Hurry up and wait . . .
Tom Walden
January 17, 2016
WHAT ARE THE ADVANTAGES OF SELF-PAY?
Believe it or not, there are advantages to you of paying for psychotherapy services out of your pocket. If you are scratching your head in wonderment at this revelation, I have compiled a list of reasons I hope will relieve you of disbelief. Here they are:
Cascades on the OHT
Zina Hall
December 13, 2014
֗ PRIVACY – When you pay for psychotherapy out of your pocket, your employer, managed care organizations (MCOs), and insurance companies do not have access to such things as your diagnosis, symptoms, and personal information. Many MCOs and insurance companies require psychotherapists to provide them with the patient’s diagnosis and a brief outline of the symptoms and/or presenting problem(s). This could result in your diagnosis being registered in the Medical Information Bureau database. Information required by an insurance company or MCO to be supplied to them could affect your insurability or increase your premiums on down the road. Additionally, that same information could adversely affect hiring decisions made by a potential employer if you apply for a job in a ‘sensitive occupation’ (e.g., law enforcement, airline pilot, physician, politician). MCOs sometimes require that symptom checklists be faxed to them at times during the course of treatment, and some MCOs may even audit a patient’s file.
֗ FREEDOM OF CHOICE – Many insurance companies impose limits on such things as your choice of therapist, the number of sessions and type of therapy that will be reimbursed, and where the services can be performed. Such limitations could leave you feeling pressured to schedule your sessions at intervals not conducive to your optimal progress in treatment. As well, those limits could keep you from choosing a therapist who was highly recommended but may not be on the company or preferred provider list. For adults, virtually all types of treatment reimbursed by MCOs and insurance companies must occur “onsite.” In other words, you would not have the choice of getting your services anywhere but in a therapist’s office unless you arranged to schedule your services with a reputable therapist who takes only self-pay consumers.
Greasy Creek
Ozark Highlands Trail
Tom Walden — December 21, 2014
Another matter of importance is that many problems and concerns leading individuals to seek treatment can be thoroughly addressed in one session lasting anywhere from two to three hours. But, MCOs and insurance companies will not pay for sessions lasting longer than an hour or 1.5 hours, depending on the modality of treatment. So, what this means for many of those who are willing to pay for their psychotherapy services out of pocket, the hassles of scheduling multiple psychotherapy sessions can be forgone. Put simply, leaving behind managed care and insurance companies can broaden and deepen your access to helpful, beneficial services while freeing up your schedule.
֗ NO NEED TO BE ‘SICK’ TO GET SERVICES – When a third party pays for services, ‘medical necessity’ must be established. For this to happen, your symptoms must be such that your therapist can give your condition a psychiatric diagnosis. When you pay for services out of your pocket, you do not have to have a diagnosis in order to receive services that could be of benefit to you. This means you could use therapy for
Aaah . . . sunlight!
Brush Creek
Leatherwood Wilderness
Zina Hall — October 2014
purposes such as personal growth, to help you learn to address and resolve problems and concerns you are having on your job or in your relationships, or to get consultation for almost any reason. Put simply, the variety of reasons for seeking and receiving treatment becomes virtually limitless.
֗ COST OF SERVICES – Providers of health care services who take third-party payments incur extra costs of doing business that are not realized by ‘self-pay’ providers. Consequently, those extra costs may get passed along to the consumers of their services who do not have a third-party pay source and are, thus, relegated to pay for their services out of pocket. Specifically, though it does not hold true for all providers who take third-party payment, it is common practice for such providers to charge their patients who have to pay cash the same fee for services that is billed to third-party payers. Therefore, it you are one of those who does not have a third-party to pay for your services, compare the fee for services charged by providers who take third-party payments to those who do not. You just may save yourself some money by doing so.