I have health insurance and I use it with my medical doctor. Nonetheless, as a therapist, I have decided not to be a provider on insurance panels. Seems hypocritical, right? I have veered away from insurance and turned more towards self-pay due to the following reasons:
using insurance impacts you
Insurance companies have the right to audit your mental health records at any time. When audited, I must send your diagnosis, date/time and my note with what was discussed during the session.
Additionally, even though you may be ‘healthy’ by normal standards, insurance companies require that you be labeled with a mental illness to receive treatment. This diagnosis then becomes part of your permanent medical record and may be used against you when applying for future health coverage.
accepting insurance impacts me
Insurance companies are a business. They pay companies to audit therapist records for any paperwork errors. If they can say the session was documented incorrectly, they then force the therapist to pay the insurance company back. Insurance companies do this to help their bottom line, not your treatment. Therapists in the Pioneer Valley have paid tens of thousands of dollars back to insurance companies due to these audits, after having provided successful treatment.
Using insurance impacts our work
Insurance companies regulate the length of the session, what treatments are used, and how we use our time. If they think the length, treatment or intervention does not meet what they determine as medically necessary for your mental health diagnosis, they will not pay for our work.
- $125 for a 50-Minute Session for Individuals
- $150 for a 50-Minute Session for Couples
- $495 for a 15-Hour “Hold Me Tight”® Relationship Enhancement Workshop, per Couple
- $1400 for Couple’s Intensive
In addition to self-pay, I accept the following two options as they will not impact our work together:
- ‘Health Saving Accounts’ or ‘Flexible Spending Accounts’. These work like self-pay but with a card.
- ‘Out-of-network’ benefits with your insurance. These benefits allow you to see someone who does not take your insurance, but the insurance company will reimburse you a percentage of what you are paying the provider (so they may reimburse you 80% of the session cost, for example).
Confused about health savings accounts or out-of-network benefits? You are not alone! Please contact me and ask me about these so I can explain them and help you decide what could be best for your situation.