this issue and will be advising us on our actions moving forward. We will update this site when we have updated information. 

We are obliged to follow this law.  As a practice, we don't agree with this law and we support you contacting your representatives to tell them your opinions. 

There are multiple community led organizations that are under different rules. These community led organizations offer many different types of support for families navigating these difficult times. If you want information about community led, non-clinical organizations, please reach out to us and we will link you to the organizations that might best fit your particular need for support. 

FAQ:

• Do I have to stop going to therapy?

No, the law has a specific carve out (section) that does not limit therapy or what we talk about in therapy related to gender

• Do I have to stop my medications? 

We don’t know. This is a great question for your provider

• Can I get accommodations at school connected with my gender? 

We don’t know how schools will interpret this law. As your mental health providers, we are still able to provide recommendations for IEPs, 504 plans, and other accommodations as they relate to your treatment as long as those recommendations are within state law guidelines. We are happy to discuss this further with you in sessions as it will fit your particular needs. 

Once you have set up an account with your clinician, you can use TherapyAppointment to view all billing and appointment information. TherapyAppointment also provides a portal to communicate with your clinician and our office team. 

TCS takes seriously the health and well-being of our community, clients, and staff. We have access to telehealth services to be able to offer virtual, HIPAA-compliant therapy sessions to all clients. This allows you to still recieve your therapy services while also maintaining the health of our staff and community. 

We ask that if you, or anyone in your household, experiences any symptoms of viral infection that you notify your therapist and shift to a virtual appointment. Your therapist may also request this shift to a virtual appointment if their household has symptoms present. Symptoms to look out for may include: elevated temperature, cough, congestion, chills, sore throat, or body aches.

Here are some tips and tricks we have learned in offering telehealth:

• Find a quiet space where you won’t be disturbed or heard. This may be in a bedroom, home office, basement, large closet, or even a parked car. 

• If you live with others, ask that they do not disturb you during your session time and that they refrain from using the Wi-Fi so that your connection remains strong. 

• Check that the device you are using (computer, tablet, phone) has a working camera and is charged. 

• Consider using headphones to improve sound quality and maintain privacy. 

• Treat your telehealth therapy session as if you are meeting with your therapist in person. Avoid engaging in any tasks you wouldn’t do if you and your therapist were meeting in person (such as laundry, smoking, or cooking).

The Department of Health and Human Services also offers this guidance for managing safety and security when using telehealth options. 

Each insurance plan offers different terms and expectations of coverage. The TCS team works hard to get information about your individual coverage and communicate with you as soon as we know information. Here is a glossary terms and how they are used with health insurance.These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan. Some of these terms also might not have exactly the same meaning when used in your policy or plan. You are able to see your Summary of Benefits and Coverage for information on how to get a copy of your policy or get additional information about your individual coverage by calling the customer service number on the back of your insurance card.

It can take anywhere from 1 to 3 months for TCS to hear back from your insurance about submitted claims. This is why we collect known copays/deductible amounts at the time of service. If you have more questions about how your specific insurance situation works, TCS is not privy to this information. However, if you are a current client and need help contacting your insurance please contact Corina who can help in finding the right contact information for your plan.  

• Allowed Amount - Maximum amount on which payment is based for covered health care services. This may be called “eligible expense,” “payment allowance" or "negotiated rate." If your provider charges more than the allowed amount, you may have to pay the difference. 

• Appeal - A request for your health insurer or plan to review a decision or a grievance again. In some cases, your healthcare provider will be able to appeal for you, but there are cases where you will need to appeal to your insurance yourself. Ask your provider for assistance if you do not know what the steps are.  

• Co-insurance - Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service. You pay co-insurance plus any deductibles you owe. For example, if the health insurance or plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your co-insurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount.

• Co-payment - A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service. 

• Deductible - The amount you owe for health care services before your health insurance or plan begins to pay for covered services. For example, if your deductible is $1000, your insurance plan won’t pay anything until you’ve met your $1000 deductible for covered health care services subject to the deductible. The deductible may not apply to all services. 

• Excluded Services - Health care services that your health insurance or plan doesn’t pay for or cover. 

• In-network Co-insurance - The percent (for example, 20%) you pay of the allowed amount for covered health care services to providers who contract with your health insurance or plan. In-network co-insurance usually costs you less than out-of-network co-insurance. 

• In-network Co-payment - A fixed amount (for example, $15) you pay for covered health care services to providers who contract with your health insurance or plan. In-network co-payments usually are less than out-of-network co-payments.

• Medically Necessary - Health care services or supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine. 

• Network - The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services. 

• Non-Preferred Provider - A provider who doesn’t have a contract with your health insurer or plan to provide services to you. You’ll pay more to see a non-preferred provider. Check your policy to see if you can go to all providers who have contracted with your health insurance or plan, or if your health insurance or plan has a “tiered” network and you must pay extra to see some providers. 

• Out-of-network Co-insurance - The percent (for example, 40%) you pay of the allowed amount for covered health care services to providers who do not contract with your health insurance or plan. Out of-network co-insurance usually costs you more than in-network co-insurance. 

• Out-of-network Co-payment - A fixed amount (for example, $30) you pay for covered health care services from providers who do not contract with your health insurance or plan. Out-of-network copayments usually are more than in-network co-payments. 

• Out-of-Pocket Limit - The most you pay during a policy period (usually a year) before your health insurance or plan begins to pay 100% of the allowed amount. This limit never includes your premium, balance-billed charges or health care your health insurance or plan doesn’t cover. Some health insurance or plans don’t count all of your co-payments, deductibles, co-insurance payments, out-of-network payments or other expenses toward this limit. 

• Plan - A benefit your employer, union or other group sponsor provides to you to pay for your health care services. 

• Preauthorization - A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification. Your health insurance or plan may require preauthorization for certain services before you receive them, except in an emergency. Preauthorization isn’t a promise your health insurance or plan will cover the cost. 

• Preferred Provider - A provider who has a contract with your health insurer or plan to provide services to you at a discount. Check your policy to see if you can see all preferred providers or if your health insurance or plan has a “tiered” network and you must pay extra to see some providers. Your health insurance or plan may have preferred providers who are also “participating” providers. Participating providers also contract with your health insurer or plan, but the discount may not be as great, and you may have to pay more. 

• Premium - The amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly or yearly. 

• Provider - A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine), health care professional or health care facility licensed, certified or accredited as required by state law 

• Superbill- A superbill is similar to a document that you can submit to your insurance company and they can choose to reimburse you for what they would have paid if you had been with an in-network provider. A Superbill can be used if your provider is not an in-network provider. You pay for the services up front, and then you send the superbill to your insurance to see if they will reimburse you for some of it. 

TCS is committed to finding ways to make therapy accessible. One way in which we do this is through contracting with health insurance companies to use your health insurance benefits. Health insurance contracts lessen the cost of therapy sessions based on each company's benefits plan and lock in the cost of therapy.  These contracts prevent TCS staff from offering sliding scale therapy spots. If you are in need of sliding scale therapy options, please reach out to TCS through our Contact page and we can offer referrals to other providers.