Fees - Alan Behrman & Associates
 
ALAN BEHRMAN & ASSOCIATES

Fees

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Our therapists primarily work with private pay or out-of-network as well as with some insurance companies (please see the section below discussing working with insurance companies vs private pay).  Our private pay fees range from $125 to $170 depending on therapist and they are detailed in the informed consent for each therapist and in the confirmation email you receive when setting up your first appointment.  About 60% of our clients prefer to be private pay as they don’t want the health insurance companies or government dictating and having access to their mental health care.
We do work with a multitude of insurance companies though.  If you’d like to use your insurance please let us know when scheduling your first appointment and we’ll do our best to make sure you are set up with someone in-network.  We can’t always accommodate based on schedules, but we’ll never set you up with someone who is out-of-network if you ask for someone in-network without confirming with you first.  Additionally, please do not rely on insurance company websites to have the most updated list of who is and is not in-network.  We can give you the most updated information since we are the ones that do the final billing everyday.  The insurance companies databases are full errors. Also, please don’t rely on people outside of our practice who may tell you that we are in-network with a certain insurance company.  Please confirm that information with us directly.

If you have any questions regarding fees, please contact us.

Information on using in-network insurance vs out of network and private pay:

Insurance premiums have continued to rise to unprecedented levels while the amount of coverage continues to decline. When using in-network insurance, therapists run into a number of problems that can significantly impact you, the client.

The first of which is the mandatory diagnosis. In order for the insurance companies to cover the cost of your therapy, we have to provide a diagnosis (or diagnoses) that is actually covered. These diagnoses then go on permanent record with your insurance company which could impact your future ability to obtain health or life insurance and the premiums of that insurance.

Second, the moral dilemma of the therapist with regard to your diagnosis. Often clients come in with sub-clinical issues or diagnoses, life coaching, adjustment disorders, etc. None of which are covered by most insurance companies. This leaves the therapist with a very serious ethical and moral dilemma. Do we report a “no-diagnosis” code or a code that is accurate, but we know won’t be covered, or do we provide a “close enough” diagnosis that can be argued, but can follow the client for the rest of his/her life?

Third, the insurance companies may determine your treatment length. The insurance company will know nothing about you at first other than a diagnosis. Your plan may have a pre-determined number of yearly visits. Say, for instance, you have an anxiety disorder of some kind that is complicated by present situations or other diagnoses, the insurance company can say, “This person has an anxiety disorder and it should be fixed in 15 sessions. Therefore, we are not covering anything beyond that.” We, as therapists, can do basically nothing to dissuade the insurance company from this very unfair and uninformed decision. The only thing we can do is appeal. In the appeals process, we then have to divulge a significant amount of your personal information from therapy to some other “authority” that is usually paid by the insurance company to argue our case for more sessions. Rarely are these approved. Of course, why would someone being paid by the insurance company to hear appeals make a decision that is going to cost the insurance company more money?

Fourth, what if what you need is not what the insurance will cover? Say for instance, you are in crisis and need a two hour session or sessions on back to back days? The insurance company will pay for neither. Period.

Next, HUGE deductibles. Many insurance plans now have deductibles that are absolutely outrageous. These are figures that many people don’t often come anywhere near, so it doesn’t make sense to put your diagnosis in the system forever, simply to try to reach that deductible and then never get there. If you do get there, its often at the end of the year and you only have a few sessions left until you have to start all over with meeting the yearly deductible again. If you do happen to meet it, you still could have a substantial co-pay or co-insurance. Just food for thought.

By choosing not to use your insurance, we (you and the therapist) can take control over your therapy. We can give you what you need with no arguments and no questions asked. You can improve your life and get better without the influence and involvement of the insurance company. Don’t get us wrong, about 40% of our clients still use the in-network insurance (who can pass up a $20 co-pay?), but the other 50% of our clients do choose the private pay route to avoid the issues mentioned above. If you choose to use in-network services, we’ll be more than happy to get your services authorized and file for you with no problem at all. If you’d like to do private pay, we can definitely work out a fee that works for you!

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