Why I Don’t Accept Insurance (and What That Means for You)
Choosing private pay care gives you more privacy, flexibility, and focus in your therapeutic journey.
Many therapists accept insurance, and I fully understand why you would choose to work with a therapist who is in-network with your insurance. I also know that every day, therapists are leaving insurance panels to become "private pay" or "out-of-network" for various reasons. I've worked for practices that take insurance, and quickly realized that when I opened my own practice, I would not work directly with insurance. Here's why:
Lack of Privacy: Insurance companies can demand that I share private information with them, beyond just your diagnosis. Yes, this may include the notes I write for each session.
Late payments: Insurance companies get THEIR payments (the monthly premium you pay them) on time. However, they may decide to pay ME whenever they feel like it. Providers often wait 2-3 months for payments.
Fighting for payments: Even the simplest of clerical errors can result in late payments, lost payments, etc. This can mean spending hours of time on the phone to figure out why I never received a payment.
Insurance dictates treatment: Despite what a client, or myself, feels will be helpful - ultimately insurance companies decide what is appropriate to cover. Couples and family counseling is often not covered. Sometimes a "lower level" diagnosis is not considered serious enough to cover, and payment will be refused. Or an insurance company will only cover a higher level of care (such as inpatient) and a client cannot commit to such a program at that time, so their choice is: expensive and intensive care that may disrupt their life, or no care at all. A client who wants an "emergency" session and is seen twice in one week may not be covered because the insurance company also dictates how frequently a client is seen.
Rising costs: Premiums, deductibles, and copays continue to rise, yet the contracted rate stays the same, or even goes down. Basically, the insurance companies continue to make more money while slashing the amount the therapist gets paid.
Clawbacks: Imagine spending 30 hours on a work project, and then having your employer ask for 30 hours worth of your paycheck back because you weren't supposed to be assigned to that project in the first place. In the therapy world, these are called "clawbacks". Basically, an insurance company can demand a refund from the therapist, often as result of an error on the insurance company's end. Perhaps they sent me 30 payments for 30 sessions I spent with a client, then realized that they were not supposed to pay me because the client's employer had switched insurance companies months ago. The insurance company can then demand that money back from me, and I then have to inform my client that they owe me several thousand dollars. Imagine what that does to the therapist-client relationship. Even worse, there seems to be no time limit on how far back these clawbacks can go. It may take the insurance company 18 months to realize their error, and I might not even be treating that client anymore!
Long Story Short, Staying Off Of Insurance Panels Allows Me To Focus On You, And The Work We Do Together. It Allows Me To Focus On Your Needs With Flexibility And Creativity, And Without Influence From Insurance Companies. On Your End, Self-Pay Allows You Privacy And Ease - You Know Exactly What And Who You're Paying, And When. No Surprises.
I Do Provide Superbills To My Clients Upon Request. This Is An Itemized Receipt That You May Submit To Your Insurance Company If You Believe You Have Out-Of-Network Benefits And May Get Reimbursed. Please Note That In Order To Get Reimbursed, Your Superbill Must Have A Diagnosis On It, And Allows The Insurance Company To Request Your Records From Me If They So Choose.