A client reached out to me last week and asked me if I could explain why I don't accept insurance. Many people have this question. Here is my answer and my personal thoughts. I respect others who accept insurance. I believe that there are wonderful therapists who are in-network with insurance companies. However, I am not in network with any insurance companies and below you can read why.
I am exclusively a cash-pay private practice. This allows me to focus on providing personalized care for each client with no constraints from insurance companies. Some of the constraints that insurance companies may impose could impact the treatment planning process, or the number of sessions.
My priority is always to tailor care to each client's individual needs and goals.
For example- if you have a goal of wanting to work on your relationship with a family member, even though it isn't impacting your daily functioning or your ability to work, I believe that is still a valid goal for you. Insurance companies will vary on whether or not they would cover this. They tend to want a certain level of "dysfunction" before they will cover services. But what about prevention? Working on this relationship with this family member could very well prevent complicated grief if this family member were to pass away, or possibly improve your quality of life significantly.
I want you to be able to work on the goals and use the exercises that you find most important in your therapeutic journey.
This could take 3 sessions, or 30, depending on the situation, but I believe that the client’s journey should be just that- their own personal journey. How can the insurance company know how many sessions it “should” take? Each person and story are unique.
I like to avoid these constraints. Therapy is enough hard work on its own without adding the pressure to perform for an insurance company.
Surprisingly, sometimes using insurance can add a financial stress to the therapeutic relationship.
In addition, another reason I don’t work with insurance companies is the financial stress of “clawbacks.” A clawback is when an insurance company covers fees initially, but then comes back later and says, “Actually, we aren’t going to cover those costs” and they “claw back” the money that they already paid. If the insurance company paid the provider, then it means the provider has to give back the money to the insurance company. If it was paid as reimbursement to the client, then the client has to give back the money to the insurance company. A colleague of mine had this happen with over $2,000. She was given one month to pay this insurance company back, and then she had to ask the client pay her that money back. It was a huge stressful mess and put a lot of financial stress on the therapeutic relationship. Thankfully the client and therapist were able to come up with a payment plan and continue working together, but just hearing that story stressed me out!
To be fair, there are good reasons to use your insurance when seeing a therapist. Many wonderful therapists take insurance and the risks associated. I’m so thankful for insurance companies helping to cover the cost of therapy for individuals who otherwise wouldn’t participate. This is a personal choice and you get to weigh your own pros and cons in the decision process.
I hope that no matter whether you choose to use your insurance or not, you find the best therapist for you. If there's a way I can help feel free to reach out.
Take Care!