FAQ
What is the best way to set up an initial appointment?
Please send me an email at patrick@patricktullytherapy.com. Due to a high volume of spam calls received these days, this is much preferred over phone calls. I appreciate your understanding. You are also much more likely to receive a faster email response compared with phone, even if you leave a voicemail, as spam voicemails have dramatically increased as well.
You can ask questions or schedule an appointment! I will be able to send you intake forms via a secure portal easily and conveniently, which need to be filled out prior to a first appointment. I look forward to hearing from you!
Where are you located?
I am only offering telehealth / video therapy, which has proven to be a wonderful shift. Many published peer-reviewed studies have shown the virtual space to be just as effective, and it’s flexible too.
Many clients who were hesitant at first found that they loved the flexibility as well as realness it provides. I admit that I am a big fan too! Otherwise, I would make in-person work somehow! Modern Age Therapy includes Telehealth!
Telehealth is secure and encrypted, and I encourage you to visit the dedicated online therapy page to learn more! Of course, feel free to ask me questions!
What is Courtesy Insurance Billing? - Yes! I offer this! You won't necessarily need to submit invoices if I'm out-of-network!
I am in-network with certain insurance plans, such as Aetna, Cigna, and Humana.
But even without being in network, I can bill your insurance directly rather than only provide you an invoice for services. This cuts down on the paperwork you need to send them to be reimbursed. The out-of-network benefits for many insurance plans that are labeled as POS or PPO (HMO is an exception) are often quite generous, and having worked with insurance for many years, I am very happy to help you through this process. Many insurance plans now offer electronic submission as well for out of network reimbursement.
The secure electronic health record system I use that is designed for therapists, similar to MyChart for medical care, formats invoices, superbills (which are what are used for out-of-network visits), and other forms for HSA reimbursement if the HSA requests them, and can directly bill your insurance carrier even if I am out-of-network!
I am very happy to be helpful in this way, because counseling is an investment and I want you to be able to receive reimbursement if possible. Please do not hesitate to ask me any questions about this process! In addition, I do invite you to ask your insurance company specific questions which I have curated from working with insurance.
Please refer to the Rates question Rates question when contemplating what questions to ask your insurance company about your benefits.
The difference between in-network and out-of-network benefits is that providers who are in-network with an insurance company have a contract with them for a specific rate. For an Explanation of Benefits (EOB – often mailed to you by insurance and sometimes viewable online in the insurance website portal), while the Amount Charged by the provider will typically be much higher than the Allowed Amount (lingo might vary depending on plan), the Allowed Amount will be set to a known contracted amount. You’ll also often see Copay and/or Coinsurance on the EOB as well.
This amount is the total paid to the provider by the insurance company as well as by you (Copay/Co-insurance with or without deductible). If you have an in-network Copay, you’ll often only need to pay this amount and not the entire Allowed Amount. If you have an in-network coinsurance (often based on a percentage), you’ll be responsible for the full Allowed Amount unless your in-network deductible has been met. you’ll only be responsible for the listed Copay or Coinsurance (usually with an in-network deductible applying before the coinsurance percentage covers the sessions).
Plans that have Out-of-Network benefits are often either PPO or POS plans (The plan type might use different lingo, so refer to your plan documents or call your insurance company to confirm your benefits). HMO and EPO plans do not have out-of-network benefits as they only allow you to use the providers within their network.
Compared to using in-network benefits, with out-of-network billing, the Allowed Amount (AKA Eligible expense, payment allowance, negotiated rate) is not known by the provider but is typically much higher than the Allowed Amount for the service that you would see if in network. This is because insurance companies are known for allowing a much larger amount out-of-network for each procedure and this is why they like you to use in-network providers so they don’t have to pay the higher amount. The benefit to a higher Allowed Amount is that it would allow the deductible (if you have one) to be met sooner. The Allowed Amount is what the insurance pays for a certain service. And the coinsurance percentage is based on this Allowed Amount, not the Billed Amount.
An example: If your Allowed amount/Negotiated rate/Eligible expense/Payment allowance is $150, and if you’ve met your out-of-network deductible and your coinsurance is 70%, then you would be reimbursed $105 for the session by the insurance company.
Insurance companies do not share out of network allowed amounts with any medical professionals and the amount can vary per policy. As mentioned earlier, insurance companies are known for setting allowed amounts for out of network procedures/services at much higher amounts, as they pay in-network providers less than their worth. There’s no way for out-of-network providers to know what the allowable amount is until it appears on the EOB for the client. The amount can even vary from one client to another. It could be between $100 and $200 if we use Medicare rates as a way to estimate the cost and then lower it a bit (Sometimes insurance base their out-of-network negotiated amounts for commercial plans on Medicare reimbursement rates.
Keep in mind the Allowed Amount is not the same as the amount you and I have agreed on for each session. We will agree to a rate and then bill the insurance and that will likely appear as the Billed Amount (or some similar naming scenario) and then on the EOB, the Allowed Amount would be revealed, and the reimbursement would be based off of that.
With a PPO or POS plan, you could be reimbursed a significant amount after deductible has been met. Sometimes, a plan may allow you to be reimbursed before deductible, or you may not have an out-of-network deductible. The percentage or copay that you are responsible for when using out-of-network benefits can be found in your healthcare plan documents (refer specifically to the Summary of Benefits and you’ll find information on out-of-network deductible, coinsurance, or copays. You can also call your insurance company and ask them).
Here’s an example: You have a $200 out-of-network deductible with a coinsurance of 70%. This means you wouldn’t be typically reimbursed for the first $200 of out of network claims (from any providers who are out-of-network), but you would be reimbursed 70% of the “Allowed Amount” after the out-of-network deductible has been met. Some policies may have different rules for different services/procedures though, so it’s possible you don’t need to reach deductible. I would call your insurance to confirm. Sometimes they won’t know for sure.
Since my rates are on-par and often lower than other providers in the Los Angeles Westside area (often $200+), you’ll potentially end up paying close to an in-network copay by billing your out-of-network benefits. And even with a deductible, the savings could add up over time.
As mentioned earlier, for plans that I don’t have a contract with as an in-network provider, I am unable to find out what the plan-specific reimbursement rates are for out-of-network reimbursement, as these are not shared with providers by insurance companies. But these become clear once you’ve billed out of network and receive your EOB (Explanation of Benefits), which is usually mailed to you and often viewable online through your account with the insurance company when looking up finalized claims.
Please remember that you’re able to use any FSA/HSA benefits to pay for your sessions!
I’m here for you to help navigate through any confusion that you might encounter. I write this as a way for you to hopefully understand out-of-network billing a bit more. But I understand it’s confusing. If you have a high deductible, it can be beneficial to have your therapy sessions go towards your out-of-network deductible since any unanticipated future out-of-network costs during the year (from other providers) would more likely have better coverage.
Do you see people in both California and Florida?
Yes. I’m able to see people in Florida via telehealth, in addition to California, also via telehealth!
My Florida registration number allows me to see people there via private pay or through Modern Health EAP.
TLHT TPMF163 is my Florida registration number allowing me unrestricted telehealth visits to anyone in Florida seeking therapy.
Florida Telehealth Registration Number Directory
My California license is LMFT 115115. California is where I physically reside and can see people in my office in Los Angeles, CA. I also offer telehealth appointments to anyone in California!
Can I use video therapy or teletherapy in lieu of visiting you in the office, or in addition to office visits?
Many clients have found that online video therapy (also referred to as telehealth) by itself is extremely helpful. It’s common to use it in conjunction to in-person therapy: when you might not be feeling well, when you might be overwhelmed by the week, or maybe when you’re out of town.
Telehealth is secure and encrypted, and I encourage you to visit the dedicated online therapy page to learn more! Of course, feel free to ask me questions!
What is your rate?
My therapy rate is $150 – $250 per 50 minute session for individuals.
I believe in listening to you, being attuned to what isn’t working, and helping you handle the roadblocks with greater ease. I try to tailor your experience as each individual is different. Each person has their own story to tell. My fee reflects my education, including doctoral level coursework, years of supervision, supervising others, as well as reflecting continued costs for continuing education.
Keep in mind, out of network insurance benefits can be generous and you can ask them certain questions (listed below accepted insurance) if you wish to utilize those for your therapy. You can also use HSA/FSA benefits as therapy is a medical expense. If you do not wish to send an insurance company any diagnosis (which is discussed during our initial session), you will want to not utilize insurance either in-network or out-of-network. Insurance companies can ask for therapy notes (which I keep vague but clinically sound) if you use in-network or out-of-network benefits. Even out-of-network, I am often able to courtesy bill on your behalf to PPO/POS insurance so you don’t have to submit any paperwork to them.
I am In Network with the following plans (HMO, EPO, POS, PPO):
Aetna / Coventry / Meritain
Cigna / Evernorth
Humana (non-Medicare).
I do accept EAP benefits through:
Modern Health and Lyra Health.
Please note that at this time, Lyra doesn’t make their directory searchable by name. But it’s not necessary to find me in the directory when using Lyra. Simply send me a message sharing you have Lyra and we can work together without the Lyra directory being the point of contact. If you have Modern Health and would like to use this benefit, please feel free to reach out directly as I can email them to link us together. Please ask if your company utilizes Lyra Health or Modern Health – they’re popular with tech-based companies.
Out of Network:
If you have a PPO or POS plan, you likely have both “in network” (providers who are contracted and agree to a certain rate) as well as “out of network” (no contract exists but the insurance may provide reimbursement) benefits. Upon request, for certain PPO and certain POS plans, I can automatically generate and send you insurance reimbursement forms (“superbills”) that you can send to your insurance company for reimbursement if you have a PPO plan and certain POS plans as well. If you’d like clarification on your out-of-network mental health benefits, simply call the Customer Service number on the back of your insurance card and ask them:
1) Do I have coverage for mental health sessions with an out-of-network Licensed Marriage and Family Therapist (LMFT)?
2) Do I have a deductible to meet before I receive reimbursement?
3) What is the “Allowed Amount” for “CPT code 90837” (A CPT code is used to bill sessions) for Licensed Marriage and Family Therapists?
A CPT code is used to bill sessions and they should know what you’re referring to.
The amount I bill may or may not be the same as the Allowed Amount. This amount is only known by the insurance company.
4) If they don’t accept 90837 out-of-network, ask them the “Allowed Amount” for CPT code 90834 and if it is consistent for all their out-of-network LMFTs.
5) Do I pay a percentage or a co-pay of this “Allowed Amount” after deductible?
If you prefer to not use insurance, you can opt-out by requesting an Insurance Opt-Out Form. I cannot make this decision for you or simply suggest you not use insurance. Some people don’t want to use insurance out of personal preference even when I’m in-network and so if this is the case, then this form can be sent to you electronically.
Please also feel free to refer to the question on out-of-network benefits in this FAQ: What is the difference between in-network and out-of-network benefits?
Please do not hesitate to let me know if you have any questions!
How long is each session?
If you wish to have longer sessions, this can be discussed either at the start of seeing each other or in the process of our work together.
I have learned that sticking to a consistent timeframe is important for the therapeutic alliance, but that sometimes a longer session, or more frequent sessions, can be helpful.
The most common format is once a week. I see many clients twice a week, especially in the beginning of therapy, as this can help build therapeutic trust and jump-start the process. I also can accommodate every other week as well – but this is not as beneficial as weekly.
Therapy is designed to be flexible just like the human experience and develop boundaries for a healthier self and satisfaction in relationships.
What should I expect the first session? I've never been in therapy before.
My way of doing therapy is designed to alleviate your troubles. I do therapy in a collaborative and safe setting where you can share and ask me questions, knowing confidentiality is upheld in the highest regard.
My approach to helping you will be based on your goals and the organic process in the room. I work collaboratively and empathically to understand your strengths and concerns. Sharing this information with me is a process, so you can feel relief in a safe setting.
I will check in with you as part of my responsibility to respect what you want out of therapy. Sessions are tailored to you, meaning I see and respect you for who you are. True compassion and caring in a safe and confidential space are among my top priorities!
My training was extensive in terms of incorporating psychodynamic, cognitive behavioral, EMDR, and other techniques. There is a common model of empathy that I often use in my own way and either add to or subtract from that’s described in detail here:
https://ct.counseling.org/2017/02/creative-novel-approaches-empathy/
Real empathy that not only reflects but calls to your experience in the therapeutic exchange is essential to a successful therapist-client relationship dynamic. My approach blends this skill with other forms of therapy naturally and when needed (eg. CBT, narrative therapy, family systems, etc.). I aim to be curious to help you delve further into your own curiosity and awareness to cultivate a deeper understanding of events and feelings.
I enjoy incorporating humor into therapy, as it has always been a natural part of my personality to discover humor organically. I feel it also leads to a deepened appreciation of the therapeutic process because I’m being just as genuine with my sense of humor as when I am not joining with you in a joking way.
In addition, being LGBTQIA+ Affirmative means I bring not only my experience of being a part of the LGBTQIA+ community through self-disclosure, but also training of the models of Affirmative therapy. This also includes me acknowledging that I have privileges as a cis gay man that other members of the LGBTQIA+ community do not. I do not aim to ignore these privileges either.
Being Anti-Racist also means I acknowledge my own privilege as a white man in this world. The life experience of BIPOC clients is different and must be brought into session as otherwise I feed into the false narrative that the privileges I have do not make a difference.
I consider myself a feminist as well. I also must acknowledge the privileges that come with being a male that females do not have in our world and society.
What do you specialize in?
General Anxiety
Social Anxiety
ADHD
LGBTQIA+ Affirmative Therapy
EMDR
PTSD / Trauma
Sex Affirmative Therapy
Understanding Sexual Behavior
Accepting and Coping with Hearing Loss: Parents, Individuals
Coping with Chronic Health Conditions
You can always ask me more about whether I specialize in a certain area and how I treat it by calling / texting 323-819-0747 or by emailing patrick@patricktullytherapy.com.
How does therapy work?
My approach to helping you will be based on your goals and the organic process in the room. I work collaboratively and empathically to understand your strengths and concerns. Sharing this information with me is a process, so you can feel relief in a safe setting.
I will check in with you as part of my responsibility to respect what you want out of therapy. Sessions are tailored to you, meaning I see and respect you for who you are. True compassion and caring in a safe and confidential space are among my top priorities!
My training was extensive in terms of incorporating psychodynamic, cognitive behavioral, EMDR, and other techniques. There is a common model of empathy that I often use in my own way and either add to or subtract from that’s described in detail here:
https://ct.counseling.org/2017/02/creative-novel-approaches-empathy/
Real empathy that not only reflects but calls to your experience in the therapeutic exchange is essential to a successful therapist-client relationship dynamic. My approach blends this skill with other forms of therapy naturally and when needed (eg. CBT, narrative therapy, family systems, etc.). I aim to be curious to help you delve further into your own curiosity and awareness to cultivate a deeper understanding of events and feelings.
I enjoy incorporating humor into therapy, as it has always been a natural part of my personality to discover humor organically. I feel it also leads to a deepened appreciation of the therapeutic process because I’m being just as genuine with my sense of humor as when I am not joining with you in a joking way.
In addition, being LGBTQIA+ Affirmative means I bring not only my experience of being a part of the LGBTQIA+ community through self-disclosure, but also training of the models of Affirmative therapy. This also includes me acknowledging that I have privileges as a cis gay man that other members of the LGBTQIA+ community do not. I do not aim to ignore these privileges either.
Being Anti-Racist also means I acknowledge my own privilege as a white man in this world. The life experience of BIPOC clients is different and must be brought into session as otherwise I feed into the false narrative that the privileges I have do not make a difference.
I consider myself a feminist as well. I also must acknowledge the privileges that come with being a male that females do not have in our world and society.
How long does therapy take?
I work with you for as long as the therapy is beneficial. What you need is going to be different than what another person desires.
During our sessions, I will continue to ask you how you feel about our work together, and at any time you can bring up questions and curiosities. You are the expert of your own life. I will never tell you to be in therapy longer than you desire.
Do you just sit there and not say anything?
Virtual therapy can sometimes lend itself to not appreciating silence as much as in-person at times. I feel I have gotten used to it. But this is something I have noticed. However, I feel silence was always challenging in-person as well. Let’s discuss if you want to give silence a try!
I will say that sometimes you may prefer a different ratio than I am providing in the moment. And if that is happening, let me know. I may not immediately sense it, and it is absolutely WONDERFUL when you can give me the heads up if that occurs!
Styles of each therapist will vary, and each therapeutic alliance will vary as well. It’s hard to tell what will happen until therapy begins. Some prefer a listener, which I agree is a lost art of healing that helps a lot of people. Try it out and see how it works. Let me know if you prefer that. Or you may not know right away, and that is OK! We are on the journey together!
Isn't therapy just for people who have serious problems?
Listening therapy that is healing is so helpful: If you’re interested, search for Adlerian therapy as he is an early theorist that contemporary theories draw from (and there have of course been updates). Also, ask me how it works as there are many theories (over 100) therapists can utilize: Often we combine organically after years of school and post-graduate experience.
Many clients come in weekly and share about their experiences and find that the processing that occurs both in the session and between sessions is helpful! With all our responsibilities and pressure, it can feel wonderful to have the freedom to have a space to open up without worry. Confidentiality is held in the highest regard as part of the licensed MFT psychotherapy legal and ethical codes, unlike ANY OTHER profession! We CANNOT break confidentiality except in VERY FEW circumstances which are clearly outlined in paperwork prior to the first session and covered during the first session if not clarified.
Please ask me any questions as you deserve to know where I am coming from, and I very much enjoy the collaborative process! Collaboration with you is crucial so you feel heard and you can express yourself.
I don't know if my issue is primarily "emotional" rather than situational and focused on figuring out my goals. Should I go and see you?
Some people want to first work on their emotions and how the way they’ve been living their life, or life obstacles, get in their way. Other people have specific goals that are not necessarily rooted in emotion.
We are emotional beings, so decisions and life changes often do come with their share of overwhelm and desire for change. So, with my license, I can help all of that and create clarity for you and your future. The intake process is key as it allows you to write down anything you want to discuss during our first appointment.
Therapy for the Modern Age isn’t only for your moments of anxiety, but also for those times you need to figure out the direction of your life! Give me a call or email me and learn more!
Are Marriage and Family Therapists only trained to see families or couples?
But there are many therapists who specialize in only individuals, couples, or families, so LMFT therapists are able to be very diverse.
I’m happy to answer any questions to clarify this further.
Will you hold my time slot?
We can figure out scheduling week-by-week, as well, as naturally our schedules can change sometimes. But my suggestion is to think of a few regular times that work best weekly, so when scheduling for follow up appointments we can discuss a time that can be set to repeat on both our schedules to avoid future scheduling conflicts.
How often should I come in for therapy sessions?
Best practices for therapy call for us to develop a therapeutic bond that assists you in multiple areas of your life and addresses surprises that come out of your unconscious (what you’re not aware of yet). Insight, continued growth, and other factors continue outside of therapy, and weekly appointments allow us to check in to what is happening.
Our society does not prioritize mental health treatment the way it should. Mental well-being often translates to physical well-being. In addition, the insights you gain are made stronger every single week. Not every session is obviously cathartic or deep. The intent is to allow for a comfortable pace for you to open up freely to a therapist you trust. I hope I have the opportunity to provide this experience to you for your own clarity and overall well-being.
Therapy is the continuation of deeper exploration into yourself and weekly or twice weekly visits allow for emotions that come up throughout the growth process to be identified and addressed so you are able to cope better with yourself. People sometimes are worried about the cost of therapy, but similar to how other physical treatments require consistency, therapy benefits those who come in with consistency.
The therapeutic experience continues between sessions: think about it, the session is the time where “processing” takes place and between sessions, our mind doesn’t stop thinking, and we don’t stop feeling. Having an impartial observer, such as a therapist, assist with processing is very helpful. You deserve to have this time and commitment.
Even when sessions don’t evoke strong emotions, when we meet regularly we are able to work together to increase insight and unpack your experiences. This all has been found to be true through research and my personal experience. Commitment to therapy is important and you deserve it.
Will you go into psychological babble that I can’t understand?
Reigning in theory is an essential component of good therapy, as it allows us both to respond as two human beings working to help you. While you may get a phrase from Freud or a phrase from a movie I’ve seen, it should make sense.
You’re always free to ask questions, and I’m a great reader of body language.
Do you work with certain ages?
What does therapy look like?
When walking in, you’ll be met with a gentle demeanor that is curious about your day and wondering about how you’re feeling or what you’re thinking about.
Do you charge extra if I use too many tissues?
What is a Good Faith Estimate, a part of the No Surprises Act?
In 2022, a new federal law called the “No Surprises Act” took effect. This required many medical providers, including Licensed Marriage and Family Therapists to provide Good Faith Estimates to at least clients who pay without insurance and maybe more people as time goes on. As part of the therapeutic process, we do clarify the fees before appointments, so this document may seem redundant. But it is a federal requirement and serves to clarify fees in a structured way.
Currently, there’s many components of this law that have been delayed pending further lawmaking. But if you are one of the clients that the law ends up requiring a Good Faith Estimate for, you will find one by logging into your portal. You also have the right to ask for one at any time. It’s uncertain right now if mental health providers will even be included since we are transparent about fees before the first visit.
You’ll find a document with your Good Faith Estimate in your secured portal once you become a client if one needs to be provided to you according to the law, which may expand to more or fewer people as it is clarified over time.
You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.
Under the law, health care 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 to clarify the total expected cost of any non-emergency healthcare services, including psychotherapy services.
You can ask your health care 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 or call (800) 985-3059.