Why do you not take insurance?
We get this question a lot, and for understandable reasons. Counseling can be an expense some are unable or unwilling to pay outright. Insurance companies enable a person to pay lower rates out of pocket.
However, there are also many downsides to billing through insurance companies when it comes to mental health:
Lack of Confidentiality
When billing through an insurance company, they are required to look through specific parts of your counseling record to ensure your treatment follows their protocols for necessity. Insurance companies profit when you do not use their services. They often set high standards for claims to get accepted, which requires a lot of your private information to prove what treatment you need and why.
Standardized Specifications for Treatment
Because insurance companies are not staffed by trained mental health professionals, they create standardized treatment plans they will accept for each mental illness. If they see something they don’t deem necessary or disagree with a certain treatment method (such as length of treatment, type of treatment, etc.), they can decline authorization. While we respect the desire to help people quickly and efficiently, we think it should be up to the therapist and the client to determine the best treatment plan rather than an untrained third party.
Using the Medical Model
Because mental health is complex, insurance companies utilize a medical model to determine necessary treatment specifications. They will only pay for services for medical reasons, which require a diagnosis. While many people do seek therapy for help with a specific diagnosis, this can get tricky with those who do not meet all the qualifiers or are only seeking therapy for growth and personal development. In these scenarios, a therapist is forced to apply less than perfect labels to get claims approved, risks having claims get denied and not getting paid, or is forced terminate therapy altogether.
Requiring A Diagnosis
Following along with the previous reason, insurance companies require a diagnosis to pay for treatment. While some people may not care about having a diagnosis, or even want one to help better understand their situation, an official diagnosis on record can come up in other scenarios that may prevent you from taking certain life paths. For example, some job fields (such as military, government, aviation, security, even some professional schools) can require medical records and not hire you if you have a mental health history. Mental health records may also affect your ability to own a firearm or gain life insurance. Ultimately, having a diagnosis on record via an insurance company may bite you later.
Sliding Scale Fees
Because we do not take insurance, we do take a limited amount of clients through the Open Path Psychotherapy Collective to support clients who are unable to pay the full session fee. This enables a wider reach of people to attain services.