Because changes in health care are more & more impacting the provision of counseling services, the following information is provided to help you be informed
about your choices & how the use of medical insurance impacts counseling.
Private Counseling
(self-funded)
There are no requirements of dysfunctional impairment.
Your counseling care will involve you &
your therapist.
You may receive any type of counseling appropriate.
The counseling does not become part of
your general medical record. Your private counseling information stays in my office &
is not reported to any other party, even the
fact that you are attending sessions.
Sessions are tailored to you & focused on
your needs; you are free to use the
counseling for the purpose you desire.
You decide when you are ready to stop the counseling.
You maintain control of the focus, the
process, & your information, & fund the counseling yourself.
Insurance-Funded Counseling
(In-Network)
Requires you to be diagnosed with a mental health diagnosis & experiencing an impaired-enough level of functioning (that is, there must be a “medical necessity”).
Your counseling care will involve 3-4 parties:
1. You
2. Your therapist
3. Your insurance company (who often also requires that your doctor [PCP] be involved)
Types of counseling you may receive will be determined by your plan benefits (that is, individual, couples, family therapy).
Your insurance company will receive record of your mental health diagnosis, the date of each session, & the type of each session for your medical record. In many cases they will also receive record of your counseling goals & progress, & your level of functioning & progress toward improvement.
Some of your session time will be spent on explaining how your insurance use works as well as focusing on your symptoms of distress (for example, depression or anxiety), since that is how your insurance will monitor your progress.
When your levels of distress have adequately improved (according to your insurance company), you will no longer be eligible for insurance-funded counseling.
You pay your co-pay or deductible.
Insurance-Funded Counseling
(Out-of-Network)
Same as above, however your insurance company receives only record of your mental health diagnosis, dates of sessions, & type of sessions to be posted to your overall medical record.
You pay the fee & then get reimbursed by your insurance company. I provide you a statement to submit to your insurance company for reimbursement.