I feel that it is important for you, the client, to understand why many people are choosing not to use their insurance for mental health purposes and why I do not accept it.  I will, however, provide a "superbill" for potential out-of-network reimbursement.  Please call your insurance provider to confirm your benefits.

Once a client agrees to use their mental health insurance they have given up a large portion of their confidentiality. Insurance has the right to audit the client's case file at any time. It had been suggested that approximately 14 insurance company employees will view a claim while being processed! That includes: history, progress notes, diagnosis. Whatever you discuss in therapy now becomes accessible to the insurance company and all of individuals they have been assigned to process the claim. Once information is required to be faxed to insurance, the information loses it's security. Multiple hands will have access to the client's very personal information.  With many therapists now utilizing electronic health record services, some insurance companies require unlimited electronic access to the client record. 

Quite often insurance companies will dictate the number of sessions that a client can have. This puts pressure on the client to rush the therapeutic process and divulge more than one may be ready to.  The client may also never reach the opportunity, due to the time constraint, to share necessary information in therapy that may be needed to resolve one's discomfort.

Insurance REQUIRES a mental health diagnosis code in order for the practitioner to get reimbursed. What this means:

Insurance typically does not reimburse for relationship issues with friends, family or spouse (I will detail this further in a moment). Insurance requires that a code is assigned to the client's name that is now forever attached to the medical record of this client. This client now has a pre-existing condition. Initially, you may not see this as an issue, but if you have a career or intend to seek a career in the future that involves security clearance, including any government position or any other job that requires mental health-care checks, it is encouraged that you make an informed decision before utilizing your insurance. Many careers will rule out an individual who is deemed "unstable" or could cost too much money due to lost works days, all due to a mental health diagnosis code from using insurance.

Couples and Family Therapy are not typically reimbursable therapeutic services. What insurance commonly will pay for is multiple people in the therapy room supporting the "identified patient" with his or her mental health condition. Essentially, if you use mental health insurance for marital counseling one of you has been given a mental health diagnosis and insurance is permitting the spouse of that person to be in the same room as the "IP" for counseling. This is NOT marital therapy. Therefore, insurance typically does not reimburse for marital (or family) therapy.

Frequently, a client will call hoping to use their insurance. Sometimes a client will choose to call another facility in hopes that they can use their insurance. Once they call that other facility and their insurance is pre-checked they find out, for example, that they have a $3,000 deductible to reach before they can use their insurance or that they have a contracted rate with insurance that is more than my rate. These clients often call me back for services! For those clients that have a co-pay, the rates are comparable. I do not get involved with insurance companies, allowing MORE time and attention to my clients.

I am committed to a high-quality standard of service for the client. I am not consumed by the back-and-forth dialogue with insurance companies, pleading for reimbursement for my client's treatment. This allows more time for attention to your needs, including research, care and thought to your treatment plan.

After you've gained a full understanding of the risks involved with utilizing insurance for mental health services and you still would like to proceed with reimbursement, I are happy to provide a "superbill" to you, which you can then submit to insurance for potential out-of-network reimbursement.

Please call Suzanne at (631) 633-5989 to learn more about prices and treatment options.