I do not currently provide claim filing services for insurance; however many of my clients’ insurance policies do reimburse them for my services.
With a few exceptions, insurance policies for North Carolina residents must accept my license (Licensed Clinical social Worker – LCSW) as a provider of counseling or therapy services. However, your policy may have stipulations that limit reimbursement and you will need to check with your insurance company the details of your coverage. I am pleased to guide you in that process, if you wish to have your counseling with me. I will also provide you with statements that include all the information you’d need to file your claims.
Why Not Accept Insurance
While it is an unfortunate state of affairs, most insurance* is not very user friendly about counseling or other mental health services, for either the client or the clinician. I encourage all counseling clients to take some time to become fully informed about the pros and cons of using insurance for mental health services. Some factors to consider are offered in more detail on the Insurance FAQ page, along with links to independent articles on the topic. My reasons for not directly accepting insurance complex and are interconnected, but the 5 main reasons are here.
1) Pressure to over-diagnosis to get payment authorized
Most insurance companies treat everything like you’re going to a doctor and will not authorize payment for counseling or psychotherapy unless it is deemed “medically necessary”. This puts pressure on Read More
2) Risks to Your Confidentiality:
Insurance companies require diagnoses, treatment plans, reports of progress, and often other personal information before approving treatment or Read More
3) Difficulty Getting Treatment Authorized:
Recent media stories have supported the idea that many insurance companies regularly resist authorizing payment, even for legitimately covered treatment. So, there is often a lengthyRead More
4) One Size Does Not Fit All:
The counseling needs (frequency of sessions, length of treatment, methods of counseling, etc.) of clients varies widely; but many insurance companies have a Read More
5) Insurance Coverage Does Not Assure Your Counseling will be Reimbursed:
I’ve worked with several clients having genuine mental health issues who were surprised to have their insurance claims denied. Unless you have contacted your insurance company Read Moreand received “pre-approval for treatment” before your first session, they might deny your claim even if it appears to be a covered service.
This is often done by a process called “utilization review”, which is just a fancy way of saying they check to see if your use of your insurance meets the terms of your policy. If it’s the least bit questionable (or even if not), it’s quick and easy for them to simply deny your claim… and put the burden back on you to ‘prove’ you’re entitled to reimbursement. This is done by appealing their decision and perhaps needing to submit documentation from your personal use of counseling. Going through these appeals can be very time consuming for both the client and the clinician.
With or without insurance, counseling is an investment and does involve some costs. For more information on where your counseling fees go, you may wish to look at the article Why Does Counseling Cost So Much?