Why We Don’t Accept Insurance for Therapy

This is a question we, at My Therapy Connection™ (MTC), often get asked. With the mental health crisis on the rise, and reaching out for therapy becoming less taboo, it seems very difficult to find a counselor that accepts insurance for clients. Those counselors who do take insurance often have long waiting lists. There are options for those who can’t afford “out-of-network*” care, which will be discussed later—as will how MTC can help. In the meantime, let me explain why we are currently an out-of-network provider.

Protecting Our Clients’ Right to Privacy

When I opened a private practice, I decided not to take insurance for several reasons.

First and foremost, PRIVACY! When a counselor decides to take insurance, they enter into a contract with an insurance company. Within the contract, the insurance company requires that they have full access to the client’s mental health records. As an “out-of-network” provider, the client gets to determine whether he or she will submit receipts to their insurance company for reimbursement.

When a counselor takes insurance, the insurance company can audit a client’s record at any time and can withhold payment until the audit is complete.

We have many clients that don’t want a paper trail showing that they are receiving therapy. Clients have a right to privacy and we do our utmost to respect this.

Diagnosis From The Diagnostic & Statistical Manual of Mental Disorders

When using insurance, the counselor is required to diagnose the client with a mental health disorder from the Diagnostic and Statistical Manual of Mental Disorders. Sometimes, if the diagnosis isn’t deemed as being serious enough, the insurance company will limit the number of times a client can be seen by a counselor.

This places invisible pressure on the counselor and client who then must make sure there is enough “material” for therapy to take place. We believe that having a counselor isn’t just for those in “crisis” or someone who has suffered a recent significant trauma. Sometimes, people choose to have therapy as a part of their routine self-care. Having someone walk with them through their day-to-day lives, decision making, parenting, and relationship struggles is extremely beneficial, and should not be dictated by your insurance company.

The Expense

Running a business (as small business owners know) the expenses can be extremely high. Some costs include rent, insurance, software, marketing, and staff salaries.

Practice owners who accept insurance tell me that reviewing insurance contracts, verifying eligibility, submitting claims, and following up on billing and accounts payable takes them 15-20 hours per week, per caseload of about 30-35 clients.

Being an out-of-network provider keeps things simple for our practice and allows us the time to see more clients and to invest more money training our counselors. Of significant importance, being out of pocket helps our counselors to maintain a reduced caseload–therefore not exhausting our counselors.

The process we have adopted for seeing clients is very simple. I developed a system where we provide our clients with a special receipt required by insurance companies if they reimburse for insurance called a “Superbill.” If clients choose to provide the Superbill to their insurance company for reimbursement, it is up to the client. The counselor’s time spent in the office is providing therapy.

Access to Qualified Clinicians

I started this practice as a solo practitioner. The model I had developed worked for me so I stuck with the old motto, “If it ain’t broke, don’t fix it.” when I started my group practice. Now, my core values of constantly educating myself and our counselors are carried throughout the group’s practice. Because I made a commitment to myself to always provide the best possible high quality therapy through continual learning, remaining in supervision (so I am held accountable even though it’s not required), and not overloading myself with clients to prevent burnout, these values are shared by my staff.

For the counselors who work at MTC to earn a good living without feeling burnt out, provide high quality therapy, and take care of themselves, I decided to invest in counselors through continual training, ongoing supervision, and a reduced caseload. This means that in order to provide the best possible therapy to our clients, we need to charge a fee for private pay.

It’s no secret that insurance companies pay counselors much less than market rates. This amounts to much lower pay, more paperwork (which would mean I would have to hire additional staff to handle billing, contracts, and claims). This would result in our counselors being required to have a greater caseload to earn the same living. And that’s a surefire way to being burnt-out.

While this is our current reality, my hope IS to be able to take insurance one day. This is provided we develop a system where our counselors are still highly trained and providing exceptional care, without being overworked.

Investing in Your Mental Wellness

Y’all! The work we do as counselors is so very important!!! I am constantly amazed by my team of counselors. The level of care and professionalism they display and the care they take with every single client blows me away. We have clients come to us feeling absolutely broken. To witness the miracle of healing take place, and seeing people grow from a broken place to a thriving place is….well…I’m at a loss for words. I just can’t describe! I am so very fulfilled to be doing the work that we do, to offer a place of employment where my counselors can earn a living by helping people (and being damn good at it!) and helping literally hundreds of people each week! It’s truly amazing and I am so very blessed to be able to do it.

When you opt to receive your counseling from My Therapy Connection™, take comfort in the fact that its’ owner (yours truly) has made it her mission to care for each client and counselor that chooses to be a part of this practice. I hope you will be reassured that each of our counselors & (now) coaches are always learning, are practicing good self-care, have a place to go for guidance, and we support each other. If we care for them, they are better able to care for you!

Just as we care for our counselors, we assure you that they will care for you—making your investment into yourself worth the while. So, whether you are looking to heal from a devastating loss or break-up, struggling with PTSD, OCD, anxiety, or depression. If your relationship is in trouble; rest assured that making an investment in yourself, your children, and your relationship will result in you living life more clearly, with more direction and purpose, and abundantly. You are most certainly worth the investment!

I don’t ever want to have to turn someone away from receiving therapy. And until we’re able to accept insurance, when clients call and they need to use insurance for various reasons, I make it a point to find them a provider who takes their insurance.

We have a list of providers in our office that we can refer you to. So if having an out-of-network provider isn’t an option for you, reach out anyway. I am blessed to have a network of counselors who we can refer you to.

*Out-of-Network Provider is a healthcare provider who does not have a contract with your insurance provider. 

 This BLOG was written by Michelle Leyman, Licensed Marriage & Family Therapist, Founder & Owner of My Therapy Connection™.