Insurance is great…
but there’s no free lunch…
Insurance is great. They help pay for expensive major health procedures. Before using insurance, here are a few things you need to know.
Insurance is a common topic in the mental health industry. Clients ask us about it all the time. We used to take insurance but there were some things that made us change our ways after learning more about it.
Many clients prefer to use insurance, and some choose not to use insurance after learning about the fact. We will leave the decision up to our savvy clients.
If you want to use your insurance, the instructions on how to your insurance are at the end of this article.
Here is why we decided to stop accepting insurance:
1.) Whenever we use company-sponsored insurance or EAP, oftentimes employers ALWAYS know what we are using it for. They may or may not know your diagnosis, and they know which providers you’re going to. Legally they can do that. It’s called Health Insurance Utilization.
Company sponsored programs (EAP and insurance) are like your mom paying for your cell phone bill. Your mom doesn’t know the content of the conversation, but she knows exactly what number you were calling or texting and what time you call/text. She has the bill after all.
In 2014, AOL’s CEO faced a firestorm because of a “distressed baby” comment. He was discussing benefit packages with the upper management team, and he singled out two women because they had been using insurance extensively to treat their babies medical condition.
This is the major reason why we do not like to attach treatment with employer-sponsored programs. Employers who spend money on benefits, know how much they are spending and on what. They know every cent in and out. This grossly violates employee privacy. We may never know what employers do with that information about their employees. There is a natural mistrust right now.
Therapy isn’t brain surgery, it doesn’t cost tens and thousands so many opt to private pay. We have clients who work in upper management, as well as classified positions in the public-private sector. Often they chose to do private pay because of this reason. There is more information in this article on CNN.
2.) We have to give a mental illness diagnosis when we bill insurance, even when you are not mentally ill. This doesn’t make sense, but there is simply no way around it. Insurance needs therapy to be a medical necessity. There are many of our clients who don’t fall into that category of having a mental illness, but we are forced to give them a diagnosis which stays on their medical file for life.
If this is a company sponsored insurance plan, your employer may or may not know your diagnosis. Your insurance company may or may not have confidentiality rule in place.
We work with teenagers. Teenagers often get very attached to a diagnosis and have a lifelong struggle with thinking they’re sick. As stated above, many of them don’t fall into a mental illness category, yet we have to diagnose them for insurance purposes. We want to help teenagers approach life stressors with a strength-based approach.
3.) Insurance dictates how many sessions a client can have in a year. Some insurance limits clients to six sessions a year regardless of symptoms. There is no way effective treatment that can be achieved in that short amount of time. Six weeks can decrease some symptoms, but it doesn’t get to the core of things.
If you choose to use your insurance:
1.) Find out how much coverage you have and if you have mental health coverage. It’s important to get educated as a consumer.
2) Please note that we are considered as Out-of-Network providers. This means we are not in insurance panel. We do this for the reasons stated above in this article.
3.) When you have a session with us, we will provide you with an invoice with a mental illness diagnosis. It is generated monthly. You can access that in your client portal or have one emailed to you. You can submit this to your insurance provider through the mail or online.
4) Many of our clients use Better as an easy way to get the paperwork done. We are NOT paid by Better or have any affiliation with them. We are not sponsored by them. It’s just many clients use it and they tell us about it, and we want to inform you.
Finding the right therapist is important to our mental health. Want to learn more if we are the right therapist for you? Let’s chat for 20-min over the phone. Reach out to us today, and schedule online!