MyThoughts

     In my practice of counseling and psychotherapy, I specifically choose not to be a provider for any insurance companies.  There are a couple of very important reasons as to why I choose to do this.  Before I explain what those reasons are I should mention that many insurance companies will still pay for my services.  I am what you call an "out-of-network provider" for many insurance companies.  Basically, that means that the client is responsible for paying me directly for my services and that  if the client's insurance is willing to pay for me as an "out-of-network provider" then they will send the client a reimbursement check for some or all of the cost.  
     There are two significant reasons as to why I choose not to be a direct provider for insurance companies.  I discussed the first reason in last month's newsletter which was centered on how client confidentiality could be sacrificed.  The second reason and the focus of this month's newsletter pertains to how the overall treatment process can be obstructed from the direct involvement of insurance companies.
     As I mentioned last month, if I was a provider for insurance companies, many times I would first have to get pre-authorization from them to see clients before they even come in.  Right from the start the treatment can be thwarted if the insurance companies decide not to offer payment for client problems that they feel are not significant enough for treatment.  Many people who may be suffering with emotional or relationship issues choose not to start counseling because their insurance will not pay for it.  This is unfortunate for the person seeking treatment for two reasons: 1) feelings of humility and debasement will now be comorbid with their initial mental health problems after the insurance company minimized their presenting problems by their unwillingness to pay for treatment and 2) treatment will not be initiated which will only allow the presenting problems to perpetuate to an unhealthier level.  
     Some insurance companies have realized that preventative maintenance is a good idea in the medical field; getting a colonoscopy to prevent colon cancer for instance.  However, they have not adopted the preventative maintenance philosophy into the mental health field.  I happen to believe that preventative maintenance for mental health is just as important as in the medical realm.  My approach is to treat every problem with equality whether it seems minor or major.  Treating minor problems early on will only prevent them from becoming major problems later on.
     When insurance companies decide to pay for treatment they will often put several limits on the treatment process rendering it ineffective.  Some insurance companies will require that I call to do a review every few sessions.  During those reviews they want to know what the presenting problems of the client are and how I plan to treat those problems.  Often times they will disagree with my treatment approach stating that I should be using another approach which is far less time consuming.  The insurance companies do not want to admit that mental health problems take time for people to overcome.  The problem with using the quick approaches that the insurance companies want me to use is that they are ineffective.  It is comparable to putting a band-aid on something that needs major surgery. 
     After all, insurance companies make money by getting people to pay insurance premiums every month and making it very difficult for them to actually use the benefits.  Their only concern is to keep the costs that they pay out to a minimum.  In the end, the people who suffer the most are the clients because they are not getting the treatment that they need and deserve.

Sincerely,

Nathan M. Comerford, MA, LLPC, NCC   
    
If you or someone you know needs to speak to someone regarding relationship issues, emotional difficulties or mental health problems, help is a phone call away.  Schedule an appointment today!
Just call (248) 932-7799 to set up an appointment with
Nathan Comerford, MA LLPC NCC.
    
Visit www.thoughtperspectives.com for more information on counseling and psychotherapy!

Visit the "Ask the Counselor" Blog at: www.thoughtperspectives.com/blog

• This is a question and answer blog where Nathan answers questions concerning mental health topics.
•  If you have a question, you can send it to: questions@thoughtperspectives.com to have it answered by: Nathan Comerford, MA, LLPC, NCC.

Nathan M. Comerford is a psychotherapist in Farmington Hills, MI who has been helping people with their relationship issues, emotional difficulties and mental health problems for the past 8 years. 

Thought Perspectives Counseling
31275 Northwestern Hwy., Suite 120
Farmington Hills, MI 48334

 In my practice of counseling and psychotherapy, I specifically choose not to be a provider for any insurance companies.  There are a couple of very important reasons as to why I choose to do this.  Before I explain what those reasons are I should mention that many insurance companies will still pay for my services.  I am what you call an "out-of-network provider" for many insurance companies.  Basically, that means that the client is responsible for paying me directly for my services and that  if the client's insurance is willing to pay for me as an "out-of-network provider" then they will send the client a reimbursement check for some or all of the cost.  
      There are two significant reasons as to why I choose not to be an insurance provider.  The first reason is that the confidentiality of my clients will be sacrificed.  If I was a provider for the insurance companies, the first thing that I would have to do is get permission to see my clients before they even come in for the initial session.  This would involve them requesting all of the confidential information pertaining to the client such as why they need treatment, what their diagnosis would be and how I would plan to assist them in solving their treatment issues.  
     The insurance company then decides if the treatment issues being presented are worthy of actual treatment through counseling or psychotherapy.  If they decide to pay for treatment they will usually pay for the initial 4-6 sessions.  If more sessions are needed (more sessions are always needed because nobody can be treated in such a short period of time) then I would have to call the insurance company and review with them everything that was discussed in treatment thus far and explain why further sessions may be required.  The more reviews that I do with the insurance companies, the more difficult it becomes to get them to pay for further treatment.      
     Perhaps the most disturbing element in all of this is the fact that the client's confidentiality is being sacrificed over and over when dealing directly with the insurance companies.  They will know everything that has been going on in the treatment from the reviews that I would be required to do with them.  There is no sure way to know that their records will be kept safe or that their employees will not leak confidential information.  Insurance companies are usually large corporations which means that your personal information could be passing through the hands of countless employees.  
     I personally put every effort into maintaining the confidentiality of my own clients.  I believe that in order for the process of counseling and psychotherapy to work, the client must feel safe in knowing that what they discuss in therapy will remain confidential.  

Sincerely,

Nathan M. Comerford, MA, LLPC, NCC      
    
If you or someone you know needs to speak to someone regarding relationship issues, emotional difficulties or mental health problems, help is a phone call away.  Schedule an appointment today!
Just call (248) 932-7799 to set up an appointment with
Nathan Comerford, MA LLPC NCC.
    
Visit www.thoughtperspectives.com for more information on counseling and psychotherapy!

Nathan M. Comerford is a psychotherapist in Farmington Hills, MI who has been helping people with their relationship issues, emotional difficulties and mental health problems for the past 8 years. 

Thought Perspectives Counseling
31275 Northwestern Hwy., Suite 120
Farmington Hills, MI 48334