Insurance/Out of network Costs
At this time I am only in network with Blue Cross Blue Shield of MA (BCBS). Despite the below reasons of why I otherwise do not accept insurance, I have made this allowance in order to reduce the barriers that too often get in the way of people accessing care. For those that do not have BCBS, I do offer a "superbill" at the end of every month. This is a invoice of what you have paid me to provide to your insurance carrier to obtain partial reimbursement for my services. I encourage inquiring about this with your insurance carrier by asking if they reimburse for out-of-network providers if you are interested in working together. Please note that I do not file claims on your behalf for this and will expect payment for services to be made at the time of each appointment.
I currently charge $175 for the intake for an individual therapy client and $150 for every subsequent 50 minute session. I currently charge $200 for the intake for partners seeking therapy and $175 for every subsequent 50 minute session. I currently charge $50 for every group therapy session. As I understand life can be unpredictable, I am happy to discuss a sliding scale during our relationship with the agreement that this is for a limited period of time due to extenuating circumstances.
Why do I not provide in-network insurance services?
There are a number of reasons why I do not provide in-network insurance services (with the exception of BCBS). As I pride myself in being transparent with my clients, I wanted to provide this information to you.
All insurance companies require a diagnosis and evidence that services as "medical necessity." In other words, therapists are required to prove that you need therapy by fitting into the criteria of a diagnosis. I do not view clients in this way. In the same way you can go to the doctor for a cough without it being bronchitis, you should be able to meet with a therapist when you are sad without it being clinical depression.
Insurance companies can, and often do, retroactively deny a claim and take money back that they have already paid. This is known as a "clawback". This has nothing to do with the quality of services provided, but it often more due to administrative issues. Many times this is due to the insurance not deeming it "medically necessary." This further puts pressure on clinicians financially and to pathologize you.
Most reimbursement rates from insurance companies are far below my out of pocket fee. Working with insurance means therapists often work longer hours, seeing more clients to ensure they can support themselves and afford the costs that go into supporting a private practice. This may mean higher levels of stress, which can impact the quality of the services they provide.
As billing is often extensive and time consuming, most therapists pay someone to complete this task, which is costly. Insurance carriers do not account for this, among many other costs when considering reimbursement.