Hey y'all! Good evening to you 😀

I am writing to share some incredibly exciting news and important updates about the practice! Because this email contains a lot of detailed information, here is a quick summary of the changes going into effect on June 1, 2026:

The Quick Guide:

• Practice Growth: Gareuhpist Counseling & Consulting is officially a group practice! Future goals include adding associates, medication management, out-of-state services, and agency partnerships.

• Communication & Scheduling: We are transitioning away from text messaging. Please use the private portal for all messaging and scheduling. Email is reserved for sending attachments (like photos!).

• The Client Portal App: Just a friendly reminder that there is a mobile app available! Please make sure to download it for easy access to the portal.

• Insurance Opt-Out: If you have insurance but choose to self-pay, industry regulations require you to sign a brief waiver.

• Rate Adjustments: Base cash-pay rates will be adjusting.

• Billing & Balances: Copays/fees are due at the end of every session, we are transitioning all payments to the secure portal (phasing out Venmo), and we will work together on manageable plans for any outstanding balances.

Below are the full details regarding these exciting next steps.

The Details

Exciting Practice Growth:

 Gareuhpist Counseling & Consulting is growing. I am now fully in-network with Anthem, Aetna, Cigna, United, and dozens of affiliated companies, and I am proud to report that I am also now a licensed Medicaid provider. Furthermore, GCC is officially registered as a group practice! I am so excited to bring my own therapeutic brand of neurospiciness to a broader audience, and looking ahead, my goals include expanding my license to practice out of state, and potentially partnering with other specialized agencies to broaden our holistic offerings. It is also my intention in the future to bring on an associate who can provide medication management, creating a much more comprehensive care experience for you. This is the first step in expanding my ability to reach and help more people, and I am incredibly positive about the future of this practice.

Secure Communication & Scheduling:

Starting June 1, I am asking that we transition all of our day-to-day messaging and communication over to the private client portal. If you need to share specific attachments with me—especially photos of what you are doing so we can continue to share in some vicarious joy!—please feel free to send those via email.

Additionally, I know many of you have been comfortable texting me in the past, particularly to adjust appointment times. While your initial intake forms acknowledge that you accept the privacy risks of non-HIPAA compliant text messaging, I need to officially phase out general SMS texting for clinical and administrative communication. As the practice grows, trying to juggle scheduling across multiple text threads makes it easy for things to slip through the cracks. Going forward, I invite you to use the portal to schedule, cancel, or reschedule your sessions. If you review the calendar and cannot find a day or time that works for you, please send me a message through the portal. As I have always promised, I will always find time for you. Using the portal to request a time helps us efficiently coordinate a spot that fits your needs while keeping the daily schedule flowing smoothly for everyone.

Unless we have explicitly discussed and agreed upon an exception for your specific circumstances, please direct all future messages to the portal.

Insurance Opt-Out & Self-Pay Agreements:

If you have health insurance but prefer not to use it for your therapy sessions, you are completely within your rights to self-pay. However, to remain compliant with my new insurance contracts and state regulations, you will be required to sign an "Opt-Out" waiver. This simply documents that you are voluntarily choosing to decline your insurance benefits and pay out-of-pocket. Please know that this is not a personal policy I created to be difficult; it is a strict requirement from the insurance panels to prevent the misrepresentation of healthcare costs. Having this form on file protects the practice from contract violations and aligns with broader healthcare regulations designed to protect consumers.

Cash Rate Adjustments: 

As the practice expands and operating costs evolve, I will be adjusting my base cash-pay rate. I have proudly maintained my standard cash rate without a single increase since I first introduced it in 2015. However, to keep up with the current costs of running the business, effective June 1, if you are currently paying my standard $50 rate, it will be adjusting by $10 to the new standard rate of $60 per hour. This new rate will automatically be reflected in the portal for sessions on or after June 1.

However, if you and I have previously established a specific, reduced rate based on your unique circumstances, that exception will remain honored. As an independent practice owner, I will always reserve the right to make specific financial arrangements to ensure my clients get the care they need. If you have any questions or concerns about your specific rate, please feel free to send me a secure message through the portal.

Billing and Outstanding Balances:

To maintain the financial stability required to grow and support more clients, all copays and self-pay fees are due at the end of each session. Your card on file will be automatically charged for the balance due at that time or at the close of business that day.

I recognize that financial flow can sometimes be unpredictable. If you ever prefer to log into the portal and process the payment yourself, or if you need a brief pause on the charge, you absolutely have the right to request that from time to time. I simply ask that you explicitly let me know at the end of our session before we wrap up. No forms are required for this—just a quick, direct heads-up so I know to pause the automatic charge for that day.

Additionally, as the practice continues to grow, I’ve hit a point where my bookkeeping needs to be much more centralized. Unfortunately, this means I have to phase out Venmo as a payment option. Moving forward, I ask that we transition all billing through the secure portal so that all financial records stay in one place.

Regarding existing outstanding balances, I am shifting to a more structured approach moving forward. My goal is to completely eliminate any ongoing back-and-forth about money so that our time together remains focused on your clinical growth. If you currently hold a large balance, we will need to establish a clear, manageable payment plan.

I want this process to be as comfortable as possible for you. If you have a specific arrangement in mind that fits your budget, please send me a secure message through the portal with your suggestion. If you are unsure what to propose, that's ok too. I am open to whatever you can suggest. If you have any questions about your balance due please let me know and I will dig deeper into the invoices and payments and re-verify. My intention is to support, not shock. 

I began working privately 11 years ago, and my goal has always been to provide the best possible care. I hope you can understand why these steps are necessary for the next logical phase of this journey. Regardless of how long you have been on my journey with me, I am incredibly appreciative of your trust in me, my brand (no matter how scattered it may sometimes feel!) and I look forward to seeing where this road takes us. I thank you again for your grace and cooperation as we make this transition!

If I make any mistakes in this process, I beg your grace. We're all just frightened children, fumbling around...

Many blessings to you and all those you reach today,

Gary W. Nelson, LCSW

Licensed Psychotherapist in Private Practice

Gareuhpist Counseling & Consulting, LLC

Indianapolis, Indiana  46237

w: www.gareuhpist.care

e: gary@gareuhpist.care