Letters of support for surgery
Experience and Approach to Letters
In a perfect world, medical transition care for trans and nonbinary individuals would operate on an informed consent model. While we are moving in this direction, there are still some parts of the process that may require a letter from a mental health professional. Despite WPATH releasing an updated standards of care last year, insurance companies are continuing to require letters to be written according to the previous guidelines in the 7th edition, which I also have extensive experience with. I am happy to offer this service as a part of my practice.
I have probably written over 250 letters of support to date and to my knowledge, I have never had someone have their procedure denied on account of my letter and have never had a letter sent back for edits. Because of the various types of experience I have gained in my career, including working for a facility gaining insurance authorization and then later, working at an insurance company doing the authorizing, I am very knowledgeable about medical necessity criteria and what/how insurance approaches authorization. In addition to this experience, as a person with lived experience as a nonbinary trans guy, I’ve been through the process myself, and know it’s not always the most pleasant process and can feel quite vulnerable. My goal is to create an environment of trust and comfort so that we can work together to help you achieve your gender journey goals. I’d honestly be happy to never have to write a letter of support again but in the meanwhile, my goal is to remove barriers and write a letter that is reflective and honoring of your journey while also fulfilling the criteria of “medical necessity” required for health insurance to cover the care needed. I do this by ensuring all the necessary information is in the letter for your insurance to authorize coverage and that the process is not prolonged with edits or denials by insurance on the basis of my letter. In order to do this, we will need to meet for a session so that I can gather the necessary information to do this.
Sessions for Letters of Support
I complete letters on a single session basis, unless I am unable to gather all the information necessary in one session, I would then require another, although this is rare. Sessions for an evaluation for a letter of support are 60 minutes long and the cost of this session is $165. I complete the letters themselves on a pay what you can donation basis, which literally means whatever you are able to contribute. I’ve had folx donate from $0-$250 and there is no wrong amount! The funds that I receive from these donations assist in off setting the costs associated with maintaining 30-35% of my caseload available at a reduced fee to assist young trans and nonbinary adults access mental health care who would otherwise be unable to do so.
Some additional helpful information about letters: Letters are generally “good” for a year and if a year passes and an update to a letter is needed, we would need to meet again. If you need another later for a different procedure other than one we have met with about before, we would also need to meet for a separate session. While I am hopeful that Texas will be joining a multi state reciprocity compact for counselors eventually, we unfortunately aren't there yet and since I am only currently licensed in the state of Texas, I can only meet with people who are physically located in Texas at the time of our session.
Availability and Process to Schedule
Because I carry a caseload of therapy appointments, my availability for letters is limited. I typically have only 4-6 sessions available each month. Availability for the next month is posted on the second Friday of the month (for example, availability for June 2024 will be posted on Friday May 10th, 2024).
You can self schedule at the link below. If no appointment comes up, this means that all appointments are filled.
https://nextquestcounseling.clientsecure.me
If you have any questions, please reach out via the contact form below!
Contact form
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical 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 bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or 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.
Providers cannot balance bill a patient unless patient was notified prior to services and signed an agreed upon consent to waive protections.
Any State laws supersede Federal protections against balance billing.
Listed below is contact information for individuals who feel a facility or provider has violated the state of federal requirements against balance billing.
For questions or more information about your right to a Good Faith Estimate, visit (if your State does not have guidelines relating to No Surprises Billing, contact the Department of Health and Human Services)
Department of Health and Human Services: www.cms.gov/nosurprises or 877-696-6775
Texas: https://www.tdi.texas.gov/medical-billing/surprise-balance-billing.html or 800-252-3439