Our therapeutic services are considered “private pay” services, meaning that all of my services must be paid for by the guardians of the client (if client is a minor) or the client himself (if adult).
However, if a client wishes to file a claim themselves (out-of-network), we will provide an invoice showing payment has been received, along with other information often required by insurance companies.
Many established mental health professionals do not join or remain on insurance panels for a few reasons. First, the in-network filing process usually requires a significant breach of client confidentiality.
To meet the requirements for in-network reimbursement, the professional must submit an official client diagnosis and ongoing progress report, treatment plan, etc. This requires the professional to divulge personal information about clients, which then becomes part of his or her permanent medical record (potentially driving up client insurance rates and creating problematic “pre-existing conditions”).
Next, there is a great deal of paperwork to submit for in-network benefits, which takes time and energy away from the focus on the client and his or her needs. Finally, insurance panel fee schedules are well below national averages, and therefore not ideal for established professionals.
Because of these considerations, the majority of mental health professionals who choose to become in-network providers are either just beginning their practice, have only a part-time practice, or find it difficult to sustain their full-time practice load.