Frequently Asked Questions

Please find below the most common questions we are asked.  If you have other questions not listed below, please click here to contact us.

If you have a general question that isn't answered here, please contact us.  You may also call or text us at 423-834-7209
If you have questions about billing and/or insurance, please reach out to the billing coordinator directly at 423-510-1999 x8

Dr. Santan's rate is $110 per session during business hours and $135 for evenings and weekends. Reduced fees are not available at this time. We are able to file claims for insurance. If you can use your insurance then your fee is based on your specific plan (co-pay, deductible, co-insurance, etc). Please see below for more information about insurance. For payment of fees, we accept cash, check and credit/debit cards. Some services may qualify for HSA/FSA use. Please click here for additional information about rates. There is a small additional administration fee for those who choose to take the Prepare/Enrich assessment (see below for more information).

We are able to file claims with most insurance plans. We are currently in network with BCBS, Cigna, Aetna and UHC (excluding Medicare and Medicaid plans). Please know that not all services are covered by insurance.

If Dr. Santan is not an in network provider for your specific plan, you may be covered at your out of network (OON) rate. You are encouraged to contact your insurance provider to ask what your OON reimbursement rate is or you can contact the billing coordinator at 423-510-1999 x8.

We do not file for insurance reimbursement for couples therapy (see below for more information about couples therapy).

Insurance companies require a lengthy application process. Chances are good that our application is just stuck in the red tape of the insurance company's vetting process. Sometimes they will expedite the process or approve a single case insurance claims if you call and ask them to.

In other instances, insurance companies will both/either decline acceptance into their network and/or insurance companies reimburse at rates that are just too low and devalue the services we provide. We aren't willing to enable such disrespectful behavior from those organizations.

In most cases Yes, but please keep in mind that out of network claims are NOT paid directly to the practice.  As a result, you will need to come to sessions prepared to pay out of pocket and we will file a claim for you.  Reimbursements for out of network claims are typically paid directly to you by the insurance company.  

Although we are very sympathetic to the trials of financial strain, we are unable to offer a reduced fee at this time. We consider therapy an investment in your health and/or the health of your relationship. You should be prepared to prioritize this part of your self-care strategy when you begin treatment.

If you are using insurance, a GFE is not necessary or possible since the insurance company dictates the fee and reimbursement structure.

For patients who will be paying out of pocket, we are required to provide to you a GFE regarding fees.  You will be provided our GFE to review and sign when you are completing your new patient paperwork before the first session.  

Unfortunately, most claims for couples therapy are denied by insurance companies. This outside of our control. Rather than try to submit a claim and have it rejected and then present you with a large bill to cover the costs, we’d rather be upfront about this to avoid unpleasant surprises. All fees for couples therapy are private pay only: cash, check or credit card.

It’s our understanding that relationship distress is not considered a medical condition and therefore is not covered by a medical insurance plan.

Nothing has changed really. Some mental health practices have been able to negotiate with the insurance companies to allow reimbursement for Z codes. Some therapists have decided to use a diagnosis code that is covered by insurance in order to get insurance to pay the claim. Neither applies to Thrivepoint® and using a diagnosis code that is covered by insurance but isn't accurate in the medical record is unethical and illegal and I'm am not willing to accept the risks associated with doing that (it could be considered insurance fraud which carries with it hefty fines and consequences).

The diagnosis code for problems in a relationship is Z63.0. You’re welcome to contact your insurance company to ask if they will reimburse for that diagnosis code. If so, you can submit a written confirmation of that to our office and we will submit a claim for you.

We can also give you an itemized receipt called a “superbill” which can be used to verify your treatment. You will then be able to submit the superbill to your insurance company to ask for reimbursement which will likely be paid at your plan’s Out of Network (OON) rate. In this case the reimbursement will be paid to you. You will still need to come to your sessions prepared to pay the full fee.

This really depends on your plan, but from what we understand about those accounts, an HSA/FSA account is only supposed to be used for medically necessary and billable services. Since relationship counseling isn't considered a medical treatment nor does it carry with it a billable diagnosis, you probably shouldn't use your HSA/FSA account.   When you add a credit/debit card to your account for billing purposes, you're welcome to use whatever card works best for you, but please know that this isn't something we can monitor.  If you are audited by your insurance company to justify your use of an FSA/HSA account, you'll need to be able to demonstrate that you used your account in accordance with the plan's requirements. Sometimes when a FSA/HSA account is used for non-covered services, such as relationship counseling, you could be fined or required to reimburse that account or there could be a tax penalty. Please refer to your insurance plan's details for more information.

Aliquam purus sit amet luctus venenatis lectus magna fringilla urna. Egestas congue quisque egestas diam in arcu cursus euismod.

...

Yes. There is a $35 assessment administration fee. This fee is charged by the organization that maintains the assessment and the fee goes directly to that organization. This is not an add on fee for counseling.

The PREPARE assessment is for pre-married couples and the ENRICH assessment is for married couples. Dr. Santan will set up access to the assessment for you and you will each take the assessment individually at your own convenience. The assessment is administered online by the Prepare/Enrich organization. Once each member of the couple submits their assessment answers, the organization will compile the results and send the report to Dr. Santan who will review the results with you during your sessions.

Due to the extensive nature of the assessment results, Dr. Santan requires a commitment of at least 4 sessions to review the results and begin discussing any areas of your relationship that present a concern for you.

For married couples, Dr. Santan will ask you to schedule an initial appointment to discuss your challenges and to see if the assessment will be a good fit for you (not every relationship will benefit from the assessment). Once he determines that the assessment will be a good fit for your situation, you can take the assessment at your leisure.

For pre-marriage couples, Dr. Santan strongly recommends that you take the assessment as early as possible - preferably before your commitment to each other in engagement. Pre-marriage counseling should not be just a box you check just prior to marriage. The pre-marriage counseling that Dr. Santan offers is best done after you have determined that you would like to move your relationship to the next level but before you get engaged.

In order to qualify for the marriage license discount available in TN, you must have at least 4 sessions. For instructions on how to apply for the discount and for the certificate of completion form, please visit the Hamilton County Clerk website by clicking here.

...

...

Dr. Santan is certified to administer the PREPARE/ENRICH assessment (see the "Prepare/Enrich Assessment" section of this FAQ page for more information) and uses that as a guide if couples want to do that assessment, but other than that he uses his own methods for couples that he's developed over the last 15 years. His methods do incorporate some principles from resources such as Gottman, EFT and a few others but he doesn't rely on any one particular method.

Dr. Santan prides himself on tailoring treatment to each couple's needs and to their unique situation and relationship rather than try and use a "one size fits all" approach.

As long as you are each in one of the three states in which Dr. Santan is licensed to practice (TN, GA and FL - see the "Telehealth" section of this FAQ page for more information about telehealth), you can each be in different locations and Dr. Santan can conference you in on the same video call. The best practice is for you to be together in the same location but it's understandable that you may not be able to sometimes. Just let us know before the session so that we can coordinate everyone's access to the video platform.

Unfortunately no. To avoid conflicts of interest and a loss of objectivity, Dr. Santan can only provide either your couples counseling or one person's individual counseling.   He can't provide both couples and individual counseling for you and/or your significant other.   

The couples therapy Dr. Santan provides is best suited for couples who want to stay together and are motivated to heal, grow and work on change together.

Dr. Santan's approach is NOT typically a good fit for couples who are in crisis mode or ready to split and are just doing couples therapy as a last resort.

Dr. Santan's approach is more suited for couples who are looking for preventative measures and couples who are looking to fine tune and smooth over rough areas.

...

...

Yes. Dr. Santan is a board certified telemental health (BC-TMH) provider and can provide counseling online via phone, video and messaging (secure texting) to people who are located in Tennessee, Georgia and Florida. ***Please note: Due to current licensing laws, you MUST be located in one of those three states (TN, GA, FL) at the time of the appointment.  

The virtual office is currently located at: https://doxy.me/drsantan. When it's time for your appointment, click on the link and you will be given instructions for entering the virtual waiting room. This is a permanent link so please bookmark it for future sessions.

Due to current licensing laws, you MUST be located in one of those three states (TN, GA, FL) at the time of the appointment.

Couples can be in different locations as long as you are each in one of the three states in which Dr. Santan is licensed to practice (TN, GA and FL), Dr. Santan can conference you in on the same video call. The best practice is for you to be together in the same location but it's understandable that you may not be able to sometimes. Just let us know before the session so that we can coordinate everyone's access to the video platform.

As long as you are each in one of the three states in which Dr. Santan is licensed to practice (TN, GA and FL - see below for more information about telehealth), you can each be in different locations and Dr. Santan can conference you in on the same video call. The best practice is for you to be together in the same location but it's understandable that you may not be able to sometimes. Just let us know before the session so that we can coordinate everyone's access to the video platform.

...

...

We will initially spend time discussing together what it is that brought you to counseling. Our first few sessions will consist mostly of information gathering where I get to know your unique situation and needs. I spend a great deal of time during the first few sessions listening to your story, asking questions, answering your questions, helping you refine and prioritize your goals, assessing your mental health and developing a treatment plan that’s specific to your situation.

Then, as the sessions progress, we will dig deeper into the problems and any emotional turmoil and work together at solutions using problem solving techniques. Occasionally you will be given assignments or things to do during the week to either practice what we discussed in a particular session or prepare for the next session. When you feel that you are at a place where I’ve pointed you in the right direction and you can continue on your own you will be discharged from my counseling services.

With a few exceptions, we maintain an open-door policy. You're welcome to come back to counseling for a "checkup" to make sure you're still on the right path or to begin therapy again with a new problem should the need arise.

Most people carry around trauma and Dr. Santan can address issues of trauma as part of your treatment plan if trauma experiences are part of your history and play a role in something like anxiety, depression, anger, etc. but he's not a trauma specialist. If you want/need to focus on trauma resolution as your primary objective in treatment, you'll need to seek the help of a trauma specialist. Some people have severe trauma experiences and will need to do trauma resolution first and then move on to treat other issues.

...

...

...

By "holistic" I simply mean that I consider the whole person in all domains of life (emotional, mental, physical, spiritual, social/relational/familial) as interconnected and comprehensive. I believe that health is achieved when all parts are synchronized and working together in concert and I work towards that goal. It also means that I search for root causes rather than just focus on symptom management.

I'm perfectly fine with the use of medications and I try to coordinate care with prescribing providers as much as possible. I don't interfere with medication management. I leave that between you and your physician.

By "spiritual" I simply mean the part of us, as humans, that's connected to the metaphysical items of life such as logic and reason, subjective music appreciation, emotions, a 'higher power' and/or the connections we feel to other human beings and to our fellow citizens of the world. 



Bad church experiences...

In the interest of being genuine and authentic, I do consider myself a Christian in my religious perspective, but, in the work I do as a therapist, I'm a therapist first and a believer second. I do not focus on religion (unless a patient wants to focus on that) or push my faith on others or require that patients have the same faith as me (or any faith at all). It does help if the patients I work with have a similar world view, but it's not necessary. I'm more than capable of flexing to a very diverse range of world views, faiths and spiritual beliefs.

...

...

...

Thrivepoint® is a registered trademark of Thrivepoint®, PLLC. All other product names, company names and logos are trademarks™ or registered® trademarks™ of their respective holders. Use of them does not imply any affiliation with or endorsement by them.