Are you ready for the possibility of a pivotal change and/or getting back to or the re-discovery of your best self?
Given my belief in everyone having access to quality mental health services, I offer a variety of options to connect with me through my practice!
I am a fee-for-service provider. With this, I am able to offer a Superbill for client’s who wish to seek reimbursement from their healthcare insurance provider as an out-of-network provider. Client’s may also wish to use the source Reimbursify to seek reimbursement.
Sessions are $150 per 50-minute session.
I also offer text-based services for my “on the go clients” at $80 per week (equivalent to one, 50-minute session).
Within my work with insurance companies, there is some valuable information that I have learned along the path that I desire my prospective clients to also know so that they can make a well-informed decision on how to best proceed.
Your therapist must diagnose you in order to get reimbursed for your care.
Similar to when you go to a doctor for the common cold, your medical professional must diagnose you in order to be compensated for the medical care provided.
Also, in the mental health field, insurance will not reimburse for difficulties that are associated with your marriage, family difficulties, relationship challenges, grief/ loss, personal growth, values clarification, self-esteem, stress management, or even if the person is just “having a hard time.”
In fact, beyond diagnostic criteria, most of the issues my clients seek out therapy with me for would ultimately not be covered. This is often because many of my client’s are functioning well beyond the basic level managed care/ insurance companies compensate for.
Here are some of the typical therapeutic focus areas that I work with my clients on:
This means (even for couples or family therapy) a person within that treatment unit must receive a label and these “labels” (aka Diagnosis) will remain a part of their official record permanently. This may not seem like an issue now but what if they need to seek out new medical coverage in the future…a mental health diagnosis could mean the difference between obtaining the preferred coverage or none at all.
Records may not be protected.
When one uses their insurance to receive mental health services, the insurer may have access to your records at anytime they desire via an insurance audit. This could mean that the most confidential and personal details that you entrusted with your therapist are now exposed to the eyes of the “claims specialist” that your insurance company hires.
This exposure may also apply if an individual decides to seek out or apply for high clearance employment or even if you have other reasons for your records to remain confidential. When utilizing private pay your records remain secure with few exceptions–unless there is a court order signed by a judge or you, yourself sign an authorization for release of records (see informed consent).
Your care is dictated by the insurance company.
Insurance companies require a treatment plan to be submitted by in-network providers. This means that when individualizing your mental health care and treatment towards the optimal benefit of your needs…your therapist is obligated to share what the focus of your sessions will be, how long you will require treatment, and gain approvals for initial and ongoing treatment. It is an highly intricate and tangled web and sometimes, despite best efforts, your therapist may not even be compensated for your care.
To put it simply, your in-network therapist works for the insurance company–not you. Oftentimes, it may not matter what your therapist decides may be the best approach to your therapy as your treatment will need to fit within the insurance companies/ managed care matrix of decisions. Further, the amount of sessions you will receive is decided head of time and may not based on your ideal need(s).
Insurance Companies almost never pay the full session fee.
Since insurance almost never pays the full session fee, the client is typically responsible for the difference between what the clinician charges and what insurance may pay. Also, if the claim is denied (for various reasons)…you got it…the client is on the hook for payment for services rendered. If your therapist does not charge the difference…this means your therapist is working for, what may be, less than fair market wage.
Insurance may limit your access to quality mental health care options.
Many therapists may at least attempt to take insurance (at least in the beginning); however, based on my experience, many of us (as we gain experience and grow within our profession) eventually conclude our work with insurance companies in order to provide more optimal and quality care to our clients. This means, there may be very few seasoned / experienced therapists on insurance panels. Given the limited options this could also mean you may not be able to get into your therapist as frequently or when desired (given their full and often overloaded schedule). Therefore, to summarize, choosing to utilize an insurance-based therapist may severely limit your quality options.
Pay cash for sessions…often referred to as “Private Pay.”
This will best ensure–with very few exceptions–your records remain confidential. That is all information between you and your therapist remains between you and your therapist. Further, your care is dictated by what YOU think you need–not your insurer.
If you cannot afford to pay cash, consider seeking out a non-profit organization.
Many areas have non-profits in place that may offer a lower private pay fee. In fact, given my belief of quality mental health care for everyone, I devote my time as a Director at a local non-profit agency. You may likely see less experienced clinicians (e.g., ones that I personally supervise) but you will be able to more greatly maintain your confidentiality and control over your care.
If you need to bill insurance, consider an out-of-network provider and submit a SuperBill for reimbursement.
You may pay upfront and your diagnosis will be recorded but it will give you the freedom to choose any clinician/ therapist and your records will be more protected than if you go with an in-network therapist.
If you must absolutely use and bill your insurance with an in-network/ insurance-based clinician, be ready to ask questions and do your due diligence ahead of time.
Your in-network therapist should be able to discuss what level of transparency the insurance provider expects/ requires. The therapist will likely know what notes may be requested, if a treatment plan is required, and what diagnosis may qualify as “Medical Necessity” to give you coverage and even if you meet this criteria (via an intake assessment). Please keep in mind, it may be possible that you may have to pay for this assessment if you do not meet criteria. Asking these questions ahead of time may better support you in determining how you would like to proceed.