You pay a lot for insurance so you want to use the benefits, right? That makes sense. However, there are a few things you should know before using insurance to pay for therapy.
1. By using insurance to pay for therapy you are giving your insurance company access to your records. It is in the insurer’s contract with you, not the contract with the therapy office. Fortunately, it is not often that insurance “audits” your therapy chart, but it is important that you know it can happen.
2. By using insurance you are placed in a “medical model” of treatment. This means you have to be given a diagnoses (like anxiety or depression) and be actively working on goals to remediate the symptoms of your diagnosis for insurance to pay for services.
3. If you used insurance and later the insurance company deems the services “not medically necessary” they can demand a refund for payment. This means you would then be responsible for all bills owed to the therapist for uncovered services. The good news is that therapists who accept insurance are familiar with all of these parameters and chart in ways that support payment for your treatment. 4. Many therapists no longer accept insurance due to the hurdles insurance puts in place for providers to get paid. The billing processes are complicated, certain reasons you sought treatment are not covered, clerical errors by the insurance companies result in claims needing to be investigated and payments lagging, and insurance companies severely underpaying for services. Most insurance companies pay about 2/3 of the going rate for therapy in any zip code. They underpay, but try to justify it by saying they provide steady business. However, this also means that some providers are overworked and underpaid.
5. Many of us need to use insurance though. Not a problem. You may just need to search a bit harder, or accept a less preferable time due to the difficulty finding new appointments with therapists who accept insurance. Don’t give up! Many agencies, such as Conscious Living Counseling, accept many types of insurance because we believe mental health services should be accessible to all.
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