Insurance Considerations

1. I am an Associate-level professional. Most insurance companies will not cover services provided by an Associate-level counselor.

​

2. A lack of confidentiality. Insurance companies require clinicians to disclose diagnoses, symptoms, behaviors, treatment plans, and what occurred or was said during the session. I must provide private health information to an insurance company to justify and defend a client’s treatment. 

​

3. Insurance requires a mental health diagnosis for coverage. Diagnoses can be limiting to the counselor and client. A diagnosis is a way to conceptualize a problem a client is experiencing, it is not their identity. Every individual experiencing a mental health disorder or transient symptoms is different, therefore the treatment (and the time is takes for that treatment) needs to be flexible and appropriate for that individual. Further, what a client is seeking counseling for may not be a mental health disorder. I believe clients are the experts in their own lives and need tools and guidance to help identify what they need to overcome the problems they experience. 

​

4. There is a limitation on what is covered. Insurance companies limit the amount paid for treatment and the number of sessions a client can attend. Insurance companies can pay-out an amount that isn’t sustainable for a counselor to run a practice full time, given the expenses that go into a private practice such as continuing education, training, licensing and certification fees, supervision, office rent, utilities, liability insurance, marketing, and more. This also includes time spent that does not get paid for, such as working with insurance. Insurance companies can also double-back and claim that a client’s treatment was not medically necessary, recouping payments that was already paid out to the counselor. Through collaboration between client and counselor, I focus on meeting client goals, which can take any number of sessions. I also want to be able to give back by providing a reduced rate to a limited number of clients.

​

5. It’s a time suck. There is a reason why working with insurance is a job position in a doctor’s office. Working with insurance companies demands an incredible amount of time and patience to credential and contract, verify insurance policies, submit claims, pursue reimbursements or pay-outs, submit re-authorizations for treatment, and more. I would rather invest that time in my clients and seek valuable education to give more to my clients. It is also time I can be engaging in self care so I am at my best.

​

6. My specialty is in sexual health and wellness counseling, and I work with many couples. Many insurance policies do not cover couples counseling or sex therapy. Counselors who bill insurance for couples counseling are often providing a diagnosis to one client with a family member present, rather than being true to what the couple is seeking services to address.