Fees and Policies
IT IS ALWAYS IMPORTANT TO ADDRESS MENTAL HEALTH CONCERNS AND ESPECIALLY DURING THE COVID-19 CRISIS. I will be accepting new BlueCross/Blue Shield patients during this time period. Please check with Blue Cross to fully understand your mental health benefits, any co-pays and deductibles.
My fee is $160.00 per 45 minute session. Fees are payable at the time of service. In general, I would be considered an “out of network” provider if you choose to use your insurance. You may be reimbursed for some amount of your fee, although each insurance company contracts differently with its client organization. Please read below about my thoughts regarding why I choose to not be on Managed Mental Health Plans.
My fee is $160.00 per 45 minute session. Fees are payable at the time of service. In general, I would be considered an “out of network” provider if you choose to use your insurance. You may be reimbursed for some amount of your fee, although each insurance company contracts differently with its client organization. Please read below about my thoughts regarding why I choose to not be on Managed Mental Health Plans.
Why Are Many Mental Health Professionals
Choosing To Not Be On Mental Health Plans?
Choosing To Not Be On Mental Health Plans?
CONFIDENTIALITY
All Managed Health Care Plans involve direct clinical management by the plan's case managers. This is to manage cost to the insurance company ultimately. If you access therapy through your Managed Health Care Plan, it can make it necessary for your therapist to disclose information related to your case to gain additional sessions. For some plans, you may have an "assessment session" and the therapist gives a comprehensive review of your problem(s), medications you may be on, current family and work situation/history, along with the likelihood that you may become aggressive toward others or harm yourself.
This information is used by the Managed Health Care Plan to determine benefits, which they allocate at their discretion. This impacts your confidentiality; your information is stored in ways that allow access by other case managers that are employed by the Managed Health Care Plan. My preference is that your information be your information. You are able to decide who has that information and under what circumstances they should have it.
MANAGED MENTAL HEALTH PLANS DECIDE WHO RECEIVES ACCESS TO THERAPY
The vast majority of Managed Mental Health Plans do not pay for marital therapy or for family therapy. With marriages and families experiencing unprecedented stressors and challenges, this policy seems out of touch with today's needs. However, under a typical plan, only individual therapy is recognized and authorized.
Under this policy, members of the family or couple are seen individually with only a few minutes of mutual consultation or discussion at the beginning or end of the session. The person with "the problem" is the one given the diagnosis and therapy; insurance is then filed on them. This policy is more than unfortunate to those who want to include their partner, child or other family member(s). My preference is to work with those who are wanting to make changes, no matter how the individuals are related to one another.
DIFFICULTY IN GETTING TREATMENT AUTHORIZED
Due to the direct care management by Managed Mental Health Care Plans and their desire to keep costs to a minimum, getting therapy sessions approved often becomes quite cumbersome and time consuming. Every plan has different requirements and standards or authorizations. Phone calls to, and paperwork required by, the Managed Health Care Plan in order to get initial authorizations and receive additional sessions can be frustrating for both the Mental Health professional and the client.
Additionally, Managed Mental Health Care Plans allow a certain number of sessions per year for each plan. Many plans allow 20 sessions per calendar year and you may have to "share" those sessions with another mental health professional - a psychiatrist for example.
Unless the client is in severe distress, and this can be proven in some way, then coming to therapy once a week is the acceptable standard. If you as the client felt that it would be beneficial to come twice a week to work through an issue more quickly, the Managed Mental Health Care Plan would still pay for only one visit per week. You and your therapist are not in control of your case - your Managed Health Care Plan and an unknown employee is.
LACK OF COVERAGE FOR MANY COMMON PROBLEMS
Many Mental Health Care Plans do not cover common issues like Parent-Child Relationship stressors, concerns about how to deal with an aging or ill family member who may be experiencing behavioral symptoms or work oriented concerns for example. Wouldn’t it be helpful to speak to a Mental Health Professional about whatever you want to discuss, whether the concern is potentially covered or not?
All Managed Health Care Plans involve direct clinical management by the plan's case managers. This is to manage cost to the insurance company ultimately. If you access therapy through your Managed Health Care Plan, it can make it necessary for your therapist to disclose information related to your case to gain additional sessions. For some plans, you may have an "assessment session" and the therapist gives a comprehensive review of your problem(s), medications you may be on, current family and work situation/history, along with the likelihood that you may become aggressive toward others or harm yourself.
This information is used by the Managed Health Care Plan to determine benefits, which they allocate at their discretion. This impacts your confidentiality; your information is stored in ways that allow access by other case managers that are employed by the Managed Health Care Plan. My preference is that your information be your information. You are able to decide who has that information and under what circumstances they should have it.
MANAGED MENTAL HEALTH PLANS DECIDE WHO RECEIVES ACCESS TO THERAPY
The vast majority of Managed Mental Health Plans do not pay for marital therapy or for family therapy. With marriages and families experiencing unprecedented stressors and challenges, this policy seems out of touch with today's needs. However, under a typical plan, only individual therapy is recognized and authorized.
Under this policy, members of the family or couple are seen individually with only a few minutes of mutual consultation or discussion at the beginning or end of the session. The person with "the problem" is the one given the diagnosis and therapy; insurance is then filed on them. This policy is more than unfortunate to those who want to include their partner, child or other family member(s). My preference is to work with those who are wanting to make changes, no matter how the individuals are related to one another.
DIFFICULTY IN GETTING TREATMENT AUTHORIZED
Due to the direct care management by Managed Mental Health Care Plans and their desire to keep costs to a minimum, getting therapy sessions approved often becomes quite cumbersome and time consuming. Every plan has different requirements and standards or authorizations. Phone calls to, and paperwork required by, the Managed Health Care Plan in order to get initial authorizations and receive additional sessions can be frustrating for both the Mental Health professional and the client.
Additionally, Managed Mental Health Care Plans allow a certain number of sessions per year for each plan. Many plans allow 20 sessions per calendar year and you may have to "share" those sessions with another mental health professional - a psychiatrist for example.
Unless the client is in severe distress, and this can be proven in some way, then coming to therapy once a week is the acceptable standard. If you as the client felt that it would be beneficial to come twice a week to work through an issue more quickly, the Managed Mental Health Care Plan would still pay for only one visit per week. You and your therapist are not in control of your case - your Managed Health Care Plan and an unknown employee is.
LACK OF COVERAGE FOR MANY COMMON PROBLEMS
Many Mental Health Care Plans do not cover common issues like Parent-Child Relationship stressors, concerns about how to deal with an aging or ill family member who may be experiencing behavioral symptoms or work oriented concerns for example. Wouldn’t it be helpful to speak to a Mental Health Professional about whatever you want to discuss, whether the concern is potentially covered or not?