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Self-Pay vs. Insurance

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Though it may surprise some, there are many reasons why you may choose to forgo the use of your health insurance when seeking therapy.  For your convenience we have compiled a non-exhaustive list below that we encourage you to review prior to initiating treatment. 


If you expect to use your health insurance to help pay for psychotherapy, you must allow us to tell your health insurance company about your problem or problems and give you a psychiatric diagnosis. The insurance company may also request information about the treatment we are providing, your progress during treatment, and about how you are doing in many areas of your life (your functioning at work, in your family, your social life, and in activities of daily living).

All of this information may become part of the insurers' records, and some of it will be included in your permanent medical record at the Medical Information Bureau, a national data bank. It is not open to the public, but it may be examined when you apply for life, disability, or health insurance, and it may be considered when you apply for employment, credit/loans, a security clearance, or other things in the future. You will have to release this information or you may not get the insurance, job, loan, or clearance.

Requires a Diagnosis

When you wish to utilize your insurance to pay for psychotherapy, your therapist is required to identify the presence of a diagnosable condition in order to proceed.  If one exists, your therapist will submit this diagnosis to your insurance company in order to accurately justify the treatment episode. Because insurance companies usually decline requests to pay for services that they do not deem “medically necessary”,  the circumstances that brought you to therapy must meet this requirement to be “billable”.   What's more, this diagnosis remains part of your medical record which could have a significant impact in a variety of situations (see “confidentiality” above).   Self-pay gives you the option to continue to meet with your therapist for important issues like interpersonal stress and other personal problems but without a formal mental health diagnosis.

Due to the agreement that we make with insurance providers when asking them to cover the cost of therapy, we sometimes relinquish some control over the length of a treatment episode. While we aim to make treatment at Collective Mind as efficacious as possible, there are times when you may have a conflicting opinion than that of your insurance company on the appropriate duration of treatment.  We are also bound by the prescripted length of individual sessions and many insurance companies will not cover more than one “service” or 45-55 minute session per day.  In circumstances where we wish to add additional sessions to our treatment episode, the best case scenario may require us to provide additional information to the insurance company. 

Insurance companies tend to be very specific about which types of services they are willing to pay for. For instance, many insurance policies do not yet cover video sessions and most will not cover a phone session at all. However, their methods for determining coverage and benefits are not always easily interpreted, complicating the billing process and potentially leading to unexpected fees and claims rejections. 

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