My fee is $160 per 50-minute clinical hour, and is pro-rated for any additional time beyond that. For example, a 90-minute session would be billed at $240. I rarely schedule sessions of less than 1 hour, and I only run longer than that with the clients’ agreement.
The intake phone call for a new client is free of charge. The first 10 minutes of any phone call for established clients is also free; calls lasting longer than that are billed at the pro-rated $160 fee.
I require 24-hour notice of appointment cancellation or rescheduling; if less than 24-hour notice is given, or if you fail to attend a scheduled session, the full fee will be charged, payable at the next session or within a week, whichever comes first.
I request payment by cash, check or credit card at the beginning of each session, as I do not regularly send bills.
Many clients ask about using health insurance to pay for their therapy, and wonder why I am not on any insurance panels. Here is my reasoning, briefly. I’ll be happy to discuss it further with you at any time.
In order for insurance to reimburse for counseling, you need to be diagnosed with a mental illness. Many clients, for obvious reasons, don’t want a mental illness diagnosis in their health records. Most of my clients are not mentally ill, just unhappy and unfulfilled in their lives and relationships. Couples therapy and grief therapy, two of the primary reasons people come to therapy, are not reimbursable.
A diagnosed mental illness can interfere with your life in ways you never imagined. It can create problems getting future health or life insurance, get in the way of being approved for security clearances, sway judges in child-custody hearings, to name a few. By not taking reimbursement from insurance companies, I am not forced to label my clients; I simply treat the problems they bring to me, without a diagnosis.
Insurance companies require me to submit treatment plans and progress updates frequently, often every 4-6 sessions. This is usually done over the phone, and confidential personal and clinical information is usually required. I have absolutely no idea who is on the other end of those calls, what their qualifications are, or if they abide by a code of ethics which holds client confidentiality sacrosanct, as I do. In addition, that information goes into the insurance company’s database, and is theoretically available to anyone with the appropriate passwords. Therefore, my clients’ clinical information would be potentially unprotected. This makes me very uncomfortable.
Because I don’t take money from insurance companies, your confidential information can be found in one place and only one place…my locked file cabinet in my locked office. I am the only one with access to it, unless and until you authorize someone else.
If my treatment plans and your progress are deemed acceptable, the insurance company will authorize a few more visits within a certain time-frame, after which I have to go through the entire process again.
Insurance companies rarely if ever reimburse a therapist’s full fee, and often reimburse at a ridiculously low rate. It therefore becomes difficult for me to pay my bills or realize a profit. Imagine being expected to work on very important and complex projects for significantly less than your actual salary.
Finally, insurance companies are often very late in paying benefits, sometimes holding checks for weeks or months. That would be like your employer sitting on your paychecks; how would feed your family & pay your bills?
I hope this helps you understand why I’m not a member of any insurance panels. Here is your option regarding insurance payment, if you are still interested in pursuing it. Many plans have out-of-network benefits, and I will be happy to give you the form to submit for reimbursement. Keep in mind that I will still have to give you a mental disorder diagnosis, which will still be part of your permanent health record. You will pay me directly and will then be reimbursed by your insurance carrier according to the terms of your plan.
Please talk to me with any questions or concerns you have about any of this. I’m happy to spend as much time as we need to find a solution that works for both of us.