Fees and Insurance
Currently I am accepting several major insurance plans. For those plans for whom I am not in network I can provide the information your insurance company needs in order for you to file your out-of-network benefits.
If you choose to use your insurance benefits please read this.
Insurance companies only pay for services that are deemed “medically necessary.” This necessity is determined by diagnosing a client. This means that in order to use your insurance benefits for mental health services you will receive a diagnosis. Part of the diagnostic evaluation is demonstrating that your mental health condition is affecting and interfering with overall functioning on a daily basis in a clinically significant manner.
Many of the reasons people seek counseling are not mental health disorders and are not diagnosable. Many people are simply looking to learn skills and strategies to manage and resolve relationship conflicts, increase productivity in their lives or careers, or improve their ability to manage life’s daily stressors. As important as these things are, and left unresolved many of them may lead to a disorder, insurance will not reimburse for these situations. Please be aware that you must meet diagnostic criteria in order to use your insurance. This means that it is possible that you will pay out of pocket if you do not meet this criteria. Whether or not you have a diagnosable condition is determined on your first visit.
Another thing to be aware of regarding using insurance for counseling services is that your diagnosis becomes part of your medical record. This is important for a couple of reasons:
You will have a pre-existing condition on your insurance record. This can potentially mean that buying health, disability, and life insurance may be harder and more expensive for you and your family.
You lose control over the confidentiality of your information. A mental health diagnosis goes on your permanent insurance record. This record can be accessed by any insurance company or government agency during background checks. This information includes diagnosis, treatment plan, and session notes which are usually very personal.
If you need security clearance for work, want to join the military, are applying for jobs that require a criminal background check, or are involved in a Workman’s Comp case, all your mental health information can be accessed.
This is not an effort to scare you or prevent you from using insurance. Many people believe that they need to use insurance and we will bill your insurance if that is what you wish. We just want you to be aware of the full picture.
I accept insurance but please contact to make sure your insurance company is one that I am currently working with. Please note that insurance does not cover couple’s or marriage therapy.
For some companies I am an out-of-network provider. This means I can offer you a more personalized therapy service without the interference of an insurance company.
Out of network means that you will pay for counseling at the time of your session and seek potential reimbursement from your insurance. It’s important to look at your benefits if you will be seeking reimbursement. Some clients receive 100% reimbursement and some have no out-of-network benefits. You can always use an HSA or FSA card for services. Also, most people have higher deductibles, so unless you have a major surgery planned, you may not hit your deductible. If you have to pay 100% up to your deductible, that means that you’ll pay out of pocket for in-network and out-of-network, so it’s about whether you want to decide on the best counselor or have your insurance decide.
If you want to use your insurance I can provide you with all the information needed to take to your insurance to negotiate out of network reimbursement. Please verify before scheduling.
