LENGTH OF THERAPY
The frequency of therapy sessions varies depending on your particular needs and desires, but we typically meet weekly or bi-weekly for 50 minute sessions. Initially, it may be difficult to predict the duration of how many sessions will be needed, so we will collaboratively discuss from session to session what the next steps are and how often therapy sessions will occur. The client reserves the right to request an increase or decrease to frequency at any time. The client also reserves the right to end treatment at any time, but I request that you communicate this desire directly to me.
The fee for each 50-minute therapy session is $175.00, and payment is due at the end of each session. Acceptable forms of payment are: exact-amount cash or credit/debit card.
REASONS I CHOOSE NOT TO ACCEPT INSURANCE
Reduced Ability to Choose: Most health care plans today offer little coverage and/or reimbursement for mental health services. Most HMOs and PPOs require pre-authorization before you can receive services. This means you must call the company and justify why you are seeking therapeutic services in order for you to receive reimbursement. The insurance representative, who may or may not be a mental health professional, will decide whether services will be allowed. If authorization is given, you are often restricted to seeing the providers on the insurance company’s list. Reimbursement is reduced if you choose someone who is not on the contracted list - consequently, your choice of providers is often significantly restricted.
Pre-Authorization and Reduced Confidentiality: Insurance typically authorizes several therapy sessions at a time. When these sessions are finished, your therapist must justify the need for continued services. Sometimes additional sessions are not authorized, leading to an abrupt end of the therapeutic relationship even if a crisis suddenly emerges. Your insurance company may require additional clinical information that is confidential in order to approve or justify continuation of services as “medically necessary.” Confidentiality cannot be assured or guaranteed when an insurance company requires this disclosure of information. Even if the therapist justifies the need for ongoing services, your insurance company may decline services. Your insurance company dictates if treatment will or will not be covered, which (in my view) violates your right to self-determination. Note: Personal information might be added to national medical information data banks regarding treatment.
Negative Impacts of a Psychiatric Diagnosis: Insurance companies require clinicians to give a mental health diagnosis (e.g. “Major Depressive Disorder” or “Obsessive-Compulsive Disorder”) for reimbursement. Psychiatric diagnoses may negatively impact you in the following ways:
- Denial of insurance when applying for disability/life insurance due to a “pre-existing condition”
- Company (mis)control of information when claims are processed
- Loss of confidentiality due to the increased number of persons handling claims
- Loss of employment and/or repercussions of a diagnosis in situations where you may be required to reveal a mental health disorder diagnosis on your record. This includes but is not limited to: applying for a job, financial aid, and/or concealed weapons permits
- A psychiatric diagnosis can be brought into court (i.e. divorce court, family law, criminal)
It is also important to note that some psychiatric diagnoses are not eligible for reimbursement. This is often true for marriage/couples therapy and adjustment disorders.
Not working with insurance leads to enhanced quality of care and other advantages such as:
- You are in control of your care, including choosing your therapist, duration of treatment,
frequency of sessions, etc.
- Increased privacy and confidentiality (except for limits of confidentiality outlined above)
- Not having a mental health disorder diagnosis on your medical record
- Consulting with me on non-psychiatric issues that are important to discuss but not billable by insurance such as learning how to cope with life changes, gaining more effective communication skills in your relationships, increasing personal insight, exploring ambivalence, and developing healthy coping.
After reading my position on why I do not accept health insurance, you may still decide to use your health insurance. Although I choose not to participate in any insurance panels directly, I am willing to provide you with the necessary paperwork for partial reimbursement of services if your insurance accepts out-of-network benefits. Please speak to your insurance company directly for specific reimbursement conditions and limits. If do you elect to submit paperwork to your insurance for purposes of reimbursement, please be aware that a written diagnosis is a requirement for coverage, the risks of which I have detailed above.