Insurance and Fees: The "hows" and "whys" of finances in therapy

Have you ever wondered why some therapists take insurance and some don't? Or why therapy costs so much? Or why some take credit cards and others don't? These are important questions! Our economy has been tight recently, and understanding the economics of therapy might help you feel more comfortable taking that first step in contacting a therapist. My goal is to help you feel safe and as comfortable as possible. Part of being able to do that is discussing the financial aspects of care. Please feel free to contact me and ask any questions you have! 
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Payment arrangements for coaching or seminars will be done on an individual basis. 

Why didn't you accept insurance in your private practice?

Accepting insurance has advantages and disadvantages, for both of us. My reasons for not accepting insurance boiled down to privacy and quality of service. Accepting insurance means providing a diagnosis to the insurance company. There is a trade-off for you there: You will get services at a lower fee, but you give up a little of your private medical information in doing so. While many people are ok with that, when it comes to mental health, some people are not.

​My other reason centered around providing the best quality of service possible. Many insurance companies, in exchange for paying part of the cost, limit the number of sessions, the length of sessions, or the type of services I can provide. I strongly believe that everyone is unique, and wanted to have the freedom to set up the best treatment plan possible for your needs, without worrying about whether or not we needed to terminate services due to arbitrary limits on sessions. It didn't seem fair to you, and it didn't fit with my values of providing the best care possible.

If you wanted to use insurance, I provided you with a document called a "superbill" which you could submit to your insurance company for reimbursement, if you wished. It had a diagnosis on it, however, because insurance companies require diagnoses in order to provide payment, even when reimbursing you.  

How can I afford therapy?
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Therapy can be expensive - there's no doubt about that. Fees range anywhere from $40 to over $300 for a 50-minute session, and if you are wanting help, that's a lot of money. Financially, I try to work with people if possible, and that's why I used to use a sliding-scale fee as well as worked with people referred from pro-bono and low-cost agencies, like Mental Health Connections in Fort Collins, CO. 

My sliding scale fees ranged from $60 to $150, depending on your income. In order to use the sliding scale, I ask my clients to bring some proof of income, such as a pay stub or their most recent tax return, as do most agencies offering low-cost or pro--bono services. My fees were based on the income of the household for the person paying for services, and I tried to be as accommodating as possible. I encouraged my clients and other people who contact me to explore options such as Connections, where fees ranged from $8 to $48 per session, as well.

I believe that therapy should be accessible and available to anyone who needs or wants it. This is why I participated in Connections' pro-bono referral program and why I use the sliding scale. It's also why I work with an agency that has financial assistance available to their patients. It's important to be able to get help when you need it!

How do I pay for therapy?
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I did not accept credit or debit cards in my private practice. I know that was slightly less convenient, but I promise there was a good explanation. Every time you use a card for payment, there is a fee charged to the merchant, whether it's a store or your doctor. Most merchants are able to incorporate this fee into their prices, and you never have to notice or think about it. The fee ranges anywhere from 1-5%, depending on your volume and income.

I made a very concerted effort to keep my fees reasonable and affordable. In keeping my fees lower, I had to make trade-offs that included excluding forms of payment in which I must pay extra. If I open my practice again, I might explore the possibility of raising my fees slightly to accommodate the extra charges, but at that point in time, I wanted to keep my fees as low as possible. 

As a result, I only accepted cash and checks and provided you with a receipt if you wished. 

​In any agency or with a provider, it's worth asking about whether they have lower-cost options for those struggling financially. In today's financial environment, many people are struggling and may need assistance to get the care they need. Don't be afraid to ask your provider or agency if they offer assistance, sliding scale, or alternative payment options (such as a payment plan.)