Why is it so hard to find therapists who take insurance?!
Ever wondered why so many therapists do not take insurance? It's not about avoiding your benefits; there are legit reasons behind it that most people aren’t aware of.
Issues for the CLIENT When Billing Insurance
When therapists bill insurance, we have to give you a diagnosis—even if what you are going through is a reasonable, human reaction to difficult circumstances. That diagnosis stays in your health records, and in some cases, it might affect things like future premiums or life insurance down the road. They also have access to your mental health records, undermining the key tenet of mental health care: confidentiality.
Insurance companies can play a big role in deciding how long your therapy should last and what's considered "medically necessary"—which basically means they assess whether or not your situation is “bad enough” to require professional help. If you’re needing help navigating the ups & downs of life, trying to improve your relationships, or hoping to process past trauma, they might not deem this “necessary,” and, therefore, might not pay. They can also decide you “should” be better and cut your benefits.
Issues for the THERAPIST When Billing Insurance
Insurance tends to undervalue the work we do and their demands can be extremely burdensome. Despite record-setting inflation, reimbursement rates for psychotherapy haven’t changed in over a decade. We are expected to provide services like other health professionals even though psychotherapy is an entirely different beast. Unlike a doctor or dentist who might see multiple patients in an hour, therapists only see one. So while a medical doctor might be billing up to 48 patients a day, therapists are only billing 6-8 (on the high end!).
Because of the sensitive nature of the work we do in therapy (often talking about heavy stuff), research suggests we really shouldn’t be seeing more than 26 clients per week to avoid burnout (which directly impacts how well we can show up for you in the therapy room!). And to meet financial needs, we end up seeing more clients than recommended, which can impact the quality of care.
There is also a lot of “unpaid labor” associated with billing insurance. Insurance companies don’t make it easy for therapists to become paneled (or “in-network”), and becoming paneled does not guarantee claims will be paid. The documentation requirements are far more taxing, and therapists often have to jump through many hoops to get reimbursed. It’s not uncommon for payments to be made several weeks, sometimes months, after the session.
But here's the good stuff about skipping insurance: more confidentiality, no mandatory diagnosis, and you get to choose your therapist. You also avoid the hassle of changing providers when your insurance does. Many therapists are constrained by insurance panels that set reimbursement rates, often with the belief that mental healthcare is not essential for overall healthcare.
To Summarize….
I know private-pay might not be for everyone, but it's worth considering. And luckily, there is hope! Advocacy groups are pushing for better reimbursement rates and less mental health stigma.
If going private-pay isn't an option, there are alternatives. Check out your out-of-network options, advocacy services like Reimbursify (which help you submit out-of-network claims), community mental health clinics, and organizations like Open Path Psychotherapy Collective and Mental Health Liberation.
And, as always, feel free to reach out to me, as well, if you’d like to discuss more :)
