The short answer is sort of.

I made the decision years ago to not sign a contract with any insurance companies. Therefore, I am considered an out-of-network provider. However, many of my clients use their insurance benefits, and I even submit the billing on your behalf, but coverage is dictated by your plan’s out of network coverage, which is sometimes the similar to in-network coverage and sometimes it’s quite different.

To explain further, a provider who is in-network has agreed to be a network provider for your particular insurance company. Specifically, this means that in order for the the provider to be paid for each session, they are contractually obligated to regularly communicate information about your treatment goals and progress to your insurance company.

The insurance company often uses this information to determine how many sessions they will allow. This also means that you will be required to have a mental health diagnosis (see the info below about mental health diagnoses).

Because of the high value I place on your confidentiality and choice when it comes to therapy, and because I work for you, I remain an out-of-network provider.

Out-of-network insurance is a good option for people who value choice, but would also like to utilize their health insurance benefits.

Using out-of-network benefits is very similar to using in-network benefits in that insurance will pay for a portion of each session, although sometimes the percentage they pay is a less than they pay for in-network (70% vs 80%, for example). 

If you elect to go this route, I electronically submit all out-of-network charges to your insurance company automatically. Or I can supply you with an itemized receipt, called a super bill if you'd like to do it yourself.

There are a few downsides to this option to be aware of. The first is that you will be assigned a mental health diagnosis (see the diagnosis question below). Insurance companies require this in order to reimburse for any service.

The second downside is that you may have a deductible which must be satisfied before any reimbursement can occur. For some people, this deductible can be sizable. However, many in-network plans also have a deductible, so there may not be a significant difference in out-of-pocket expenses depending on your particular plan.

The best way to find out about your out-of-network deductible and the percentage of reimbursement you can expect is to check with your insurance company directly.

Prior to beginning therapy, I will contact your insurance company and provide you with an estimate of your financial responsibility. This estimate is not a guarantee of benefits because we cannot know exact coverage amounts until we submit actual charges. However, it should give you a good approximation of what you will owe for each session.

If you elect to self-pay, you will owe the full session fee at each session, or an agreed upon payment plan interval.

If you elect to submit to insurance, the only way to know for sure is to send in a claim. But we can usually get a good idea when we check your benefits. I can usually do this pretty quickly for you, and will provide an estimate of coverage prior to deciding to work together.

The No Surprises Act, which became effective on Jan. 1st 2022, requires medical providers to supply a Good Faith Estimate (GFE) specifying anticipated fees prior to the start of services.

You will receive a GFE upon the commencement of therapy based on self-pay rates. It will also include estimated insurance payment/reimbursement, if you may want me to submit claims on your behalf.

More information about the GFE

If you are seeking the highest degree of privacy and choice, paying out-of-pocket is the preferred choice.

Not only will you enjoy the most confidentiality of any payment option, you will not be labeled with a mental health diagnosis (see the diagnosis question below), which all insurance companies require. 

Additionally, our work together will not be affected by any changes in your health plan coverage or network. And depending on your particular tax situation, you may be able to write off therapy expenses.

I would be happy to check on this for you. Please head over to the consultation page to schedule a free consultation. Once you request an appointment, I will send you some documentation to complete, including asking about your specific insurance information.

Here’s a guide to assist you when you call.

If you need help interpreting what they tell you, just let me know. It can be hard to know exactly what some of it means.

Yes! However, I have formally opted out of Medicare and as such, all sessions with me will be entirely self-pay. Additionally, Medicare requires a form called a Medicare Private Contract to be signed prior to our work together.

Yes! However, MNSure plans do not feature any out-of-network benefits, so we will not be able to send claims to your MNSure plan and you will need to self-pay for services.

MN Care plans do not have out-of-network (OON) benefits. So, while you can choose to work with me, you will be paying completely out-of-pocket.

MNCAre plans, Prepaid Medical Assistance Program (PMAP), and State Medical Assistance plans (MA) also do not have OON benefits. Furthermore, MN state law prohibits health care providers from collecting direct payment from anyone on one these plans. Therefore, you MUST see a provider who takes accepts these plans.

Using funds from a flexible spending account (FSA), a health saving account (HSA), or a health reimbursement account (HRA), are great because they allow you to choose your own provider and allow you to use pre-tax dollars to pay for therapy.

Because my practice is coded as a health expenditure, your FSA or HSA card will be automatically accepted. HRA accounts are sometimes accessed through the insurance billing process, so a card is unnecessary in this case. Of course, you can always opt to submit your own receipts instead.

Regarding privacy, only the organization or bank that administers the FSA/HSA account will know about your therapy charges.  

Note: Your HSA/FSA administrator may require an itemized receipt, possibly including a mental health diagnosis, if you opt to turn in your own receipts or if they decide to audit charges made to your account. These will be supplied upon request.

I offer several flexible payment options to fit your needs so that you may attend therapy as often as you'd like without straining your budget. These plans typically allow for smaller weekly or monthly automatic payments toward your balance and do not accrue any kind of fees or interest.

Payment plans may be utilized for out-of-pocket, FSA/HSA, or out-of-network insurance scenarios.

I do not offer a sliding fee scale. However, Open Path Collective is an excellent resource that will connect you with therapists who offer sliding fee scales.

Open Path Collective

The short answer is yes.

I believe you should be adequately informed of all possible implications so you may make a conscientious decision about the release of your mental health diagnosis to third parties.

A mental health diagnosis is a code assigned to the issue or issues that bring you to therapy. Normally, this information stays in your file and is subject to privacy protections. However, when it comes to insurance, this code is required on claims and tells the insurance company what you're being treated for, how long it may last, and how likely it is to return.

We do not yet fully realize the present and future implications of having a mental health diagnosis released to payers, particularly with the new laws requiring the interconnectedness of medical records. 

A mental health diagnosis could potentially affect your ability to purchase affordable life insurance, as well as affect adoption applications, high level job/security clearance, or other future legal, employment, or financial implications we have yet to imagine. Therefore, it’s important that you are fully informed of your options before choosing to release any diagnostic information for any reason.