Man paying fees with briefcase.

Insurance

Heart of the Matter is set up as a private pay clinic and does not accept insurance. Therapy fees are due in full at time of your session. I do not think that working with managed care providers would be in my clients’ best interest. In my professional opinion, the financial benefit of accepting insurance does not outweigh the potential detriments.

Why?

Conflicts of Interest

Insurance companies generally care more about their bottom line than the overall health of the individual. Because of this, they place constraints on therapists in terms of the number of sessions or type of therapy that is utilized. I believe that you and I can work together to determine what you need more effectively.

Diagnosis

Insurance companies often require therapists to provide a mental illness diagnosis in order to pay for treatment. Not all of my clients require such a diagnosis, which is a good thing, and to provide one for the purposes of payment would be unethical. Any mental health diagnoses become a part of your insurance record.

Time

Managed care companies require a review and approval of therapists’ treatment plans before treatment can begin or continue. This is time-consuming and can cause an unreasonable delay in treatment. Additionally, the effort and time required to follow up with managed care companies for payment would not allow me to keep my session fees as they are.

I understand the financial benefits of seeing someone who files insurance. To help ease the financial burden, at the end of each session, I will provide you with a superbill, which you can provide to your insurance company for reimbursement for out-of-network services. It contains the information they generally require, including your name, any diagnoses, the therapy fee, date, and my license number. Please be aware that most managed care companies require a diagnosis for out-of-network reimbursement.

What does it mean that I am an out-of-network provider?

As an out-of-network mental health provider, I do not have a contract in place with a managed care provider (insurance company).

**I strongly urge you to contact your managed care provider to inquire about out-of-network benefits prior to beginning therapy.**

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