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Transitioning Away from Insurance

Transitioning Away from Insurance

Insurance has always been something of a necessary evil for therapists. We all want to be in control of the sessions and do right by our clients, but we have to look out for our own economic self-interests as well. And that means sometimes having to deal with insurance companies, and their rules and regulations. What I would propose is that going off of a third-party payment system will not be that much of a shock, and in reality is quite doable, and will provide you all access to more potential clients.

First, according to, up to 55% of people in the United States do not have insurance, or do not have insurance that covers mental health services. Also 20% of people with a diagnosed mental illness do not have insurance coverage, or coverage that includes mental health care. That is a massive segment of the population that is available, and can be marketed to for services.

Second, you get control of how long you see the client. You do not have to abide by the mandated insurance brief therapy model. You get to the intensive, and often necessary work, of helping the client undo years of trauma and mental illness in the timeframe that makes the most sense for that person. This seems more treatment friendly, and with a longer-term client, you will have a steadier, and possibly greater, income.

Third, most clients will be coming with a co-pay already, which depending on the insurance company and your state, will not be that much less than what the insurance company will reimburse you for service. If you can work on a sliding scale within reasonable ranges, you will find most people will be willing to see you longer term, for just a little more money than their co-pay. You also have the opportunity to charge people less for those cases you feel need the help but not the cost.

Fourth, time is considered money, and for therapists that holds true as well. Your time is best spent providing services to clients, not arguing with insurance companies, filling out endless forms, or worse, trying to find a coding error. If you hire this work out to a professional biller, this could be one less expense every month, and for you it is a lot of time saved that can be used to focus on other things.

And finally, this gives you many opportunities for expanding your practice, without sacrificing a lot in terms of payments. The large population un- or underinsured gives you a larger pool of potential clients, and charging them directly on a sliding scale that would be about the same as a co-pay gives you the same if not greater income, with your time and energy focused on serving clients, rather than paperwork and insurance troubles. Your time goes towards your clients and growing your business. The amount you make per hour will go up, as you will spend less time on other matters, and focus solely on the goal of helping clients heal.

It may seem like paradoxical thinking, but it can be a better business decision to transition away from accepting insurance, and going to a client pay only system. The majority of the country is un- or underinsured, and mental health coverage is not guaranteed in every plan. You as the therapist get to set the amount of time spent with the client, not the insurance company, and this gives you better service towards your client, as well as ongoing income. And in a world where time is money, you will spend less time with paperwork, insurance claims, and billers, giving you more time to focus on your practice, and your life, and giving you a higher amount of income per hour spent on serving each individual client. Until the insurance system in the country changes for the better, moving away from third party billing towards direct paying clients is something to which therapists should give some serious thought.

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Jason Simpkins
Posted on 03/10/2018 by Jason Simpkins

Jason Simpkins is a writer at Open Counseling. He is a clinical social worker in Michigan and is dedicated to having quality mental health care available to everyone. And as a University of Michigan graduate, he says a hearty, Go Blue!



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