“What about insurance?”


2015-06-26 17.57.20-1Did you have trouble finding a therapist who would take your insurance?

Fewer than 6% of individual with behavioral health coverage make use of it. Your insurance plan wants you to choose from a list of doctors who accept a discounted rate for your treatment. Few insurance carriers have raised their reimbursement rates since 1992.  Some have even lowered rates. The only one who benefits from this arrangement is the insurance company.

Most managed-care organizations severely limit the number of therapy sessions, in some cases only paying for three to five sessions. Your therapist is required to tell the insurance company all details of your treatment. Information about your most private life will become part of the MCO’s records, and be on their computers forever. Because managed-care companies contract with therapists who are willing to receive about 60% of the normal fees, they may attract only clinicians having difficulty filling their practices, or just out of training. The latest insurance trend – EPO’s – offer a severely pared down list of therapists, further limiting your choice of caregiver.

Do you believe that you get what you pay for?

In fact, listed Psychologists’ practices are usually full and have no room to see new patients for weeks. Treatment isn’t confidential – your therapist must discuss your case with semi-trained insurance workers for “authorization”. These health plan employees make basic decisions about your care.

By not contracting with health plans, I preserve your confidentiality as fully as the law allows. Nothing leaves the office in a report to your health plan or insurance company. Billing is straightforward, and treatment decisions are made privately by the two of us.

You are, of course, free to submit your charges for insurance reimbursement. Many PPO’s will allow you to see an “out-of-network” (OON) provider and the cost to you is generally equivalent. This way, you decide how much to share with your health plan. I will supply you with a monthly itemized statement suitable for insurance reimbursement. However, you are financially responsible for services.

Extended sessions, complex report writing, lengthy phone conversations, or consultations with other professionals may be charged at an agreed upon rate.  I generally will not charge if I choose to extend the appointment.