Fees

Insurance companies require a formal mental health diagnosis in order to cover treatment, this often puts the pressure on your therapist to assign an arbitrary diagnosis that may not be relevant to your actual needs. If your reasons for coming to therapy change (as they naturally do), insurance providers actually require the therapist to redirect you back to your original issues of concern or the therapist has to provide you with a different mental health diagnosis in order to justify your treatment. Private pay therapists are able to adapt to your ongoing needs and concerns without slapping a label on you or forcing you to stick to your original treatment goals.

Most insurance companies only cover a limited amount of sessions. Once you have exceeded your session amount, the provider can demand a review of your records in order to determine whether they will allow for further sessions. If the provider determines that you are not benefitting from therapy, your session coverage can be discontinued. Some insurance providers will also require that you take medication before they will approve coverage for more therapy sessions. Private pay therapists have the freedom to collaborate with their clients to create a therapy schedule that will be the most helpful.

Insurance providers require therapists to communicate your confidential information. At a minimum, this means the provider will have your mental health diagnosis and dates of service. If the provider requires prior authorization or a review of your file, your therapist would be obligated to provide even more information, including your session notes! This information then becomes a part of your record and can be used by insurance companies to raise rates or prevent you from receiving disability insurance, life insurance (N1), or obtaining private health insurance if you become self-employed. Because insurance companies are members of the Medical Information Bureau (MIB), your medical and mental health records are reported to this agency. When you apply for health insurance, life insurance, or disability insurance, your prospective insurance provider obtains a report of your records from the MIB. When you apply for health insurance, life insurance, or disability insurance, your prospective insurance provider obtains a report of your records from the MIB. This information not only has the power to negatively impact your insurance coverage, but also your driving record, eligibility for the armed forces, and ability to participate in high-risk sports.

Due to the treatment limitations listed above, many therapists are choosing to avoid the complications of insurance companies. Insurance companies will insinuate that the therapists on their provider list have been thoroughly vetted in order to provide you with the highest quality of care. However, providers are primarily chosen for location and for reasons that economically benefit the insurance company without considering the expertise and quality of the therapist. Every individual client is unique and is not best served by this "one size fits all" approach. The effectiveness of therapy is dependent on the quality of the relationship between the therapist and the client. You deserve to be seen by a provider who can cater to your specific needs.