THE REASONS I DON'T WORK WITH INSURANCE
FIRST..... and foremost, I want to serve my clients and provide the best care possible. My experience has rendered me unwilling to spend time working with insurance issues, knowing my time as a clinician is better spent focusing on our therapeutic relationship. What are those issues?
We aren't the only ones in the room...
Many people do not realize that when you use your insurance, there is another person in the room - your insurance company. In order to use your benefits your therapist has to disclose, with your consent, your personal information in order to verify your eligibility, pre-authorize services, and process claims to obtain payment. This includes such things as the nature of your issues for counseling, psychiatric diagnosis, your treatment plan, and how long you will have the problem. If I submit a bill to the insurance companies on your behalf, your confidential information is processed by the insurance company and stored in a database. Anyone involved in the processing or handling of your claim may have access to your records and anyone who has a legitimate reason to access the medical database, such as insurance companies and future employers, can view your confidential records.
In order to be "treated", you must have a "psychiatric diagnosis"...
Most people I work with seek my service to assist them in uncovering, discovering, and recovering. By that I mean, we all have obstacles in our lives and our relationships. Some we are aware of, others we are not. We start the journey by uncovering those obstacles and personal strengths, and then we work with those strengths and also discover new ways, new perspectives, new skills to journey through life in a better way, and we continue to recover by embracing life in a new way by finding courage to change what is not working and accepting the things we cannot control. This work doesn’t require a “diagnosis”. And, just because you don't have a quantifiable diagnosis, doesn't mean you can't benefit enormously from therapy.
Although receiving a diagnosis when appropriate can be extremely beneficial, the downside of filing a claim with your health insurance company, is that it may compromise your ability to obtain life, health, disability, or long-term care insurance. Once you have received a diagnosis, it (and the stigma) stays with you. The advantage of self-pay therapy is that your information is not released to the Medical Information Bureau, and if you do end up with a diagnosis, it is kept confidential between you and your therapist and shared only with your permission and within the laws of confidentiality.
I want you to have a voice and a choice in the process...
Therapy works best when you and your therapist are invested in the process and you work together in deciding the goals and terms. If insurance is involved your choices and treatment options are pre-determined by medical necessity, efficiency, and a list of providers. This way, you get to choose who you work with and why you want to work with them.
By keeping insurance out of the equation, you can be confident that your therapist is serving you and your needs in the best way possible by focusing on what they’ve been educated and experienced doing.
I want to work with you, not with paperwork...
There is a tremendous amount of paperwork to become an in-network provider and a lot of time/paperwork to submit/file for in-network benefits. If a claim is denied for any reason, the appeals process can be long, frustrating, and in the end, unsuccessful, leaving you responsible for the bill. If you are fortunate enough to have a “co-pay” per session with insurance, you will likely have a limited number of sessions covered. And, let's face it, given the number of insurance policies with astronomical deductibles to fill, your sessions may not get covered anyway. Again, this limits your options and choices.
THE BOTTOM LINE...
In my professional and personal experience, the "value" of private-pay services over managed-care services are profound:
Personalized services that truly reflect mutual treatment goals.
No Stigma, No Judgement, No cookie-cutter approaches.
Effective services, not simply efficient, minimal care.
True privacy and freedom to engage in the process.