Questions Regarding Insurance

 

I do not accept insurance payments, and am able to accept payment by credit card or check, payable upon the end of each session. I can provide you with a receipt, affording you to file for reimbursement from your insurance company.  

I consider counseling to be "an investment in one's Self," and think it important that individuals plan to take ownership/responsibility for their well-being by making payments as they are seen. 

Here are some interesting thoughts regarding Insurance payments:

WHAT ABOUT INSURANCE? Why do some therapists choose not to accept insurance reimbursement, and some clients choose to pay out of pocket for mental health services instead of using their insurance?


A. Lack of confidentiality issues:

  • All managed care plans involve direct clinical management by the plan's case managers.  This makes it necessary for a therapist to disclose anything and everything related to your case to them.

  • This information is used by the managed care plan for allocating and determining benefits and benefits determination for future plans and is stored in a computer data base.

  • The FBI and law enforcement officials can access your insurance information, which could be problematic should a legal matter arise.

  • This lack of confidentiality could impact the ability to get or apply for jobs, especially with the military and law enforcement.

 

B.  Difficulty getting treatment authorized:

  • Obtaining authorizations for sessions is cumbersome and time consuming for therapists and clients.


  • Some authorizations may be denied.


  • Managed care plans only allow for a certain number of sessions to be used in a calendar year and many times only authorize 3 sessions at a time, making people wait long periods between appointments.


  • Some managed care plans will dictate what type of treatment can be used -- this can be anti-therapeutic or not what the client wants to work on or  talk about in their  therapy.


  • Some plans will terminate treatment despite the fact that the patient may still be in distress or that the issues have not been adequately resolved.

C.  Mis-diagnosing and/or over diagnosing:

  • Some managed care plans will not cover treatment unless it is a medical necessity -- meaning that clients have to pretend to be sick or worse off than they really are.


  • Most managed care plans do not cover marriage counseling, family counseling, adjustment counseling or career counseling.


  • Often insurance companies require the therapist to make a diagnosis after the first 45 minute session -- this may not be a sufficient amount of time to make an accurate diagnosis and puts the client and therapist in a negative situation.


  • Clients should not be given a mental illness diagnosis that is incorrect or more serious than what is true simply to get treatment paid by the managed care plan.

 


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