OUR COMMITMENT TO QUALITY CARE
Why We Don't Accept Insurance
Aspire Counseling and Wellness was created to provide quality care to members of our community. As part of that objective, we decided to accept private-pay clients only. This means we accept payment by cash or credit card at the time of service. Insurance HSA Cards (Health Savings Accounts) are accepted. More importantly, it means we do not bill or “accept insurance.” We do not participate in the payment or reimbursement process with insurance companies. This is an important boundary as an ethical obligation to our clients and a commitment to clinician self-care. Accepting Insurance for psychotherapy is complicated and problematic for both the counselor and client in a number of ways.
Use of insurance requires a mental health diagnosis. This is required before even considering payment for services. Diagnosis takes time, assessments, getting to know the client, observation of specific symptoms over a period of time, and more. Giving a diagnosis too early (especially after one session) does not fit into our ethical and professional decision-making. And insurance companies do not want to pay for personal growth, exploration, family conflict, school issues, or many more common difficulties many of us face and sometimes need support to overcome.
Insurance companies require clinicians reveal diagnoses, symptoms, behaviors, and treatment plans. This undermines the basic premise of therapy while also giving more people access to private health information about our clients. Not everyone needs a mental health diagnosis. We see our clients as capable individuals facing behavioral and emotional obstacles to fulfillment. But even if some of us do have a legitimate diagnosis, the details of the symptoms, treatment, and personal responses to that treatment should not need to be shared to receive therapy. Avoiding interactions with insurance companies protects the confidentiality of our clients.
Insurance-Driven Treatment Plans. Insurance companies decide which treatment methods will be covered and won’t be covered, even though they have never even personally met our clients. The company can decide when your treatment should end, regardless of what your therapist says.
Insurance companies limit the amount paid for treatment, the length of sessions, and the number of sessions available to a client. If they do decide to pay, they dictate the treatment. We believe the length of a session and the number of sessions needed for treatment should be an informed decision between clients and their therapist.
Working with insurance companies, or “accepting insurance,” demands an incredible amount of time and patience to fulfill paperwork demands, pursue reimbursements, re-authorizations for treatment, etc. This is all without a guarantee of even being paid for services. This is time we choose to give to our clients. It is also time we choose to re-set and care for ourselves, so we are at our best when we are with our clients—present and energetic. We know this allows more time for the therapeutic experience and relieves stress for both parties. This also maintains our commitment to provide quality care as we strive to offer a premium counseling experience.
Out-Of-Network Coverage (OON)
We do accept HSA Cards (Health Savings Accounts) for payment.
Having explained all of this, if you decide that you would like to pursue reimbursement for counseling sessions from your insurance company, we will provide you with what is called a Superbill. Payment is due at the time of service. We will provide a Superbill for you to submit to your insurance for out-of-network (OON) reimbursement after full payments. Services may be covered by your health insurance if they offer out-of-network services. If you are interested in this option, here are some questions you will want to ask your insurance company:
Do I have mental health benefits?
Does my plan cover out-of-network providers?
What is my out-of-network deductible and has it been met?
What is my in-network deductible for mental health services, and has it been met?
Will paying out-of-pocket count towards my deductible?
How much does my plan cover for an out-of-network provider?
Will I be reimbursed for payments given to an out-of-network provider?
Where do I send a super bill?
Employee Assistance Programs (EAP)
We do work with some EAP (Employee Assistance Programs) that provide mental health benefits to their employees and their families. The program and their principles of operation factor into whether we work together. Currently, we are active with One Source Counseling and Employee Assistance Services LLC. Please let me know if you have an EAP and we can discuss. Usually, these programs only provide a limited number of sessions, but it can help to alleviate some of the cost. After those sessions, clients can continue at the prevailing rate at the time of scheduling.
Please note that while the Intake fee is fixed, we do offer a generous 3, 6, or 9-month sliding scale fee program upon request. This means based on income and hardship requests, we have a limited number of sliding scale fees.
“Right to Receive a Good Faith Estimate of Expected Charges”
Under the No Surprises Act
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is substantially more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.
(Effective January 2022)