Paying for Services

Paying out-of-pocket is probably going to cost more than if you use the mental health benefits that your insurance company offers. And you may wonder why you would ever choose to pay out-of-pocket for something your insurance company will cover – that’s why you’re paying those premiums, right?! The answer seems easy, and I get it! But before you switch to looking for an in-network provider, I think you deserve to know that there are some non-monetary costs associated with using insurance to cover psychological testing. I took insurance in my previous practices and have moved away from this because I want to offer the best possible service I can … not the pared-down service that an insurance company tells me I can offer. Please read on for some of the benefits of private pay and make an informed decision!

• You can choose to see any provider you want rather than being limited to just the providers who accept your insurance.
• Making a diagnosis is not mandatory. Insurance companies typically only pay for services they consider “medically necessary”, and to to be “medically necessary”, the service must usually be associated with a diagnosis. So, a provider who is billing insurance must make a diagnosis or they will not be reimbursed for their time. When you use a private pay provider, there is no pressure to diagnosis, and even if a diagnosis is made, it will not be automatically submitted to your private health records.
• More services are allowed without restrictions. Insurance companies limit the number of hours a psychologist can see a client for testing. If the psychologist goes over this number of hours, they will not get paid for that time. With a private pay provider, there are no limits on the amount of time, and the evaluation can be more comprehensive and flexible.
• Many issues (e.g., learning problems, life stress) are not covered at all by insurance, so private pay may be the only way to get help to address these concerns before they become a bigger issue.
• You are guaranteed privacy and confidentiality because nothing is automatically submitted to insurance, and you retain control over who receives the results of the evaluation.
• Research shows that clients who pay something for their treatment have more positive outcomes than those who receive free treatment.
• Insurance premiums and life insurance policies will not increase based on mental health diagnosis and treatments. Having a diagnosable condition can make a person more ‘risky’ to insure, and so insurance companies charge more to cover the costs of treating that condition.