Blue Cross/Blue Shield
Insurance vs. Private pay:
I understand the financial commitment involved in managing therapy costs. I have made the choice to only participate on one insurance panel (BCBS of North Carolina) because I believe that insurance companies are interested in their financial bottom line, not your well-being, and they prefer to pay for treatment that helps people make their lives tolerable. My goal for you is greater than that– I want your life to be rich and satisfying.
However, I am covered as an out-of-network provider with most insurance plans and you may choose to see me using your out-of-network benefits. I am happy to provide you with a receipt which you can submit to your insurance provider, should you choose to use insurance to pay for your therapy.
To learn more about the process of using out-of-network benefits, click here.
Private Pay vs. Insurance:
Therapy is expensive, and you understandably don't want to pay out of pocket if you have insurance. However, you should be aware of some very real problems before you make the decision to pay for therapy with medical insurance.
There are advantages and drawbacks to both private payment and using insurance. Obviously, the biggest drawback of private pay is that it is an immediate out-of-pocket expense. However, there are several advantages of private pay that may make the expense worthwhile to many clients.
Why should clients choose to pay privately?
(1) A MENTAL HEALTH DIAGNOSIS GOES ON YOUR RECORD
To get therapy paid for by your health insurance, you will have to be diagnosed with a mental disorder of some kind. This diagnosis will be placed in a computer database, available to insurance companies and, possibly, to future employers.
When you apply for insurance - medical, disability, or life insurance - your diagnosis will be a factor in determining your acceptance and your rate. You should weigh these considerations before deciding to use your insurance to pay for therapy. Unfortunately, many mental health practitioners often don't consider this problem and put things in your record without consideration for the effect on you.
In addition, because most insurance providers require a mental health diagnosis in order for therapy to be covered, many issues (such as grief and loss, life stress, or personal growth) are not covered by insurance. When clients pay out-of-pocket, there is no requirement of a mental health diagnosis for treatment, which means that anyone can seek treatment.
(2) MORE CLIENT PRIVACY
Clients who pay out of pocket are guaranteed that the only people who know any of the details of therapy are themselves and their therapist. Aside from normal limits to confidentiality, therapy is completely confidential, without any third party being privy to information exchanged in session.
(3) YOU HAVE MORE CONTROL OVER YOUR TREATMENT
When you pay for your own therapy, you decide how often and how long you need to go and when you're finished. When you use your insurance, an administrator may read your progress notes and decide when you stop. If you decide you want to continue and pay for it yourself, your therapist may not be able to legally continue, having signed a contract with the insurance company to see you only through the policy. Some therapists report that this has not been a problem in actual practice, while others report cases where it ended therapy prematurely.
Private pay clients have complete control of the duration and style of their treatment. Private pay clients are able to choose the focus of their therapy, the duration of therapy, and the frequency of therapy, and even the length of individual sessions.
In addition, having a choice is an important factor when it comes to finding someone you trust with your personal concerns. You may for instance prefer seeing someone who was personally recommended to you. When you use your insurance plan, your options are usually limited to therapists within your insurance provider's network. When you use private pay, you have the freedom to choose a therapist that you feel comfortable with.
(4) IMPROVED TREATMENT EFFICACY
Research shows that clients who have to pay something for their treatment have more positive outcomes that those who receive free treatment. Not only do you get what you pay for, but the fact that you are paying out of pocket provides extra motivation and incentive to make the most of therapy.
(5) POTENTIALLY REDUCED SERVICE COSTS & SLIDING SCALE AVAILABILITY
For some clients, their insurance providers require a co-pay and a large deductible to be met when seeking treatment, with the additional feature that standard rates for service apply. By not taking insurance, I am free to set my own rates and offer a sliding scale to my clients. This means that privately paying clients can actually pay less than those who pay with insurance, depending on where they fit in the sliding scale, how long treatment lasts, and the details of an individual's insurance plan.