“You don’t take insurance?”
The ubiquitous nature of this question inspired us to write a blog in hopes of providing clarity on our decision to operate outside of insurance panels. So, if your curiosity, or frustration, guided you here, know that you are not alone.
We get it. Why would one pay premiums to their insurance and decide not to see a provider that participates within their network? It is bewildering. However, I hope the information below can shed light on this issue.
Why we do not participate in insurance panels:
Treatment Restrictions: Insurance companies often impose restrictions on the number of sessions or the type of treatment that can be provided, limiting the flexibility we need as specialists to provide the best care. OCD treatment, especially with therapies like Exposure and Response Prevention (ERP), often requires time and consistent follow-up, which may not align with insurance limitations. Insurance companies employ clinicians (who do not have a personal connection with you) to dictate treatment, leaving us as your therapist beholden to their opinion. By not participating, we eliminate this middleman, keeping the dictating and collaborating with you, our client, and us.
Increased Autonomy: By not accepting insurance, we have more control over our practice, fees, and treatment protocols. This allows us to spend more time with you and offer a more personalized approach, rather than adhering to insurance company guidelines.
Administrative Burden: Working with insurance companies can create significant administrative work, including submitting claims, following up on denials, and managing paperwork. We prefer to avoid this and focus on what we value most: client care. By eliminating this piece, we can choose to spend our time fine-tuning our treatment expertise.
Payment and Reimbursement Challenges: Insurance companies often have complex billing processes and may not reimburse us adequately or promptly. Reimbursement rates can be lower than what we feel is fair for our services, which makes it difficult for us to run our practice and keep our business healthy. Moreover, it isn't uncommon for insurance companies to "claw back" claims, causing a major risk for therapists to carry, and could ultimately cause the practice to close up shop.
Out-of-Pocket Fees: Ultimately, we feel that we can provide more specialized care if patients pay out of pocket. We can offer a more tailored treatment plan without the limitations and pressures associated with insurance contracts. Additionally, certain mental health treatments, like those for OCD, may be long-term or specialized, and insurance may not cover the full extent of care needed.
We understand that our fees can pose challenges. A few options to consider:
Ask about Superbills: Depending on the details of your insurance plan, you may be entitled to partial reimbursement of your sessions. We are happy to provide you with this documentation, referred to as "superbills." We recommend speaking to your insurance company about this potential to understand their rate of success and their process of submission. While we can't commit to managing this relationship, we will provide guidance. Furthermore, a company called Reimbursify can help simplify this process: https://reimbursify.com/
Bi-weekly Option: Many of our clients elect to get on our schedules on a bi-weekly (one week on, one week off) basis; this helps to reduce costs. We often assign homework (readings, exposures, activities, etc.) designed to expedite treatment success and maintain therapy education.
Sliding Scale: All of our clinicians carry sliding-scale slots on their schedules. Although these are highly coveted, if you are experiencing difficulty affording therapy, please do not hesitate to ask.
Thank you for taking the time to understand our decision. We believe therapy is an investment in quality living; therefore, we are determined to help you feel confident about your return on that investment. If you have additional questions, reach out to our team to learn more.
Contact us here!