Why, “Do you take my insurance” is a Maybe…
You have been trying to get an appointment through your insurance provider’s therapists for months. You finally booked an appointment but it was awkward, you did not really like the therapist, and the next available appointment is in 4 weeks. You need help now, not in 4 weeks. You need consistent support because you are at your breaking point. So you decide to look up therapists in your area. The therapists who do take insurance cannot be the only therapists in the world, right?
“Do you take my insurance?” is a question I get asked on a weekly and sometimes daily basis.
So you hop on google and search, “Therapists in Long Beach, CA who work with anxiety” and find some awesome-looking people. After completing the initial consultation you just mesh. You feel understood, you feel there could be progress, and most importantly you feel safe with this person. But this therapist does not take your insurance. Or maybe they only provide a superbill. What is up with that and what even is a “superbill?”
“Do you take my insurance?” is a question I get asked on a weekly and sometimes daily basis. My answer is almost always “maybe” but let me tell you why.
Lack of privacy
This is a serious issue that has become normalized. Therapy is built on a trusting and confidential relationship between the client and therapist. When an individual is using insurance to cover their services the insurance billers have access to all the client’s medical records, diagnostic history, and progress in treatment. While your therapist does their best to write in a confidential manner there is a limit to this confidentiality as the insurance billers need to “make sure” you still need help. This leads to point number 2...
2. Insurance decides if you need help, not you
When seeking mental health support through insurance you need to have a diagnosable mental health disorder to justify treatment. You cannot just seek support merely because you want support. With this said, there are many “issues” that insurance does not deem as reimbursable even if it is diagnosable. Issues such as marital or partner conflict, soical and emotional issues in children due to caretaker separation or divorce, social and emotional pressures due to poverty or lack of housing, premenstrual dysphoric disorder, and the list goes on and on. Instead, these issues become pathologized by a “billable diagnosis” that follows clients for the rest of their lives.
It is true that many of the social issues I listed before can lead to legitimate diagnosable issues such as post-traumatic stress disorder, generalized anxiety disorder, or major depressive disorder. I passionately believe, however, that if a person would like mental health support they should not be reliant on a person in an office, who has never sat in a session with them to determine if their presenting problems are “worth” being reimbursed.
3. Therapist Burnout
First and foremost insurance companies have notoriously low reimbursement rates for mental health therapists. Unfortunately, this means that therapists then must take on higher caseloads to pay not only life demands but also business expenses. This leads to higher levels of burnout in therapists, lower quality of care for clients, and fewer resources available (both time and money) for therapists to continue their training to help more people in current, research-based treatment.
Personally, I have worked for agencies that accept insurance. While this absolutely provides needed treatment to people who cannot afford therapy otherwise, it continually left staff, me included, in a constant state of burnout and compassion fatigue due to the extremely high caseloads.
4. Dealing with the insurance companies
My final point on why I do not accept insurance at this time is having to “deal” with the insurance companies. In addition to unpaid hours of report writing, submissions for reimbursement, and audits, there is no guarantee of reimbursement from the insurance companies in general let alone for my whole fee. Also, the process of becoming credentialed for insurance companies is incredibly long and tedious. Of course, this leads to extremely high levels of stress for your mental health providers and an overall shortage of insurance credentialed clinicians. This also can lead to resentment for the whole therapeutic process, which is not how I want to approach the healing journey with my clients.
So what is a superbill anyway?
A superbill is a receipt, provided upon request by my clients, that clients may submit to their insurance for reimbursement of services. This is generally only for clients who have a PPO plan, which means they can see healthcare providers outside of the preferred list of in-network providers.
That is nice but I still cannot afford therapy
It is understandable that there are very real financial barriers to seeking help and I want to be sensitive to these barriers. While I have clearly listed the issues I have with insurance as a provider, insurance is still a viable option to seek mental health support. There are also options such as asking private therapists if they offer sliding scale spots, which are discounted prices for people with real financial barriers. Also seeking help through group therapy or organizations like Open Path Collective are great ways to still get mental health support for lower prices.
If you are ready to start your healing journey please stop waiting and give me a call at (562) 353-7136. I would be happy to help in your healing journey from dysfunctional anxiety, panic attacks, relationship issues, and the perinatal/postpartum journey.
