In short, no - but - also maybe.

I’ve been asked why I don’t take insurance directly, and I’ve put a lot of thought into this decision. I know this choice can hinder some people’s access to care. I’ll provide a super bill (which is explained in another question, if you’re not sure what this is) at your request, but I’ve decided not to participate any further with insurance companies. It’s been my experience that insurance companies have negatively impacted treatment for too many people, due to billing issues, fee regulations, and interference with treatment planning.

Insurance companies also typically require a diagnosis to be made as part of the initial intake. This means, after meeting with you one time, a diagnosis is required to bill insurance for the assessment. Diagnosing a person is a complex, intricate process, and requires time in order to get to know the nuances of that person’s life. I believe that diagnosing immediately after the first session can be unethical, as it often is not accurate.

To be in-network with insurance providers, I would be required to report certain parts of your treatment information. Insurance companies can also request additional treatment records at any time and for any reason. They are paying for some or all of the services rendered to you, and can request access to your health records. I feel while legal, these disclosures violate your right to privacy and autonomy of your medical treatment and history. By paying for services yourself, you maintain the level of confidentiality and control you prefer.

I also feel that while diagnoses can often be helpful, they do carry a stigma and I believe you should have significant control over your records and when or where they are disclosed.

Some insurance companies and insurance plans set limits on which diagnoses are covered and deem how long treatment is covered. At times, treatment does not progress at the pace insurance companies think it should and this can add additional stress and pressure to both you and me, and can hamper treatment goals.

Finally, many of these regulations are determined by and decided on by individuals who do not have a clinical or mental health background, and are making decisions strictly based on the finances involved for the insurance company.

For these reasons (and more) I have moved toward a pay-what-you-can model. Yep, pay what you can. You and I can discuss a personalized treatment plan that includes fees, frequency, and timeline, all based on your goals, life, and comfort.