Fees & Billing

Why We Don’t Accept Insurance

We believe clients and clinicians should direct care, not big business. Having worked in the therapy world for over a decade we have seen how at times, the modern healthcare system is not designed for an individual’s success at meeting their treatment goals.

When client’s choose to use an in-network provider they may face the following challenges:

• Limited choice in experience, qualified providers
• Inability to have marriage counseling or relationship counseling covered or to require one partner have a qualifying mental health diagnosis and be the focus on the counseling (often not disclosed to the couple when billing)
• Inability to have an evidence-based treatment matched to their specific issue
• Diagnosis Required (even for young children)
• Breaches in privacy that can have serious legal and employment implications
• Unable to seek help for general wellness or quick problem resolution

You can learn more about these issues below:

Limited choices in qualified providers

Insurance companies have profit margins to make and can significantly tie a medical professional’s hands. Not only does this cause many talented clinicians to avoid taking insurance, but it also severely limits your choices in choosing the right therapist for you.

Difficulty receiving couples counseling

To make matters even more complicated, nearly every insurance companies will not reimburse for couples or family therapy. While the billing code itself be a covered code, in order to have insurance cover those codes, ALL insurance requires a MEDICALLY NECCISARY diagnosis for at least one individual in the relationship. As an added complication, the notes and records must demonstrate that all couples counseling sessions are geared toward treating that one individual’s mental illness.

This shifts the treatment from relationship focused, to individual focused and can create a feeling of bias and targeting. Even worse, if those records are ever subpoenaed in court, they can be highly damaging to the party with a diagnosis (see privacy issues below).

Difficulty Receiving the best care

Insurance companies also do not allow couples or individuals working through trauma to choose a longer, more intensive structure to gain rapid resolution. Instead they default to a 45 minutes session (and occasionally 55 minutes) per week model not suited for most evidence-based therapy types, issues, or individuals. Many of the treatments such as EMDR, ART, and the Gottman Method for couples require a minimum of 90 minutes and are evidence-based for a high level of success. This can extend your treatment unnecessarily.

diagnosis Required and Privacy Concerns

There are also several privacy issues to consider when using insurance. Insurance requires clinician’s to record and report a diagnosis to justify a medical necessity for treatment. This diagnosis becomes a permanent part of the medical record (even for young children) and can lead to future denials of life insurance and higher health insurance premiums.

Employer sponsored plans can request records leading to personal medical information released to an employer and unintended consequences. Additionally, records subpoenaed for court due to divorce, criminal or civil suits would also contain this sensitive information.

The need for a medical diagnosis also prevents individuals from seeking general wellness care for mental health, seeking problem-focused care or support during life transitions, or even for learning new skills for coping or emotional regulation. This also means sometimes treatment with an insurance provider will end before you would like it to or that insurance could recoup funds paid long after treatment ended if they deem it did not meet the threshold for medical necessity.

For all of these reasons, although some of our clinicians may on rare occasions take insurance, for the most part, we are a cash practice. By being able to direct your therapy from start to finish based on clinical assessment and a customized treatment plan, we can assist in healing your hurts and helping you to work through your customized treatment plan as quickly and safely as you are comfortable with.