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      <image:title>Logistics - TL;DR: I am licensed in Oregon and Illinois and work with clients virtually in both states using encrypted and secure tech. Bring your pets &amp; fidget toys to session. If you’re local to Portland or Chicago, I offer limited in-person meetings for ERP. I’m in network with PacificSource &amp; Aetna, and offer reduced out of pocket fees for QTBIPOC clients and clients needing letters of support for surgery. Virtual Meetings: I am licensed in Oregon and Illinois and can work with clients virtually across both states. I use a HIPAA compliant video conference platform (it’s like encrypted Zoom for therapy). If the internet gets wonky, we’ll switch to my HIPAA compliant phone line. Virtual therapy is often a good fit for clients who find it easier to talk about feelings while being comfortable in their own space with pets and their favorite fidget toys nearby, folks who hate in-person eye contact, or people who have limited time and availability to go to an in-person session during a busy work schedule. I am primarily a virtual therapist, but for clients local to Portland, OR or Chicago, IL, I may offer limited in-person sessions for exposure and response prevention (ERP) therapy out in the community. Insurance and Fees: I am in network with PacificSource commercial plans (employer, college, and marketplace based) and Aetna. If you are not in-network, I accept out of pocket payment and can provide you with a monthly superbill to submit to your insurance company if you have out of network benefits. I use a HIPAA compliant billing app (it’s like encrypted Square for therapy) and can take credit, debit, or HSA (Health Savings Account) cards. As a social justice focused practice, I offer several reduced fee spots for clients experiencing multiple levels of systemic marginalization that cause other therapy options to be inaccessible. In recognition of the historical and current harm caused to these communities and individuals by the field of psychology, priority is given to QTBIPOC clients (queer, trans, Black, Indigenous, and other people of color). Assessments for gender affirming surgery letters of support are offered on a Pay What You Can community care model, with all funds collected going to ensure I can keep providing this service regardless of people’s ability to pay, and still get paid fairly for my labor as a trans person doing this work. Contact me to find out about rates and current availability. Privacy Focused Practices: As a person who is both horrified by tech overreach and uses tech for therapy, I care deeply about safeguarding my clients’ information above and beyond what’s expected of me legally. I believe therapy conversations should stay private, so I use HIPAA compliant technology for virtual sessions, phone calls, billing etc. and do not use AI tools for writing notes or assessments. I stay up to date on privacy focused mental healthcare tech and legal policies and consult regularly with data security pros. While I cannot change things out of my control like large scale data breaches from insurance companies, I do my part to keep your data as secure as I possibly can. If you have questions or concerns about this, feel free to ask.</image:title>
      <image:caption>No Surprises Act and Good Faith Estimates: In 2022, the federal No Surprises Act (H.R. 3630) went into effect. While the majority of this bill is aimed at educating consumers about their financial rights when seeking health care services at hospitals or facilities that may include out of network providers, all health care providers (including private practice mental health care professionals) are now required to notify clients of their out of network rights. This includes providing a notice on our websites, as well as providing clients paying for services out of pocket a Good Faith Estimate of costs detailing hourly rates for services. If you are a current client paying out of pocket, you will be provided a Good Faith Estimate annually.</image:caption>
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    <lastmod>2025-05-20</lastmod>
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      <image:title>About Me - Image Description: Dr. Ari Kramer, a white trans man with a beard, brown hair, and glasses sits in his therapy office smiling at the camera against a green wall. He has a variety of rainbow colored fidget toys and lego flowers visible in the background.</image:title>
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    <loc>https://www.empoweringtherapyandconsulting.com/gender-affirming-surgery-letters</loc>
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    <lastmod>2024-06-19</lastmod>
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    <lastmod>2026-08-19</lastmod>
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