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Insurance

One of the first questions I am asked is “Do you take insurance?”  While we are accustomed to using insurance for physical ailments without consequence, often the consequences of using insurance for mental or behavioral health issues are not considered.  I am hoping that an outcome of the health care bill, some of these consequences will become moot.  Until then, it is important to consider whether using your insurance is right for you.

First the short answer to the question is, no, I do not take insurance.  If you are seeking a service provider who does work with insurance, I would be happy to talk with you about finding a referrals to best meet your needs.

At Anna Tyrrell & Associates, we have what is called a self-pay practice. This allows us  to ensure treatment is client driven and to allow for increased confidentiality.   Clients do not require a diagnosis in order to receive services.  Most of the clients we see are dealing with major life stressors such as divorce, family crisis, personal life crisis, behavioral problems related to learning difficulties, interpersonal conflict or abuse, therefore, they do not require a diagnosis.
There are a number of benefits to paying for counseling without insurance. Most importantly, you will not get a diagnosis unnecessarily for the purpose of reimbursement. Not billing to insurance allows our clients more control over the course of treatment. We have found many of our clients use our practice much like a doctors office…more visits occur to get over a crisis or when things aren’t going well.   We see them again for check-ups or when life throws another curve.
Additionally, when diagnoses are reported to insurance companies, this information may then be reported to the Medical Information Database, a data base available to member insurance companies (the site notes 470 members).  More information about this data base can be found at www.mib.com .
We have found that by having a self-pay practice, we are able to keep our costs down and we pass that savings to our clients through our fees. Additionally, we have more time and attention to meet our clients’ needs.

Lastly,  common services we provide such as marriage counseling, parent-child conflict, parenting, divorce support, mediation, anger management, and parenting coordination are not covered by insurance.
Some other advantages to paying for counseling yourself are listed here:

  1. Again most people don’t realize is that in order for insurance to pay for counseling services, the counselor must provide the insurance company with a diagnosis. For many people, they are seeking counseling to deal with life situations or stresses, such as divorce, communication or relationship problems, marriage problems, parenting issues, or childhood issues. Struggling with such life hurdles may not mean that a person is suffering from a mental illness. When you pay for your counseling, the counselor is not obligated to provide a diagnosis.
  2. For some counseling services, such as marriage counseling, many insurance companies do not pay for the service. Therefore you would need to pay on your own. (Or have one of you diagnosed so your insurance will reimburse.)
  3. To seek counseling from a counselor who generally bills insurance, that counselor may not be able to adjust her/his fees due to the agreement they have with insurance companies. Anna maintains her fees for previous clients at the level they were charged when they started.
  4. Your insurance may only pay for a limited number of sessions per year. This may require you to pay full fee for extended counseling with a counselor who is unable to adjust fees due to the arrangement they have with your insurance provider.
  5. Depending on your insurance plan, some managed care plans require a counselor to submit your treatment plan for approval before providing reimbursement. The managed care company may approve a limited number of sessions, with additional sessions allotted based on progress toward treatment goals or requests from the counselor. Managed care companies vary in how many sessions they will approve at a time.
  6. Due to the need to report diagnosis, treatment plans, and or progress of treatment to insurance companies, and computer billing, your confidentiality may be compromised when using your insurance. This is not a concern when you are paying for counseling services yourself.
  7. Paying for your own counseling often contributes to a greater commitment or motivation to work toward treatment goals to alleviate the need for counseling.
  8. Paying for your own services allows you more control in how often you schedule appointments, the course of treatment, and increased confidentiality.
  9. Paying for you own services eliminates the need for information to be reported to the Medical Information Database. To access your records in the MIB, click on this link www.mib.com.
  10. Paying for your own services allows you to budget for your counseling services and allows us to focus more on treating our clients and less on billing and paperwork.
  11. We are able to pass our overhead savings to our clients through lower fees than the Usual and Customary Rate (UCR).
  12. Our self-pay practice allows us to be more flexible in working with family members and using a family systems approach to mental health care.