Why am I Out-of-Network?

In short, I am Out-of-Network and don’t take insurance so I can focus only on you and your treatment, and not what insurance may/may not approve of or pay for. I love what I do and I want to provide the best care possible because you deserve that. Insurance wants you to manage your symptoms. I don’t offer you that kind of cookie-cutter therapy. My work allows you to heal the underlying causes of the symptoms, create self-trust, and grow more into your true self.

I give you the necessary information (ex: Superbills) if you seek reimbursement from your insurance company. If this doesn’t work for you, please see https://fullhearttherapy.com/potential-clients/ for a variety of referrals.

The Reasons Why I No Longer Take Insurance

Some Reasons…

  • Increase in privacy for you.
  • Diagnosis and treatment plans that fit YOUR needs, not the insurance companies’.
  • I do not offer cookie-cutter therapy. I tailor my work to meet YOUR needs and wants. The types of therapy I use allows you to feel seen and known, heal, create self-trust and feel more connected to yourself and others.
  • Insurance does not reimburse for spirituality, self-growth or self-improvement.
  • Insurance requires a mental health diagnosis to reimburse. If clients want to work on their relationship and don’t meet the criteria for a mental health diagnosis, most likely, insurance will not reimburse.
  • Insurance companies don’t pay the same rate. Many pay less than half my rate, a couple may pay a little more, and a few may pay my full rate. Insurance companies can reduce their rate of reimbursement and rarely raise their rates. This is unreasonable and unacceptable to me.
  • Out-of-pocket costs and deductibles rise nearly every year. Yet, insurance companies do not provide any significant rate increase to providers. If consumers are paying more and providers are not being paid more, who is benefitting from the increase in premiums and deductibles?
  • Insurance companies determine how long I see you for each session and the number of times I see you in a year. Insurance companies require specific criteria for a 60-minute session. I offer 60-minute sessions because often, clients take the first 10 minutes to “download” or settle into the session. Then the remaining time is processing and doing the work.

Some More Reasons…

  • Often, insurance companies are not clear with providers on the exact expectations they have of therapists to reimburse should they audit a file (what needs to be in the note, treatment plans, etc. for reimbursement.) I, and colleagues, have spent countless hours of unpaid time on hold and then trying to figure out why a claim is denied or advocating for a client to receive the number of sessions or types of sessions deemed necessary. I also spend money and time attending trainings by therapists who have figured out the insurance industry’s game. And as the game evolves, so do the rules and requirements.
  • Insurance companies demand I turn over your private information if they request it. I don’t believe what we discuss or what you process in session is their business.
  • Insurance companies receive premiums. Premiums must be paid on time. Yet, they don’t pay their portion of the session until they decide to. They have “glitches” in their computer systems that can delay payments for over 6 weeks. There is unpaid time spent on a call trying to determine where the payments are.
  • Insurance companies may audit client files if they suspect you have too many 60-minute sessions. Therapists don’t know what this magical number is. In order to avoid making some alarm bells go off, I bill for a 45-minute session instead and receive less pay. Or they might audit your file because you have too frequent of visits in the last few months. If insurance audits your file and they determine 60-minute sessions aren’t necessary, it’s likely they will “clawback”. A clawback is when they take back the difference they pay between 60 and 45 minute sessions. When this happens, therapists may have to pay the insurance company thousands of dollars. The stress of a potential audit hangs over therapists’ heads like a dark cloud.
  • Finally, I value our work together and I want to be free to run my business without undue influence from outside sources. I want my relationships with clients to be the most important factor in the room and not worry how I document your work. I don’t want to worry if I will get paid on time. I don’t want to worry about a magical bell ringing and your file being selected for an audit. Because I no longer work with insurance companies I have reduced resentment, stress, and anxiety in and out of sessions.