Insurance Policy
TMW values confidentiality and does not participate directly in managed care plans. Your health insurance or employee benefit plan may cover services in whole or in part by looking into out-of-network mental health outpatient benefits. While we will collect fees directly from you, we will happily provide billing statements and appropriate paperwork for you to submit to your insurance company for reimbursement. Please check your coverage carefully by asking the following questions:
Do you have mental health insurance benefits? If yes, do you have out-of-network mental health benefits?
What is your deductible, and has it been met?
How many sessions per year does your health insurance cover?
What is the coverage amount per therapy session?
Is approval or pre-certification required?
Assumption of Illness
Insurance companies operate on a medical model, requiring a diagnosis to establish that you have “a medical necessity” to seek services. The vast majority of insurance companies don’t consider relationship issues, existential issues, life transitions, personal development, or self-improvement as “medical necessities.” So, we’d have to assign you a "medically necessary" diagnosis to be reimbursed for our work together. Health insurers actively seek ways to deny claims, limit care, dictate care, and intrude on your personal healthcare records.
Potential Negative Consequences for You
If given, the diagnosis will become a part of your medical record. While that might not be such a big deal right now, it may become one later on if you want to: get life insurance, work in the financial sector managing other’s assets, regularly handle firearms, or seek employment in any sector in which your decision-making might be called into question because of your emotional state.
Lack of Privacy & Confidentiality
When insurance companies pay for your treatment, it also means that their employees (clinicians or not) can (and do) audit and review treatment plans and read what we discussed in submitted session notes. In turn, the insurance company may decline authorization of additional sessions because you’re not progressing fast enough; our work in psychotherapy does not qualify as “a medical necessity." Some insurance providers don’t reimburse for 55-minute sessions anymore. TMW believes that you have a right to the confidentiality of your medical records. You also have the liberty to progress through treatment at a pace that’s best for you – one that allows you sufficient time to take everything that you’re experiencing. That unfolds differently for each person.
Retroactive Claim Denials
Unfortunately, it’s a common practice among insurance companies to audit claims and paperwork, sometimes for several years back. If they find any inconsistencies in the paperwork they missed when they originally approved the therapist’s claim, the insurance company will request that the therapist return the paid fee. This practice can amount to thousands of dollars, bankrupting a small business like a private practice.
Focus on Therapy, and YOU
Busy practices that accept insurance often drown in insurance paperwork and billing claims to get paid or spend hours on the phone contesting unpaid claims. Extensive additional staff must be hired just to process, track, and follow up on insurance claims. Therapists often have to fill out special reports (required by the insurance companies) to justify additional sessions past session number ten. Avoiding insurance allows the therapists at TherapyMyWay to focus exclusively on YOU without the multitude of distractions that insurance companies require.
No Labeling – You don’t have to carry an unnecessary (and perhaps inaccurate) diagnosis on your medical record.
Confidentiality & Privacy – You and your psychotherapist are the only people that will know you’re in therapy. You get to choose who you disclose this information to. Session notes are private records so there won’t be available prying eyes reading about your intimate details.
Self-Determination – You get to work with a psychotherapist that is free to use the best therapeutic approach to help you meet your goals. You and your psychotherapist are the only people involved in the decision about the length of your care. You won’t have to seek additional authorization to continue your work or return to psychotherapy if you have new goals you’d like to explore.
Quality Care & Attention – You’ll get a psychotherapist that’s not professionally overextended. Someone that’s alert and engaged during your session, remembering the details of previous conversations without you having to restate them every week.