Why We Don't Take Insurance FAQ
We're not alone.
When you use insurance, there is another person in the room - your insurance company. In order to use your benefits, your therapist must disclose, with your consent, your personal information in order to verify your eligibility, pre-authorize services, and process claims to obtain payment. This disclosure includes the nature of your issues for counseling, psychiatric diagnosis, your treatment plan, and how long you will need therapy for your issue. When submitting a bill to insurance companies on your behalf, your confidential information is processed and stored with your insurance company. Anyone who is involved in processing your claim will have access to your records and can view your records.
I will need to label you.
Many of my clients simply need to check in with someone to get a new perspective, learn some new skills, or explore some different strategies to try at home or work. These things, including marriage and couples counseling, are not typicall covered by insurance unless you are given a mental health diagnosis.
Although receiving a diagnosis when appropriate can be extremely beneficial, it does come with its fair share of unfortunate consequences, like compromising your ability to obtain life, health, disability, or long-term care insurance. Once you have received a diagnosis, it can follow you all your life.
The advantage of self-pay therapy is that your information is not released to the Medical Information Bureau, so even if you do receive a diagnosis, it is kept confidential between us.
I want you to feel empowered about your care.
I want you to be actively involved in determining your goals, how we work together, and when you feel complete with care. With insurance, many choices and treatment options are limited. Your insurance company will determine what is "medically necessary" and your most efficient treatment option.
Without insurance, you choose who you feel comfortable working with, rather than having a select list of providers that are covered. By paying out-of-pocket, you can be more confident that i am helping you in the way I am trained and qualified to do. Because I am not bound by insurance companies, I am able to focus my practice on tailoring your treatment plan to your unique journey.
I want to spend my time working with you - not on hold.
The insurance claim filing process requires a great amount of paperwork and time. If your claim is denied, for any reason, the appeals process can be long, frustrating, and unsuccessful, leaving you responsible for the bill.
Although you may have only a $ 40 co-pay per session, you will likely have a limited number of sessions that insurance will cover (average is 6-10). You may find that this number is not sufficient and will be faced with the options of stopping therapy, praying for it out of pocket, or go through an appeals process with your insurance company.
The value of private pay over managed-care services through your insurance company is that I can personalize your treatment, offer true privacy and provide more effective care for you. It is always your personal choice whether or not to use your health insurance to pay for your therapy. For some, using insurance benefits is the best choice and others will prefer the freedom paying out-of-pocket gives them in their journey toward mental wellness.