Payment
Private Pay
I only accept private pay/sliding scale clients at this time. Payments are collected digitally via Stripe through my client portal, Simple Practice. You can add any type of payment card, including HSA cards, FSA cards, or CashApp cards, through your client portal. It's my policy to turn on autopay for all clients, which syncs to my appointment calendar and runs at midnight the night of our appointment. By special request, I can turn off autopay on a limited basis when needed for special circumstances. My intention is to streamline things, not be inflexible!
Out-of-Network Benefits
If needed, I can provide monthly superbills (combined invoices) for you to submit to your insurance for out-of-network benefits. These benefits vary widely based on your insurance plan, so you'll want to check with your insurance carrier to determine if they will reimburse you for a portion of what you pay. Usually OON benefits for PPO plans use a separate deductible, but then can cover 50-70% of session costs. Please let me know if you plan to use these benefits and I can set up automatic superbills for you.
"Pay What You Can" Rates
My normal rate for a 50-55 minute ("clinical hour") session, including the first session, is $150. I offer reduced rates down to $80 per session as well. My "sliding scale" is more accurately called "Pay What You Can" because it is self-report – I will never ask you for documentation or proof of income/hardship. There is no set formula or scale for fee reductions. My hope is that you will be honest and upfront with me about what you are reasonably able to pay and update me when appropriate if the situation changes!
Why I Don't Accept Insurance (and the benefits for clients)
It's ubiquitously accepted that insurance companies are a pain in the a$$ to deal with, but it's very true for therapists. Because more people are seeking therapy than ever before, it's become a huge drain on insurance carriers' profits, and they're incentivized to pay therapists less, restrict what is covered, deny claims, and "clawback" payouts whenever they can. Long story short, I felt complicit in a system that exploits both patients and providers.
I made this decision because it was something I had to do for my own peace of mind and professional growth, but there are some benefits for clients as well:
- 1
Privacy
When you use insurance, therapists are required to provide copies of your assessment, treatment plan, and official appointment progress notes to the insurer whenever they audit. By not using insurance, your records stay more private and confidential. This can be especially relevant for certain careers where you might not want mental health treatment "on your record" (ex. military, aerospace, Peace Corps, or any career where you'd need "clearance").
- 2
Diagnostic Choices
Insurance companies require a diagnosis before they will cover therapy sessions. Diagnosing a client at the first session is not only clinically difficult with limited information, it also feels unethical to slap a label on someone the day we meet. Additionally, I believe therapy does not have to be "medically necessary" for it to be beneficial. With or without a diagnosis, therapy can be a helpful step in personal growth. Many of the legitimate issues that bring people into therapy (like grief or relationship concerns) don't qualify as a diagnosis and so leave clients and clinicians in an ethical/legal lurch when dealing with insurance.
- 3
Goal Flexibility
Similarly, insurance companies regulate what sort of goals can be included in treatment plans, such as requiring them to be diagnosis/symptom focused, measurable, and short-term. While these sorts of goals can be perfect for some clients, they don't fit all that therapy can encompass.
- 4
Continuity of Care
Paying privately means you'll never have to change therapists because your job or insurance changes, or because they stop accepting your plan. It also means we won't have to terminate just because you reach your appointment limit, or the insurance company deems you've made too much or too little progress.
- 5
Clear Costs
No surprises. You'll know exactly what you'll be paying for each session. We won't need to estimate your benefits or wait until your first insurance claim comes back to know how much your insurance covers.
- 6
Reduced Fees
Because insurance companies will only reimburse up to my "Usual and Customary" fee, I wouldn't be able to offer flexible rates while also taking insurance. This also means I can charge fair rates to everyone without having to inflate private rates to account for added admin time, insurances with very low reimbursement rates, or losses in revenue due to insurance issues.