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Merkaba Integrative Psychiatry
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Ketamine Therapy
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About Merkaba
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Donate to Thank You LIfe
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Access to Care & Financial Transparency

Access to Care & Financial Transparency

 

At Merkaba Integrative Psychiatry, I believe meaningful mental health care should be accessible, respectful, and sustainable.

Financial circumstances are different for every person, and they can change throughout our lives. My goal is to create a way of paying for care that honors those differences while also allowing Merkaba to remain a small, sustainable practice capable of providing deeply individualized care.


For clients paying out of pocket, Merkaba offers Community Access Pricing — a trust-based, tiered fee structure that allows you to choose the rate that best reflects your current financial circumstances.


There is no application and no income verification.


I simply ask that you choose thoughtfully and honestly.

Seed • Bloom • Rooted • Radiant

The same care is provided at every level.

Your tier does not determine the quality, attention, time, or type of care you receive. The tiers simply recognize that the same healthcare expense can have very different impacts on different people.

Seed — Supported Access

Seed — Supported Access

Seed — Supported Access

Seed is intended for those experiencing meaningful financial hardship who would otherwise have difficulty accessing care.

Seed may be a good fit if:

  • paying the standard fee would interfere with essential expenses such as housing, food, healthcare, transportation, or childcare
  • your income is limited, unpredictable, or temporarily disrupted
  • you have little financial cushion or savings
  • accessing care at the standard rate would not currently be realistic

Because Seed represents a significant reduction in fees, the number of Seed spaces available may be limited.

Bloom — Accessible Care

Seed — Supported Access

Seed — Supported Access

Bloom is intended for those who can contribute toward the cost of their care but for whom the standard fee would create meaningful financial strain.

Bloom may be a good fit if:

  • your basic needs are generally met, but finances require careful planning
  • you have significant debt, medical expenses, childcare costs, or other financial responsibilities
  • you have limited discretionary income or savings
  • paying the standard fee would require significant sacrifice, even though it would not jeopardize your essential needs

Bloom allows you to access care at a reduced rate while still contributing meaningfully toward the cost of providing that care.

Rooted — Sustainable Care

Radiant — Community Support

Radiant — Community Support

Rooted represents Merkaba's standard private-pay rate.

Rooted may be a good fit if:

  • you have stable income and can reliably meet your essential expenses
  • paying for care does not create significant financial stress
  • you have some savings, financial cushion, or access to financial support
  • you can pay the standard fee while continuing to meet your other financial responsibilities

The Rooted rate reflects the actual time, expertise, preparation, documentation, administrative work, and resources involved in providing individualized care through Merkaba.

Choosing Rooted when it is financially comfortable for you helps keep the practice sustainable and preserves reduced-fee spaces for others.

Radiant — Community Support

Radiant — Community Support

Radiant — Community Support

 Radiant is an optional community-supporting rate for those who have greater financial flexibility and would like their payment for care to help extend access to others.

Radiant may be a good fit if:

  • your essential needs are comfortably met
  • you have reliable income and meaningful financial flexibility
  • you have savings or other financial resources
  • paying somewhat more than the standard rate would not create financial strain
  • supporting greater access to mental healthcare is something you value

Choosing Radiant helps Merkaba continue offering Seed and Bloom rates to people who might otherwise be unable to access care.

Radiant is always voluntary.

Choosing Your Tier

 There is no perfect formula for determining which tier you belong in.


Consider not only your income, but your overall financial reality: housing costs, debt, dependents, medical expenses, savings, access to family resources, employment stability, and other circumstances that affect your ability to pay for care.


A simple way to think about it:


🌱 Seed: Paying for care at a higher rate could compromise my ability to meet essential needs.


🌸 Bloom: My essentials are covered, but the standard rate would create meaningful financial strain.


🌳 Rooted: I can pay the standard rate without significant financial hardship.


✨ Radiant: I have greater financial flexibility and can comfortably contribute above the standard rate to help sustain access for others.


I trust you to choose the tier that most honestly reflects your circumstances.

Fees

Availability & adjustments

Availability & adjustments

 

There is no application or income verification. I trust clients to thoughtfully select the level that best reflects their current financial circumstances.


A complete Community Access fee schedule is available upon request.


Seed and Bloom availability may be limited based on practice capacity.

Availability & adjustments

Availability & adjustments

Availability & adjustments

  • Sliding scale slots may be limited at times based on scheduling and demand.
     
  • If your financial circumstances change, you’re welcome to request a tier change.
     
  • All sliding scale conversations are handled confidentially and respectfully.

Good Faith Estimates (GFE)

 As part of my commitment to transparency, trust, and informed consent, I provide Good Faith Estimates for services when required by law and whenever it is clinically and ethically appropriate to do so.


What is a Good Faith Estimate?


A Good Faith Estimate (GFE) is a written explanation of the expected cost of your care before services are provided. It is meant to help you understand what you may be charged for a specific service or course of treatment.


Good Faith Estimates are required under the No Surprises Act for individuals who:

  • are uninsured, or
     
  • are self-pay (not using insurance for a particular service)
     

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Why I provide Good Faith Estimates


I believe that clarity around cost is part of ethical, respectful care. Providing a Good Faith Estimate allows you to:

  • understand anticipated costs before starting care
     
  • plan financially with fewer surprises
     
  • ask questions and make informed decisions
     
  • engage in care from a place of trust and safety
     

For clients using a sliding scale, the Good Faith Estimate reflects the fee tier you have selected, not the full standard rate.


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What a Good Faith Estimate includes


A Good Faith Estimate typically outlines:

  • the type of service being provided
     
  • the expected fee per session or service
     
  • an estimate of total costs over a defined time period
     
  • any assumptions used to create the estimate
     

Because mental health care is individualized, actual costs may vary depending on clinical needs, changes in treatment frequency, or additional services requested.


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Important rights under the No Surprises Act


If you receive a Good Faith Estimate and are billed $400 or more above the estimated total, you have the right to dispute the bill.

You may start a dispute resolution process by contacting the U.S. Department of Health and Human Services (HHS).

More information is available at:
www.cms.gov/nosurprises


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My approach

  • Good Faith Estimates are provided in writing
     
  • Estimates are updated if your treatment plan changes
     
  • Questions about fees are welcomed and handled respectfully
     
  • Financial conversations are kept confidential and non-judgmental
     

If you have questions about your estimate or would like one before scheduling, please let me know — I’m happy to help.


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