Six Misnomers About Accepting Health Insurance

It doesn’t matter if you have just graduated from medical school or have been practicing for years, the biggest question on everyone’s lips seems to be: “Is it ok to accept health insurance?”

There is no easy answer to that question, but the choice you make could have a major impact on your counseling practice. It seems that the more you read about it, the harder the decision becomes, especially when you consider that there is a ton of misinformation floating around.

Listed below are a few statements that fall into that misinformation category, as well as some answers that will hopefully clear up any questions that you might have about accepting health insurance.

1) “People tell me that I should stay away from accepting health insurance.”

You may very well have heard that from other counselors with previous health care insurance, which almost feels like getting advice from your parents.

The truth is that a cash only practice seems like the ways to go, especially when you won’t have to spend an inordinate amount of time with billing. The idea is that you can set your own prices, but the reality is that starting a private practice takes hard work, and if you don’t accept insurance it gets even harder.

There are some counselors that can make a comfortable living with a cash only practice, but those folks are in the minority. Many are forced to find another source of income or run their practice on a part-time basis.

2) “I’ve been told that insurance companies don’t pay very well.”

It’s true that there are some insurance companies that don’t pay well, but you can’t paint them all with the same brush.

The average payment for an intake appointment (90801) in Boston pays about $100, assuming you have a Master’s degree. Further appointments will then pay anywhere between $75 and $87, with an average of about $10 more per session paid for couples and family therapy.

It’s worth noting that those figures are for 45 minute sessions rather than 1 hour.

If you have a full schedule of patient’s paying those rates in cash, then you probably don’t have to worry about insurance. If there are large gaps in your schedule though, then that could be money that you are simply throwing away by not accepting insurance.

3) “I’ve heard that insurance companies are incredibly difficult to work with.”

That’s not entirely true. There are very few issues when claims are submitted on time and to the correct place. It can become a little frustrating when there is a dispute over a claim, which in turn can lead to some less than fruitful conversations with the provider relations department of the insurance company.

That does not add up to an impossible situation, and if you’d rather not spend your time dealing with them, then you can think about hiring a billing company to do it for you. That usually means giving up about 8% of the money collected, but since that figure doesn’t include co-pays and deductibles, the actual amount is closer to 5.5%.

4) “I don’t want to be at the mercy of insurance companies.”

Many people look at being networked as somehow becoming a slave of the insurance companies, but all it really boils down to is a professional affiliation. In basic terms, all it means is that you agree to provide a service to their insured customers.

Where you are likely to encounter the highest level of frustration is when insurance companies refuse to authorize patients with diagnoses such as relationship or academic problems. In order to receive payment you will be forced to try and justify some sort of biological diagnosis even when you feel that the symptoms that they are displaying fall a ways short of the criteria for something like Clinical Depression.

5) “I really don’t want to do all the paperwork.”

It’s easy to think of a private practice that accepts insurance in the same terms as a hospital, or other government-run medical facility, which is a mistake.

Part of your job as a licensed counselor is to take clinical notes, or at the very least have a written evaluation or treatment plan. Those notes are in fact all the paperwork that you need.

The truth is that most insurance companies won’t even ask to see those, and they will pretty much stay out of your record keeping business. Wj=hat they do need are dates, diagnoses, and procedure codes.

6) “I don’t want to be told what patients I can and can’t see.”

Being part of an insurance company’s network doesn’t mean that you are required to see their clients. You still have full control over which clients you want to treat, and which you would rather refer.

Getting To The Truth About Insurance, Not Advocating for It

The 6 items mentions above are common misconceptions that are regularly used when it comes time to deal with insurance companies. This article simply serves to highlight those, and in no way advocates that insurance is right for your practice. That is a decision that is yours and yours alone.