Gail Carson-Webb, Psy.D.

Clinical Psychologist

To Take or Not To Take--Insurance?

The decision not to be an in-network provider for most insurance panels was difficult to make.  People often wish to use their insurance for all kinds of understandable reasons.  Primarily, the advantage in using insurance coverage is the reduction of the patient's cost for covered services.  This is a real concern and for some, services are not possible without the use of insurance benefits.  Yet, having practiced in both manners in the past--taking insurance and not taking insurance--I find that clients have tended to exhibit a much greater sense of security about their therapy when their insurance company is not involved.  Paying privately:

  • enhances client confidentiality (the insurance company has no access to your personal data)
  • enhances client choice and power (an insurance company is not determining how long you can be seen, if you can be seen, etc.)
  • promotes a focus on health and strength rather than an excess focus on pathology (insurance companies often require the therapist to document that treatment is "medically necessary" in order to justify payment for services)
  • eliminates confusion and reduces anxiety over billing--there are no guessing games regarding what the insurance company will or will not cover, there are no surprises when an insurance company rejects payment for previously approved services (often on the basis of "technicalities" and limitations of which the client had no awareness), and there are no deductibles
  • assures that therapist time will be focused on therapy, research and planning rather than excess paperwork, providing greater focus on client needs
  • reduces potential future problems in relation to other benefits (e.g., acquiring life insurance after an episode of depression that has resolved) 
  • over the long term, can potentially help the client avoid some problems with insurance premiums (some insurance companies have been known to "tag" the use of mental health benefits, the client's premiums sometimes becoming very high after insurance has paid for mental health services).

Although initially it seems counterintuitive, it may literally, in the long run, be less expensive to pay privately for therapy, as some mental health diagnoses run the risk of increasing premiums disproportionately.  Additionally, many individuals do not understand that diagnoses obtained through utilization of insurance are typically pooled for insurance companies by MIB Group, Inc., formerly known as the Medical Information Bureau.  MIB Group is a reporting agency which gathers information from and shares information with almost 500 insurance companies across the nation and keeps patient information on file for seven years.  Therefore, even if a person changes insurance companies, information typically moves from one insurance company to another.  Files maintained by the MIB include data on:  medical diagnoses, medical tests and procedures, personal credit, driving histories (accidents and driving habits), personal habits that may contribute to health risks (smoking, overeating, substance abuse, gambling, etc.), and potentially hazardous recreational activities.  This information is then used by insurance companies to facilitate their investigations of applicants in order to determine whether or not to offer coverage to individuals applying for health, long-term, disability, or life insurance and what rates should be offered.  In order for information to be shared, the consumer seeking coverage has to agree to release the information, the "catch" of course being that the consumer who refuses to release the information will not be allowed to complete the application process and thus obtain coverage.

Knowing that some will feel compelled to use insurance, I made a compromise to participate in a limited number of insurance panels.  Currently, I am a Blue Cross Blue Shield and Magellan provider.  For those who wish to see me and want to submit information to insurance companies other than BCBS or Magellan for possible reimbursement, I will be more than happy to provide a superbill that they can turn in to their insurance carrier on their own behalf.

 

Fees

Most people who seek counseling come in once weekly for a therapeutic hour (45 minutes), but needs vary depending on "where" a person is in his/her therapy.  Charges are as follows:

  • Brief consultation:  $65 (20-25 minutes)
  • Standard session:  $120 (45-50 minutes)
  • Long session:  $185 (75 minutes)
  • Double Session:  $240 (110 minutes)

Payment is expected at the time services are rendered, and is addressed at the beginning of each session, in order to facilitate maximum focus on therapy for the remainder of the appointment time.