Friday, May 24, 2019

Fort Collins Counseling, Therapy, Coaching: Why Some do not Accept Insurance

Today's Blog Post

This is an info-educational post, reminding you to be good client-consumers -- to know state mental health laws and HIPPA laws.

For very good reasons, many counselors and therapists, including Your Life Counseling, do not take mental health insurance.  The information below will help you understand why, and further help you be an informed client-consumer.


⇾ At the end of your first session, clinicians are forced to diagnose clients via the Diagnostic and Statical Manual.  Forced?  Yes, without a diagnosis your insurance plan does not work, and clinicians do not get paid. 

⇾ It is highly unethical to diagnose a client after their first session, and industry reports prove the majority of diagnosis are incorrect.  Reality -- how can anyone truly understand you, your life, and your clinical issues after a 50 minute session?

⇾ The therapeutic relationship is leveraged and monetized by your insurance provider. 

⇾ Documented diagnosis are a permanent record, becoming what is called a pre-existing condition, and could be legally harmful.  Think divorce, future employment, military, education, new insurance provider, or other.  Worldwide, there are documented cases of people being rejected from employment because they sought treatment for grief and loss, but were diagnosed with depression.

⇾ Diagnosing minors is potentially harmful and questionably unethical.  In nearly all instances, unless their is confirmed biological pathology, this issue speaks to the natural psychosocial-physical-cognitive development process that all humans experience (e.g., defiant teenagers).  Typically, as we age and mature, we out grow many of theses stage development traits/behaviors.  Also, it is well known that diagnosing minors may cause a negative labeling/stereotype affect, e.g. leading to other maladaptive issues such as learned helplessness, and/or poor coping/resiliency skills.  Lastly, US minors are both over diagnosed and medicated.  It's a new social cultural norm, fueled by a multi-billion dollar system that profits from treating the symptoms, not the cause.  Research proves, especially for depression, that mindfulness based cognitive therapies are as good and/or better than treatment as usual. 

⇾ Cultural needs could be diminished, or entirely ignored. 

⇾ Privacy and confidentiality may not be guaranteed -- data breaches happen all the time.


Here's what happens behind the client-counselor therapeutic scene -- the reality of mental healthcare insurance.

⇾ As a client-consumer with insurance, you could be forced to work with a contracted 'in-network' counselor/therapist, i.e. not the most qualified and/or the counselor/therapist of your choice. 

⇾ As a private practitioner or business owner, counselors are forced to accept the terms/conditions of the insurance companies (e.g., pre-designed limited client treatment plans, periodic audits, and the lowest reimbursement rates for our professional services).  

⇾ Counselors and therapist have to diagnose to get paid, and if their diagnosis do not fit into the formulated insurance 'system,' they are frequently challenged and denied.

⇾ Clinicians might spend up to 40% of their time on the phone justifying their diagnosis (i.e., diagnosis and reimbursements effect the insurance profit model). 

⇾ All insurance companies contract with professional services (e.g., physician, dentist, counselor) utilizing a formulary profit model.  In turn, they provide client-consumers an affordable co-pay, yet your treatment plan has already been pre-designed, and most likely capped.  Reality of the model? Diagnose, reimburse the least expensive treatment plan, and get you in and out of therapy as quickly as possible.  It's the main reason why in-network counselors/therapists promote quick fix therapy services (i.e., if a counselor goes beyond the reimbursable treatment plan, and or capped sessions, they do not get paid).  FYI, therapy is rarely a quick fix process, e.g. what if you and your family need more sessions, but your plan is capped -- now what?

⇾ The insurance model pushes clinicians towards a 'quantity vs. quality' business-clinical model.  Therapy becomes a numbers game, e.g. the more clients seen per day, the more likely the counselor/therapist makes money.  It is the number one reason why many clinicians must see a large amount of clients per day. 

⇾ The business-clinical 'quantity vs. quality' issues could lead to poor professional performance, and burn out/drop out rates for counselors/therapists are at an all time high. 

    ✳ NOTE: At Your Life Counseling, we do not accept insurance because we are greedy, cash-money hungry counselors -- for reasons mentioned above, we believe the mental health insurance system is a horrible clinical-business model, and we will never participate in it.

    To learn more about Your Life Counseling clinical standards and business practice, please visit FAQ

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