Therapeutic Services
Holly provides therapy to individuals 18 years of age and older, couples and families of all configurations. She has extensive background in working with those who are dealing with depression, anxiety, severe family conflicts, trauma, blended family issues, relationship conflicts, and communication, as well as those who want to learn more about themselves for personal growth. In addition, Holly has extensive experience working with those who are involved with a Borderline and Narcissistic Personality Disordered family member. As a parent and an adoptee herself, Holly has worked with many adopted individuals of varying ages and developmental stages and their families as they work through the challenges that are unique to adoptees and adoptive parents. She has also provided workshops and support groups that focus on these unique family dynamics so that the adoptee and adoptive parents have a better understanding of the challenges that present throughout the years.
Fees
Fees are $165 for a 45-50 minute session. Sessions requiring additional time will be charged at the prorated amount, and I accept Cash, Check, or Venmo. Superbills will be provided upon request for those who would like to use a Health Savings Account or Flex Spending Account. Reimbursement requests will need to be submitted by the client.
I have always been an advocate for offering mental health services for those using insurance benefits. This has allowed me to provide services to those who might otherwise be unable to afford it. I saw it as contradictory to not accept insurance if I truly want to help people, so I continued to be an in-network provider for many plans. Over the past several years it has become increasingly difficult to work with insurance companies for a variety of reasons which is why many clinicians no longer accept insurance at all.
I truly empathize with how daunting it is to find a therapist who you connect with. When you finally find a therapist through your insurance it can be a huge relief. It is important for those seeking therapy to understand the role insurance companies play in case management and treatment. The one upside (and only upside from a clinician’s perspective) is financial assistance. Healthcare is expensive and, in that regard, insurance companies allow their members to receive care while members only cover a portion of the cost (copayments, coinsurance). The downsides are many which is why I believe it is my ethical responsibility to share the following information since many prospective clients are unaware of the role insurance companies play in their mental health treatment.
Confidentiality
Therapists are legally and ethically mandated to protect a client’s privacy unless they are a danger to themselves or others – OR if they are using insurance. When insurance companies are paying for your treatment, it means they can request session notes and your treatment plan. This will be discussed more under Case Management and Treatment Planning.
Diagnosis
Insurance companies REQUIRE a diagnosis to cover the cost of therapy. There is no way around this. They work off a model that services can only be rendered if they are deemed medically necessary, which is another way to say, “does the member meet our pre-determined level of distress to continue sessions”. Some clients do not meet the requirement for a formal diagnosis, but companies mandate it. In addition, they will only allow certain diagnoses that they believe are “severe enough” to meet medical necessity. Sadly, the courage to seek therapy can potentially have an impact on insurance premiums.
Case Management and Treatment Planning
Occasionally, insurance companies contact clinicians to review cases to discuss the client’s presenting issues, level of functioning, goals of therapy, progress with goals, necessity of care and authorization for continued care. They might request information to be faxed to them for their review. I find this to be incredibly invasive and clinically unsound since those conducting the review are not in the therapy room yet make decisions based on a 20-30 minute phone consult. The clinician who works with the client on a regular basis is required to integrate their recommended treatment approaches, regardless of what has been tried or what is appropriate for the client.
Claims and Fees
Insurance companies involve a lot of red tape which can delay reimbursement of services for weeks, and sometimes, months. Claims will be denied for a variety of reasons which cause added stress to the client when it is not clear if the services they have already received are going to be paid. Trying to resolve paperwork mishaps takes time away from providing support to the client.
Alternatives to Insurance
Many times, going through insurance is the only option. There are some options, however.
Out-of-Network Benefits / Reimbursement
Some insurance plans will allow a member to receive an authorization to be seen by an out of network provider. In these situations, clients should contact their carrier and get information about the out-of-pocket costs, what would be covered and what information do they require when submitting a reimbursement claim (i.e., specific diagnosis) when choosing this option.
Sliding Scale
I reserve a certain number of slots on my client schedule for sliding-scale clients. These are determined on a case-by-case basis. In addition, my intern, Joy Souza, works off a sliding scale for all of her clients.
Use Your FSA/HSA Work Benefits
Many jobs provide you with a Flexible Spending Account or Health Savings Account. A superbill would be provided to the client to submit for reimbursement. This way, even if you’re paying out of pocket, it’s pre-tax dollars.
This is in no way meant to sway a client’s decision about how they go about covering therapy expenses. It is simply information clients may not be aware of and may want to consider when choosing the best option for them. I find it disheartening insurance companies do not place more value in mental health – both the members and the clinicians who provide services. Mental health awareness has come a long way over the past few years and because of that I remain hopeful. When this can be achieved, an individual’s level of distress and diagnosis are not used as a means to justify coverage.
Role of Insurance in Mental Health Services
