Insurance Guidelines

Clients are required to pay for each session upfront, either through direct payment or with the expectation of potential partial reimbursement from their out-of-network benefits. At the end of each month, I will provide you with a detailed receipt (superbill) that you can submit to your insurance provider for possible reimbursement. Reimbursement rates and eligibility for out-of-network services vary depending on your insurance plan and diagnosis. I recommend contacting your insurance company to determine the specifics of your coverage.

Why I am not paneled with insurance

I have chosen not to participate in insurance panels for several reasons. Insurance companies, while not mental health professionals, typically require involvement in treatment planning, record review, and service evaluation. Here are considerations I have taken into account and suggest you consider as well:

• Insurance companies mandate a diagnosis submission for reimbursement, even after the initial session. This diagnosis becomes a permanent part of your medical record. In couples therapy, one partner must be designated as the "patient," necessitating a diagnosis for the couple's treatment.

• It's common for insurance companies to request additional clinical details once therapy begins, such as personal information, treatment plans, or session notes.

• Insurance providers may limit treatment by controlling session frequency or requiring specific treatment methods.

• Reimbursement rates for providers are dictated by insurance companies and can vary widely between different insurers.

• Engaging with insurance companies demands extra time and negotiation, which can be financially burdensome for individual providers and often requires a dedicated billing team.

What to consider when utilizing insurance for therapy

Most insurance plans include coverage for mental health services, which can offset some of the therapy costs (typically with a copay that remains the patient's responsibility). However, it's essential for each client to weigh whether the benefits of financial reimbursement outweigh the potential loss of time, autonomy, and privacy. It's important to remember that mental health claims often face initial denials. However, you have the right to appeal these denials.

Please don't hesitate to discuss this further with me if you'd like more information.