When I began my private practice, I was faced with a decision whether or not to accept insurance. And though you may not know this about me yet, I am a HUGE researcher. So I set out to find the pros and cons of using insurance within my practice.

And what I discovered through conversations, research, and my own personal journey was that using insurance was not going to work for me or my clients.

I understand this topic can be complex and your questions about why I don’t use insurance are entirely valid. I am not here to convince you not to use your insurance. In fact, I do not want there ever to be a financial strain on you if you seek services from me. I want you to do what works for you. And I want our work to be something you feel confident in paying for out of pocket.

So let’s talk about “the why.”

For insurance companies, it’s about control.

CONTROL OVER YOUR DIAGNOSIS

Insurance companies require a diagnosis be submitted with every type of medical bill. In the world of mental health, only certain “significant enough” diagnoses will be covered by insurance. If they decide your counseling isn’t medically necessary, they’ll deny coverage and require you to pay for services.

CONTROL OVER HOW MUCH THEY PAY

Insurance companies vary in what they will pay therapists. It does not matter what the therapist charges for services. Insurance will come back and say, “Yeah, that’s nice that you need $125/hr to cover the cost of services, we are going to pay you $70.” This may mean that one company will pay a therapist $37/session while another company will pay $149/session. Because of this, therapists often have to increase their overall rates to balance out for the lower-paying companies or see an increasing number of clients, which can quickly lead to therapist burnout.

CONTROL OVER THEIR MONEY YEARS LATER

Did you know insurance companies have a right to go back several years and change their minds on if a service was truly medically necessary and if they change their minds, they will ask the therapist for their money back, leading the therapist to then track down the client for payment years later or suffer a devastating loss of thousands of dollars. The stress this can cause both providers and clients is unacceptable. Oh, and if you’re curious if therapists can resubmit these claims, there’s often a 1-2 year time limit for therapists to seek reimbursement.

For me, it’s about freedom.

FREEDOM TO WORK ON ANYTHING WE WANT.

While I can and do diagnose clients when needed, much of my work is not about finding a diagnosis to make someone at an insurance company happy. It’s about your journey and your needs. If you come to me and say, “I’m just really overwhelmed,” I’m going to focus on you and your needs regardless of a diagnosis. If you want to explore new careers, I’m here for it!

FREEDOM TO SEE THE THERAPIST YOU WANT

Maybe this is an obvious one, but when you’re paying out of pocket, you get to choose the therapist who best fits your needs, regardless of what an insurance company says. Finding the therapist who helps you feel confident and relaxed in therapy is so important for your work! I want my clients to have the freedom of choosing any provider who fits their needs first and foremost.

FREEDOM TO KNOW EXACTLY WHAT YOU ARE PAYING AND WHAT YOU’RE GETTING.

When we work together, you will know exactly what to expect when it comes to what you owe. And, if the finances ever feel like a burden, we can use my flexible scheduling options such as meeting for 30 minutes instead of 60 minutes.

So let’s say after reading through this, you’re still curious about using your out-of-network benefits. I am happy to provide you with a superbill (a unique bill created with the information an insurance needs to decide if they will reimburse). If you are curious about if this is an options, I would suggest the following:

• Contact your insurance provider.

• Ask them about out-of-network coverage on your plan.

• Ask specifically if they will provide coverage for individual telehealth counseling or career counseling.

I cannot guarantee that you will be reimbursed. If you are curious what your insurance will cover, I recommend giving them a call.

Lastly, I want to thank you for reading this. Deciding on a therapist is a scary and hard thing. If you’re reading this, I’m guessing that you want to work with me, but also don’t know if its worth your time and money. If this is you, lets talk over a free consultation. I will never ask someone to pay for a service they can’t afford and would love to talk with you about how I can help.

With gratitude,

~Kali