Insurance Coverage and Lengthy Wait Times
Prospective clients often ask me why I don’t accept insurance. Herein, I’ll explain why.
Per one source, “Not all therapists accept insurance.” Why may this be? One reviewed site simply—and perhaps accurately—answers, “Psychologists, social workers and psychiatrists who don’t accept insurance say that insurers’ reimbursement rates are too low.”
Per a separate source, “Did you know that insurance companies can agree to pay for a service, and then after the service is provided, refuse to pay? Did you know they can pay for a service but then up to five years later demand the money back?”
Think about working an entire shift and discovering that you won’t receive pay for it. Can you imagine being paid by an employer today and five years from now receiving notification that you have to reimburse the entity for the received payment?
According to another resource, “The going rate for a great therapist in most major cities is between $150-$350 per session. Most insurance companies pay therapists between $40-$90 per session. This is a fraction of what therapists receive from private pay clients and it requires a lot more paperwork and time to get paid by insurance companies.”
Imagine that others in your employment setting are receiving $20-per-hour for the work they do. However, your payer suggests reimbursing you only $13-per-hour for providing the same services.
How motivated would you be to work? Is the product of your effort based solely on altruism? Perhaps you work from home and the cost associated with transportation is low. No problem, right?
With inflation, cost of goods and services consistently fluctuating, and the value of your time realized through years of education, training, and experience—would you be willing to take a pay cut?
One source reports, “[P]rivate practitioners are part of the gig economy. We do not get any benefits such as health insurance, paid vacation, or sick time—and no perks. Plus, we have plenty of expenses.”
Now, with your reduced wages ($13/hour), you’re required to pay for internet, various software programs, continuing education, business insurance, telephone services, licensing, tax services, and other expenses. Does the reduced price of your work effort conflict with the increased cost of working?
One site expresses, “When insurance companies pay for your treatment, it also means that their employees (clinicians or not) will audit my treatment plans and read what we talked about in my session notes.”
Hollings Therapy, LLC places significant value in safeguarding your protected health information (PHI). A detailed breakdown of how this occurs will be shared with clients—not insurance company employees who haven’t met with you or understood the particulars of your treatment.
Additionally, one source advises therapists, “You may have to fight for coverage of certain services or diagnose a client with specific conditions in order to provide approved types of care.”
As important as your PHI is at Hollings Therapy, LLC, I also advocate for my clients by not allowing insurance companies to dictate client treatment. For instance, if your insurer doesn’t reimburse for onychophagia (nail-biting), private pay may be a reasonable option for you.
Another reference claims, “[C]ommunity mental health centers and clinicians who do take insurance or offer affordable sliding-scale fees have long waiting lists.” I once worked for an agency with a 15-month long waitlist for services.
At Hollings Therapy, LLC, I understand that waitlists for mental health services can “range from a week to months or even a year or more.” Even at an organization in which I worked where the waitlist was only 3 months per client, that’s simply too long for some people who need to be seen.
In order to better assist clients, and reduce lengthy wait times often associated with community-based mental health clinics, I offer competitively priced services. This may be a cost-effective solution for the “market rate for a 50-minute session”—in Austin, Texas—said to be priced at $150.
Therapy is an investment. How much is your mental, emotional, behavioral, and social wellness worth?
If lengthy waitlists and insurance coverage is a barrier to care for you, I invite you to reach out today by using the contact widget on my website.
Deric Hollings, LPC, LCSW
Enriquez, A. (2021, October 25). Q. How does fair use work for book covers, album covers, and movie posters? Penn State. Retrieved from https://psu.libanswers.com/faq/336502
Envision Wellness. (n.d.). Why we no longer accept insurance. Retrieved from https://www.envisionwellness.co/why-i-no-longer-accept-insurance/
Faabian, R. (2020, March 23). How do we reach mental health parity if therapists don’t take insurance? Center for Health Journalism. Retrieved from https://centerforhealthjournalism.org/2020/03/02/how-do-we-reach-mental-health-parity-if-therapists-don-t-take-insurance
GoodTherapy. (2019, October 1). For therapists: The pros and cons of accepting insurance. Retrieved from https://www.goodtherapy.org/for-professionals/business-management/insurance/article/for-therapists-the-pros-and-cons-of-accepting-insurance
Hollings, D. (2022, March 15). Disclaimer. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/disclaimer
Hollings, D. (n.d.). Hollings Therapy, LLC. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/
Just Mind. (2022, January 4). How much does counseling cost in Austin? Retrieved from https://justmind.org/how-much-does-counseling-cost-in-austin/
Lauretta, G. (2021, October 19). How much does therapy cost? Forbes. Retrieved from https://www.forbes.com/health/mind/how-much-does-therapy-cost/
LoCicero, A. (2019, May 2). Can’t find a psychologist who accepts insurance? Here’s why. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/paradigm-shift/201905/cant-find-psychologist-who-accepts-insurance-heres-why
Marschall, A. (2021, October 8). Why wouldn’t a therapist accept insurance? Resiliency Mental Health. Retrieved from https://resiliencymentalhealth.com/2021/10/08/why-wouldnt-a-therapist-accept-insurance/
Peterson, A. (2021, October 5). Why it’s so hard to find a therapist who takes insurance. The Wall Street Journal. Retrieved from https://www.wsj.com/articles/why-its-so-hard-to-find-a-therapist-who-takes-insurance-11633442400
Rowe, S. (2021, May 6). What to do when you can’t afford therapy.” Psych Central. Retrieved from https://psychcentral.com/blog/what-to-do-when-you-cant-afford-therapy
Schewitz, S. (2018, February 20). The real reasons (that nobody tells you) about why therapists don’t accept insurance. Couples Learn. Retrieved from https://coupleslearn.com/why-therapists-dont-accept-insurance/
Therapy4thePeople. (2021, August 15). What to do while you’re on a therapy waitlist. Retrieved from https://therapy4thepeople.org/what-to-do-while-youre-on-a-therapy-waitlist/
Therapy Austin. (n.d.). How therapy works. Retrieved from https://www.therapyaustin.com/process/
Verywell Health. (2020, February 26). Health-insurance-5687e75d5f9b586a9e4dd055.jpg [Image]. Retrieved from https://www.verywellhealth.com/thmb/buSs1_hcsKWt3Zj04X0X6cVLW7M=/614x0/filters:no_upscale():max_bytes(150000):strip_icc():format(webp)/Health-insurance-5687e75d5f9b586a9e4dd055.jpg