Why did you stop taking insurance?
After several years of being in-network with most major insurances, we decided to stop “taking” (being in-network with) most of them beginning January of 2018. This was for several reasons:
- Client cost: Most clients still had to pay out of pocket up to 6-9 months into each year, until their deductibles were met. Therefore, in many cases it did not make mental health care more financially accessible at all. Submitting out-of-pocket payments to insurance for reimbursement is a greatly streamlined method for most and often has very similar cost and deductible fulfillment outcome for clients.
- Administrative time and cost: Being in-network in many cases means an enormous amount of administrative work, paperwork, and being on the phone–not just once or twice, and not just for urgent or crucial questions–but as an ongoing condition of being in-network. All of that ended up literally taking much more time than actually seeing clients in session each week!
- Who are we accountable to, the client or the insurance company?: Insurance coverage often means being required to repeatedly justify treatment based on insurance rubrics rather than individual need. Many, many clients are well-served by attending only a few sessions during times of increased stress. But for those who require longer-term support and management, return visits–whether twice a week or twice a year–may be a necessary part of staying on-track with recovery and maintenance of mental health. Furthermore, if someone is experiencing a problematic life issue that is not related to a specific diagnosis, or a diagnosis that is not covered by insurance, there may be pressure on the therapist to come up with a diagnosis more for the sake of insurance coverage than for treatment planning. In some cases, that diagnosis may then be considered a pre-existing condition for future insurance packages.
- Confidentiality: Most insurances require certain information about clients in order to decide whether they will cover sessions. At a minimum, this usually includes a covered diagnosis and a session date. Sometimes this is not much of an issue (“depression is the common cold of mental health”!), but mental illness and injury is still unfairly stigmatized. Some people do not want certain information about their mental health to be included in the medical record that their insurance company may be maintaining.
Some of these points and more are discussed by other therapists.
We offer receipts to submit to insurance companies for reimbursement, but you may need to call your insurance company for instructions, or you may even want to try a fee-for-reimbursement app service such as Better.
For additional alternatives to insurance coverage, please refer to the assistance (bottom) section of our service rates and financial page.
Originally posted 11/2018
One thought on “About Insurance”
This is exactly the reason more & more medical professionals no longer accept insurance payments, but, do work with their patients to assist them in getting insurance payment sent directly to the patient.
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