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The Insurance Dilemma: Why Are So Many Therapists Opting Out of Insurance Networks?

It seems like more and more therapists, ours included, are moving towards not accepting insurance plans. We assure you that therapists do not make this decision lightly and have decided to not network with insurance companies for many of the following reasons:

Low Reimbursement Rates

One of the main reasons why therapists are opting out of insurance networks is low reimbursement

rates. Insurance companies often reimburse mental health professionals at a MUCH lower rate than other healthcare providers (e.g., physicians). Think $60-70. While this may seem like a lot of money, once you consider taxes, overhead costs (e.g., rent, electric health record system), materials, licensure costs, school costs, continuing education costs, therapists end up taking home MUCH less than half of that fee. It can be almost impossible to maintain a sustainable practice with low reimbursement rates.

Smaller Caseload Numbers

To compensate for low reimbursement rates, clients end up seeing 30+ clients a week to make ends meet. Seeing that many clients a week can quickly lead to therapist burn out and exhaustion. Therapists who do not accept insurance can see fewer clients (12-15 clients a week), allowing us the time and space to attend specifically to your needs, show up refreshed and excited to help you achieve your goals, hold everything you give us without it impacting our own mental and emotional wellbeing, and give you the tailored treatment you deserve. Trust us, you don't want your therapist to be exhausted, burnt out, and overwhelmed.

High Deductible Costs

Many clients have insurance plans with high deductibles, so they end up paying out-of-pocket costs for therapy anyways. Many out-of-network therapists can provide you with a superbill, or a receipt of services to submit to your insurance company. This way, you can choose the therapist that is best for you and still receive credit and/or reimbursement form your insurance provider.

Administrative Burden and Costs

Insurance companies require A LOT of paperwork and documentation from mental health professionals to process claims. This can be a time-consuming process, and can take up a large portion of the clinical day. As therapists, we would much rather spend our time focused on supporting our clients and continuing to build our competence through trainings and consultation, rather than dealing with these administrative tasks. In addition, therapists often need to hire additional staff to handle insurance claims or invest in specialized software to manage billing and reimbursement.

Limited Treatment Options

Insurance companies often limit the number of therapy sessions a person can have in a year, how long the sessions are, and what the type of treatment that is covered. This can be a problem for therapists who want to provide the best possible care for their clients. By not accepting insurance, therapists have more freedom and flexibility to provide the services they believe will be most beneficial for their clients, without restrictions from insurance companies.

Privacy Concerns

When a person uses their insurance to pay for therapy, the insurance company has access to their treatment records. This can be a concern for people who want to keep their mental health history private. Insurance companies also require therapists to assign our clients a diagnosis. By not accepting insurance, therapists can offer their clients a higher level of confidentiality.

Better Control Over Practice

Some therapists opt out of insurance networks because it gives them better control over their practice. By not relying on insurance reimbursements, therapists can set their own fees and choose the clients they want to work with. This can lead to a more fulfilling and rewarding practice, and ultimately, better outcomes for clients; if we take care of ourselves, then we can show up best for our clients.

Delayed Payments

Insurance companies may take weeks or even months to reimburse therapists for their services. This can create cash flow issues for therapists who rely on prompt payment to maintain their practice. By not accepting insurance, therapists can ensure that they are paid promptly and can more easily manage their finances.

While insurance can be a helpful way to pay for therapy, it's not always the best option for everyone. It's important to do your research when choosing a therapist and consider all the factors that are important to you, including insurance coverage. If you need help deciding whether working with an out-of-network therapist is the right decision for you, contact us for a free consultation!


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