| Insurance vs. Self Pay |
For appointments
& questions, please
call my office at:
615.337.6975
& questions, please
call my office at:
615.337.6975
Clinical
Coaching & Consultation
USE YOUR OWN INSURANCE?
(Even though this practice accepts many
insurance plans, there are things you
should know)
What happens when you use:
HealthInsurance/ManagedCare?
Privacy is compromised. The
insurance company may require a
therapist to provide information about
your history and symptoms. The
insurance company usually does not
inform the client as to who has access
to this information or how the
information may limit your future
insurability. Information may be
forwarded to the Medical Information
Bureau, a nationwide database of
healthcare claims that makes
diagnoses available to insurers who
may subsequently withhold health or
disability insurance from people who
have submitted mental health claims
from another insurer.
Choice of therapists is usually
limited. Insurance companies may
only pay for therapy with therapists on
their provider panels. Panels are often
kept small, which limits your choice. A
company can drop any provider whose
treatment decisions are at odds with
company policy.
Treatment decisions are influenced
by company policy. Treatment is only
authorized if it conforms with company
policy. Reviewers at the company
determine whether treatment will be
authorized or not.
For example, outpatient treatment is
typically limited to once a week, unless
it can be demonstrated that it is
“medically necessary” for it to be more
frequent.
Company policies are apt to
encourage very brief treatment and
the use of medication. In order to
reduce costs and increase profits, the
briefest treatment tends to be
preferred. Treatment may not be
authorized unless you agree to the
company’s treatment
recommendations. Although your plan
may offer benefits up to certain limits,
those benefits will only be paid if they
are authorized by the insurance
company as “medically necessary.”
Psychotherapy and medication
appointments will usually cost less.
Your payments for these services tend
to be low as long as you use only a
few sessions. Remember that
although your plan defines the limits of
your benefits (e.g. 20 sessions a year),
the company will only pay if the
benefits are authorized as being
“medically necessary” (e.g. “6
sessions are authorized, then have
your therapist submit a treatment
report.”).
A large proportion of your healthcare
therapy dollar goes to increased
administrative costs, advertising,
executive salaries, political lobbying,
and profits to shareholders of
managed care companies.
Insurance companies emphasize cost
containment. Administrators and
reviewers interpret company policies
to limit reimbursements. Consumers
may not be informed of treatment
alternatives.
(Even though this practice accepts many
insurance plans, there are things you
should know)
What happens when you use:
HealthInsurance/ManagedCare?
Privacy is compromised. The
insurance company may require a
therapist to provide information about
your history and symptoms. The
insurance company usually does not
inform the client as to who has access
to this information or how the
information may limit your future
insurability. Information may be
forwarded to the Medical Information
Bureau, a nationwide database of
healthcare claims that makes
diagnoses available to insurers who
may subsequently withhold health or
disability insurance from people who
have submitted mental health claims
from another insurer.
Choice of therapists is usually
limited. Insurance companies may
only pay for therapy with therapists on
their provider panels. Panels are often
kept small, which limits your choice. A
company can drop any provider whose
treatment decisions are at odds with
company policy.
Treatment decisions are influenced
by company policy. Treatment is only
authorized if it conforms with company
policy. Reviewers at the company
determine whether treatment will be
authorized or not.
For example, outpatient treatment is
typically limited to once a week, unless
it can be demonstrated that it is
“medically necessary” for it to be more
frequent.
Company policies are apt to
encourage very brief treatment and
the use of medication. In order to
reduce costs and increase profits, the
briefest treatment tends to be
preferred. Treatment may not be
authorized unless you agree to the
company’s treatment
recommendations. Although your plan
may offer benefits up to certain limits,
those benefits will only be paid if they
are authorized by the insurance
company as “medically necessary.”
Psychotherapy and medication
appointments will usually cost less.
Your payments for these services tend
to be low as long as you use only a
few sessions. Remember that
although your plan defines the limits of
your benefits (e.g. 20 sessions a year),
the company will only pay if the
benefits are authorized as being
“medically necessary” (e.g. “6
sessions are authorized, then have
your therapist submit a treatment
report.”).
A large proportion of your healthcare
therapy dollar goes to increased
administrative costs, advertising,
executive salaries, political lobbying,
and profits to shareholders of
managed care companies.
Insurance companies emphasize cost
containment. Administrators and
reviewers interpret company policies
to limit reimbursements. Consumers
may not be informed of treatment
alternatives.
Insurance vs. Self Pay
Listening, Learning and Creating...
A path to a healthy you.
A path to a healthy you.
The Counseling Center
311 Franklin Road
Brentwood, TN 37027
Located in rear of Brentwood United Methodist Church
(Practice is independent from the church)
311 Franklin Road
Brentwood, TN 37027
Located in rear of Brentwood United Methodist Church
(Practice is independent from the church)
Phone: 615.337.6975
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Main
SELF PAY?
Privacy is protected. Personal information
is kept strictly confidential Your files stay
in your therapist’s office.
Choice of therapists will usually be
broader. Virtually all therapists will
accept private pay patients. So, your
choices are nearly unlimited. Obviously,
licensed therapists provide evidence of
competency and thru their licensure
board, a method of ensuring their
compliance with an ethical code.
Treatment decisions are made by you in
consultation with your therapist. There
are no reviewers or company policies to
influence treatment decisions.
The frequency and timing of sessions are
made by you and your therapist together.
The client chooses the type of therapy that
fits his/her needs. Each situation can be
judged on its merits, depending on your
preferences and circumstances.
If you think you might need more than
very brief treatment, self-pay with a
therapist may be similar in cost to
managed care plans. Many therapists
offer cash discounts.
Find out what your managed care plan
covers. See whether there are cost savings
and how many sessions those benefits will
cover. Then decide whether the loss of
privacy and control of your treatment are
worth what you gain.
Nearly all your healthcare dollar goes to
providing healthcare. Typically, most
therapist’s marketing and administrative
costs are minimal, and there are no
executive salaries or shareholder profits.
Therapists emphasizes privacy and
tailoring treatment to the individual. We
encourage you to be a well-informed
consumer and to use treatment
alternatives such as support
groups, books, or tapes to extend your
gains.
As appropriate:
MC/VISA accepted at this practice. Fees
are substantially reduced for cash or credit
payment. Example:
Full Fee Cash Fee
Intake $ 150 $ 100
Therapy $ 120 $ 100
session
*Much of the above information was
based
upon a
document developed by the Connecticut
Psychotherapists Guild
Privacy is protected. Personal information
is kept strictly confidential Your files stay
in your therapist’s office.
Choice of therapists will usually be
broader. Virtually all therapists will
accept private pay patients. So, your
choices are nearly unlimited. Obviously,
licensed therapists provide evidence of
competency and thru their licensure
board, a method of ensuring their
compliance with an ethical code.
Treatment decisions are made by you in
consultation with your therapist. There
are no reviewers or company policies to
influence treatment decisions.
The frequency and timing of sessions are
made by you and your therapist together.
The client chooses the type of therapy that
fits his/her needs. Each situation can be
judged on its merits, depending on your
preferences and circumstances.
If you think you might need more than
very brief treatment, self-pay with a
therapist may be similar in cost to
managed care plans. Many therapists
offer cash discounts.
Find out what your managed care plan
covers. See whether there are cost savings
and how many sessions those benefits will
cover. Then decide whether the loss of
privacy and control of your treatment are
worth what you gain.
Nearly all your healthcare dollar goes to
providing healthcare. Typically, most
therapist’s marketing and administrative
costs are minimal, and there are no
executive salaries or shareholder profits.
Therapists emphasizes privacy and
tailoring treatment to the individual. We
encourage you to be a well-informed
consumer and to use treatment
alternatives such as support
groups, books, or tapes to extend your
gains.
As appropriate:
MC/VISA accepted at this practice. Fees
are substantially reduced for cash or credit
payment. Example:
Full Fee Cash Fee
Intake $ 150 $ 100
Therapy $ 120 $ 100
session
*Much of the above information was
based
upon a
document developed by the Connecticut
Psychotherapists Guild
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