To Be In-Network or Not To Be In-Network, That Is The Question!

The Case For Being Out of Network

As my first official blog, I thought I would address questions and concerns about my decision to no longer accept insurance.  When I initially envisioned my private practice, I thought I would be always be able to accept all insurance plans. I hate the idea of mental services only being available to those who can afford it, as it should be accessible for everyone.

That being said, mental health providers are severely underpaid by insurance companies for their services, denied payments frequently, forced to wait on hold and transferred to many different representatives to get simple answers about coverage (I often say I could see three or four clients in the time it takes me to get answers about the benefits of one member). I have been asked to return payments received fairly and as per the contractual agreements. It can take six weeks or more to get paid, which all adds up and can put a small business owner in financial hardship. My graduate education consisted of two master's programs, a certification, two licenses, several exams, and years of externship. Many providers such as myself have been in school just as long as doctors and other medical professionals, and yet we are not treated as such and do not get compensated the same way. I took my daughter to a 15 minute doctor’s appointment and our insurance company paid over $5,000 reimbursement to the physician for their services. We as mental health providers do not even receive a fraction of this, no matter what the presenting concern we have treated. They put a cap on the length of our sessions and often the number of sessions we are allowed to have per year. The work we do in mental health should be an integral part of overall health. It is no less valuable. In my opinion, mental health is just as important as physical health, and the two are intertwined. 

Going in network now means that you have to choose from a very limited pool of therapists that take your plan. Every therapist has different specialties, skills and interests. With the surge of therapists going out of network, you may call dozens of therapists, trying to find one who takes your plan, before getting frustrated and giving up. This may further delay the treatment that you may need. Going out of network allows you the freedom to truly choose someone who is genuinely the right fit for you. 

Patient Rights In Therapy 

In order to qualify for any reimbursement, we have to provide insurance with a diagnosis. Coverage is provided only for certain diagnoses. The assessment given at that time can follow you for life. Are you someone that struggles with depression or anxiety? We all have issues that we face. This process does not accomplish anything to erase the stigma of mental health, especially when you have to be diagnosed with a disorder for life challenges such as going through a breakup, grieving a death of a family member or losing a job. The diagnosis can impact the ability to qualify for life insurance or have repercussions if you are ever in a court case. Being out of network gives me as your therapist more control over the information about your health. It means that I can provide an accurate diagnosis, and that information (with a few exceptions) stays between you and me. 

Confidentiality

Regarding the issue of confidentiality, I have been called numerous times by insurance companies looking to follow up on their members. They want to know details about our work and your issues. They need justification for continued treatment, and they will even give opinions about treatment plans. That is a lot of involvement from third parties on issues that are personal, without them ever meeting you

What You Can Do As A Patient

Insurance companies are not all bad. The good news is that a lot of insurance companies do provide reimbursement to their members for out of network services. I can provide superbills each month for you to submit directly to them. It is worth the phone call to your insurance company to find out if such benefits included in your plan can help you to choose the provider and ease the expense. I am happy to help you navigate this process so that you get the maximum amount of reimbursement. 

Why Choose To Work With Me?

I can assure you that the fees I set are aligned with other therapists. It is important for you to know that you are not being overcharged for your treatments. You can learn more about fair fees for psychotherapy by visiting FAIRHealth.  I also try to make the payment process as seamless as possible by accepting all major credit cards, Venmo, and HSA/FSA programs.  One of my passions is working with couples. and while that it can be a bit more costly because of the extra time addressing the needs of two people, it is important to keep in mind that divorce is also expensive. Whether you are seeking therapy for yourself or as a couple, your investment in yourself or the relationship is a part of the process of seeking growth, progress and change.

I consider therapy to be solution-focused, so that you feel you are actively getting results, and I will check in with you during our sessions to ensure you feel you are getting something out of our time together. I do my very best to schedule sessions around times that work best for you, and I know for the busy professional that can include lunch time, evenings and weekends. 

The Case for Telehealth

By opting to do telehealth, you can save some time in general and on your commute.  It allows you to use your precious time off for actual vacations. You can speak to me in the comfort of your own home or in a private place in which you feel you can be your most authentic self.

I Want To Get To Know You!

My favorite part of being a therapist (and one of the most important elements of effective treatment) is the relationship and trust that develops between myself and my clients. I encourage prospective and current clients to make choices that align with their values, and to advocate for themselves regarding mental health and goals in therapy. Honesty and transparency are the foundations of my practice and I am here for you and happy to help the best I can.