Make an Appointment: [email protected] | (503) 317-7780

  • FAQs

    Getting Started

    How do I get started?

    You already have! The next step is to reach out to me via phone call, Signal message, email, or a message emailed through this website to schedule a consultation call. As standard emails are not secure forms of communication, please be conscientious of the information you share. In your message, please let me know:

    • briefly your goal or issue to treat
    • your insurance company;
    • if you plan to use in- or out-of-network benefits or pay out-of-pocket (OOP);
    • your desired availability for a consultation call and for therapy sessions;
    • your desired frequency of sessions;
    • and the best method(s), day(s) and time(s) to reach you.

     

    I will reach back out to you, generally within 48 business hours.

    Do you offer a free consultation?

    Yes, when I have openings, I do offer a free initial phone or video consultation via doxy.me, a HIPAA-secure video-conferencing platform. An initial consultation is 15 minutes long; however, please plan for a 30-minute block in the case that we mutually choose to move forward so that we have time to gather your basic information and schedule an intake appointment.

    What happens in a consultation call?

    Therapy is a collaborative process, even before it gets started. In a consultation call, we will discuss what you are looking for in a therapist and any specific goals or problems you want to address in therapy. We will also discuss my scope of practice—what I am competent and able to treat and not treat—and how I work. We will also address the logistics – your availability, if you plan to use insurance or pay out of pocket, etc. This will be about 15 minutes.

    If we both feel like we’re a fit and want to move forward, we will schedule you for an intake session, plus three additional sessions, and get you set up with the client portal so you can complete the intake paperwork prior to the intake session. This will take about 15 more minutes.

    What is your availability?

    I hold therapy sessions on:

    Tuesdays 11:00AM – 4:00PM
    Wednesdays 11:00AM – 4:00PM
    Thursdays 11:00AM – 4:00PM

    Why do we schedule 4 sessions upfront?

    I schedule 4 consecutive weekly appointments (1 intake, 3 follow-ups) to complete assessment, treatment plan, and have two “standard” therapy sessions. I have found that 4 sessions (approximately 1 month) maintain momentum for change and provide enough time for you to get the feel of how I work and how we work together while balancing good clinical practices of assessment and treatment planning. I will check in with you at the end of each session for feedback as to what is working and/or not working for you and do my best to implement any desired changes. At the end of our 4th session, we come together and collaboratively determine how to proceed, which may mean maintaining a weekly schedule, reducing frequency, or referring you to another provider.

    Are you offering running therapy at this time?

    I am not currently offering running therapy sessions at this time due to the challenges of scheduling run therapy clients and my limited work hours. If you’d like to be added to my interest list, please send me a message with your desired days and times.

    Are you offering in-person sessions?

    Although I have two office locations available, I am not currently offering in-person sessions. All sessions will held via a HIPAA-secure video-conferencing platform.

    Insurance and Rates

    Do you accept insurance?

    I am an in-network provider with the following insurances and will bill them directly on your behalf:

    • Aetna
    • First Choice Health Network
    • Kaiser Added Choice (as a tier-2 provider)
    • Moda/ODS
    • PacificSource
    • Samaritan

    It is important to note that each plan can have different requirements and it is ultimately up to you to confirm your coverage and my status as an in-network provider with your specific plan. For example,  I am not participating in any of the above’s CCO/Medicaid Plans.

    If you have a different insurer, I may be able to bill them as an out-of-network (OON) provider or, if I am unable to bill directly, I can provide you a Superbill for you to submit directly to your insurer for reimbursement.

    What is my payment responsibility with insurance?

    To make a very long answer short, I recommend calling your insurance plan and speaking directly with a representative. The phone number is typically listed on the back of your insurance card. I also recommend that at the end of the call you document a “reference number.” This is sometimes a number or the name of the representative and date of the call. If for some reason you are provided inaccurate information that leads to payment issues, you may be better able to dispute the charges if you have a reference number so the insurance company can review the call.

    Some things to ask:

    • Is Lisa Sciarani, LCSW (NPI: 1669883682)/Your Path Forward Counseling, LLC (Group NPI: 1902437007) “in-network” or “paneled” with my plan?
    • Do I have a deductible? If yes, are mental health outpatient visits subject to my deductible? If yes, how much is my deductible and how much of my deductible has been met this year?
    • What is my co-pay or co-insurance (for telehealth vs. in-person visits)?

     

    For more detailed information on determining your payment responsibility and how to confirm your in-network and out-of-network benefits, please see the 3 part series on my blog What to Ask Insurance.

    What are the benefits of paying out-of-pocket vs. using insurance?

    When you use insurance, the expense of therapy may be significantly reduced. However, when using insurance:

    • You will be given a diagnosis, which will become a part of your permanent medical health record.
    • Documented diagnoses (even though diagnoses can change and/or go away) can impact future medical treatment, access to services, and life insurance eligibility.
    • You must consent to giving your insurance access to all of your mental health records – this includes assessments and notes.
    • Your insurance plan will dictate whether or not you will be covered, what will be covered, the duration and frequency, among other aspects of your care, not my professional expertise and your goals and preferences.
    • You may find difficulty finding in-network therapists with availability or certain specialties.

     

    When investing in your treatment without involving your insurance:

    • You do not have to meet criteria for a mental health diagnosis in order to participate in therapy. I am a firm believer that anyone interested in therapy can benefit from the guidance of a trained professional.
    • You do not have to be given a formal DSM diagnosis. Although a diagnosis can be relieving, it can also be stigmatizing!
    • You have more autonomy over your therapy, e.g., themes addressed, frequency and/or length of sessions, and duration of treatment.
    • My energy and time goes towards YOU and not towards fighting with your insurance, doing administrative paperwork, and jumping through hoops simply to get you the care that is warranted.
    • You have greater access to therapists who specialize in treating what YOU want to treat.
    Do you offer sliding scale?

    At this time, I am working very limited hours and am unable to offer a sliding scale.

    Intake Paperwork

    I've scheduled an intake appointment. How do I sign and complete paperwork?

    You should receive a welcome email from “[email protected]” with a link to set up your username and password for the client portal. Please check your spam folder. If you have not received the welcome email or have forgotten your password, please contact me to have the welcome email resent or your password reset.

    Once logged in, you will find a number of documents to review, fill out, and sign electronically.

    My client forms are also available on the website under the Current Clients section of the website. This section is password protected. Please reach out to me if you do not have the password. You can download the forms and return them to me BEFORE your intake appointment either by secure email or fax at 503-717-6603.

    Do I need to upload my insurance card to the portal?

    It isn’t necessary that you upload your insurance card to the portal; however, it can aid me in verifying your benefits, especially if you do it in right after our consultation. In my book, the more eyes on your benefits, the less likely we’ll have issues with insurance covering your sessions.

    The Insurance Card document that you download from the portal is a placeholder. You can skip downloading it and upload most any file formats, however, there will only be space for one file so be sure to include the front and back of the card in the same file.

    Do I need to upload a photo ID to the portal?

    No. We can verify your identify visually in the first session if that is your preference.

    Uploading the photo ID simply helps me verify your identity ahead of time. Trust me, it takes a surprisingly long amount of time for you to go get your ID, hold it up just right to your camera, and for me to squint and focus my eyes enough so I can read your name and date of birth. There’s a lot of administrative stuff that goes on in a first session. This is another way to speed the admin work up so we can get to the good stuff.

    How do I fill out the Authorization to Release PHI?

    For all Authorizations to Release PHI (Release of Information/ROI), you must download the PDF from Therapy Portal. It is a fillable form, however, if you do not have a PDF writing software, you can use PDF Escape, a free PDF editor where you can edit the form in your browser.

    Make sure to:

    • check “OBTAIN information from” and “DISCLOSE information to” as applicable
    • choose what information is to be used or disclosed
    • note the reason for disclosure
    • initial next to Mental Health Information and Alcohol/Drug Information
    • Sign and date
    • Upload completed form
    • Electronically sign through your portal

     

    Samples ROIs

    Do I have to sign the Non-Secure Electronic Communications Informed Consent?

    No, this consent form is optional. You have been assigned this form because you have requested to use regular SMS text or email. This form outlines the risks and conditions of use for using non-secure electronic communications. By signing, you are giving me permission to reply to your messages via regular email and SMS text message.

    If you prefer to use more secure methods, you can request an encrypted email from me to reply to (or reply to one you may already have); you can send an encrypted message via this website; send me a Signal message; or call and leave a voicemail if I am unable to answer.

    Therapy Sessions

    How long do sessions last?

    I schedule most individual therapy sessions as 50-55 minutes, unless otherwise agreed upon.

    How often do I need to attend therapy?

    I start with clients on a weekly basis to assist with the orientation, assessment, and treatment planning process. Your time is important and I find it most effective to determine whether we are a good fit and are making progress within the first month of treatment. As treatment progresses and your goals are achieved, we mutually decide upon reducing session frequency.

    If you are a previous client of mine, we may begin with reduced frequency if warranted.

    My schedule does not usually allow for less than biweekly clients.

    How long will I be in therapy for?

    Therapy is such an individual process. Time in treatment will depend on your goals, the degree of engagement in the process (both in and outside of session), frequency of sessions, and “medical necessity” as determined by your insurance plan, among other factors.

    I employ an individualized insight-building and skills-based approach, which has led many of my clients to experience significant changes in functioning within or by the first 6 months of therapy. At this point, clients can opt to continue work with me, take a “therapy vacation” to apply their obtained skills without the support of a therapist, move on to another therapeutic approach, or discontinue therapy having met their goals.

    What if I have to cancel or I no-show to an appointment?

    I have a 48-hour (business) hour cancellation policy. Cancellations made with less than 48 business hours’ notice and no-shows may be automatically charged the late-cancel ($100) or no-show ($100 for the first; full session rate for subsequent no-shows) fee as early as 7 minutes after the start time of your scheduled appointment. If you use your insurance benefits for payment of services and are going to be more than 7 minutes late to session, we will need to cancel the appointment and I will assess the no show fee.

    If you are an out-of-pocket client and are late, you may still attend. You will be billed the full service fee for the session length scheduled and forfeit the time lost due to the late start.

    These policies are listed in the Informed Consent form new clients sign prior to starting therapy with me.

    Online Therapy

    How does online therapy work?

    Telehealth, also known as telemental health or online therapy, is a growing field in which services are provided over HIPAA-secure webcam-based technology. I use Therapy Portal and Doxy.me for provision of my online services; generally, the former for established clients and the latter for initial consultations. Both are free for you and easy to use platforms.

    Telehealth offers several advantages such as convenience and flexibility, as well as the opportunity to receive mental health services in the comfort of one’s home. Although it is well validated by research, service delivery via telehealth is not a good fit for every person. I will discuss with you what is best for you and continuously assess for appropriateness and effectiveness of this delivery medium.

    Telehealth coverage can vary depending on plan. It is your responsibility to determine what/if services (video-conferencing, phone) are covered. Get help determining your telehealth benefits by reading my blog article What to Ask Your Insurance: Telehealth Benefits.

    I am traveling/not at my home. Can we still have our telehealth session?

    If you are physically present in the state of Oregon or Washington, you have a private space to hold a session, you own your own device, and have a secure Wi-Fi/data connection, yes, we can still have our session.

    It is strongly encouraged that you only communicate through a device that you know is safe and technologically secure (e.g., has a firewall, anti-virus software installed, is password protected, does not access the internet through a public wireless network, etc.). Additionally, please be aware that any information that you enter into an employer’s computer can be considered by the courts to belong to your employer and your privacy may thus be compromised. It is recommended that you use your own equipment to communicate and not equipment owned by another, and specifically to not use your employer’s computer or network.

    If you are out of the state, we may be able to have our session but it might require some investigating. If the social work licensure board of the state where you are physically present explicitly allows out-of-state licensed clinical social workers to provide services to those physically present in the state or I have received confirmation in writing of my ability to do so, then yes, we can still have our session. I have previously obtained confirmation from the states of Arizona, Colorado, and Tennessee. As each state is different and laws may change, please allow me sufficient time to obtain confirmation, even with the states of Arizona, Colorado, and Tennessee. You will need to provide the address of where you will be located for the session as well as the 10-digit local emergency services number.

    The social work licensing boards of California and Texas do not allow me to provide services to you if you are physically present in California and Texas.

    Please inform me with as much advanced notice as possible if you are interested in holding a session while out of state as I cannot guarantee the response time from the licensure board of the state in question. If I am unable to confirm permission prior to your departure, then I will err on the side of caution and be unable to hold the session.

    Can I do phone therapy?

    Therapy over the phone may be a possibility if you have confirmed that this specific service is covered by your insurance plan (it often is not) or if you are willing to pay for the service out-of-pocket (OOP).

    I offer phone therapy as an adjunct service to an already established client on an as needed basis. I will continuously assess for appropriateness and effectiveness of the phone as a mode of service delivery and may at any time discontinue this service to you if determined to be ineffective or inappropriate.

    Can I video/call you from my car?

    For your safety as well as liability reasons, I will not hold a session with you while you are driving. If you are participating in a session from your car, my policy is that the car must be parked and that you provide me your location (cross streets and/or address) and the make/model of your car. This information is required should I need to intervene in the case of an emergency.

    Where do I go for my online session?

    Log into Therapy Portal using your unique log-in and password. Under the Appointments tab, you will see a list of your appointments. Click on the Join Session button. This button will only appear when you have an appointment that will be starting soon.

    I can't get connected to the client portal for my session. What do I do?

    If we’ve already connected via Therapy Portal and it is failing, try our back up option at Doxy.me.

    If we haven’t yet connected and your session has started, give me a call at 503-317-7780 for more efficient trouble shooting.

    Miscellaneous

    Do you write emotional support animal (ESA) letters?

    I do not write emotional support animal letters due to the absence of clear legal and ethical guidelines for my profession to issue ESA letters. Given this ambiguity, I have determined that ESA letters are outside of my scope of practice and competence.

    Unanswered questions?

    We live in a busy world. Repeat questions will get added to the FAQs so that others in the future can find answers to their questions without having to reach out. Send me a message if there’s a question you (and likely others) need answered.