One of the hardest parts of being in private practice in the mental health field, is deciding whether or not to accept insurance. And then if you do, deciding which panels to get accredited by; in other words, what insurance will you try to take? For the practitioner, it’s a lot of paperwork, and a lot of denials, many stating that the license the individual holds isn’t quite what the insurance company wants in their area. In my case, it’s been that I cannot prescribe medications with my license, so I am not seen as a necessary affiliate for some of the insurance companies; some have assured me that may change in the future, but I won’t hold my breath. And what about payout for time spent, not just with the client, but on trying to get on the insurance panels, paperwork, client notes, office supplies, rent, et cetera? Does it work out in the therapist’s advantage, or are they paying to see clients?
So what does all of this mean for the insured? Often, difficulty finding a provider (therapist) that accepts the insurance as is. Many will provide receipts for the client to submit to their insurance after a fee has been paid to the therapist, but it won’t be the copay; it’s usually the therapist’s full fee, which can tick up to over $100 a session.
And let’s say the insured DOES find a therapist taking their insurance that also has openings currently; will those times work, or will the insured continue their search? Or what if it’s not a good fit?
Then we have the worst part of insurance: when a client’s insurance changes, the therapist doesn’t accept the new insurance, and the client can’t pay the therapist’s non-insurance fee. It is especially difficult when rapport has created an environment of care and progress to lose a client to insurance changes. What is a therapist to do? Not charge the client? As practitioners, we may take on pro bono cases at times, but what happens when 2, 3, or 6 of your clients can’t pay? Do you work for free? It’s not a logical step for a therapist, and no, it’s not just about the money, and yet, it is: we still need to be able to eat, afford a place to live, afford a place to see clients, so on and so forth. Few of us are in this to make big bank, but we do want to be able to live so that we can help others, and thus have to put our needs first at times.
In my own practice, I do accept a couple of insurance plans, and am working on expanding what insurance companies I can accept clients from. The majority of my clients, however, are still private pay. It’s not easy to tell potential clients no, I don’t accept your insurance, and hear the defeat in their voice. I’m often the 4th or 10th person they have contacted, and been unsuccessful with.
My advice for those thinking of taking insurance is, check to see what the payout is, and if you’re willing to wait to be paid.