Many people struggle to find talk-based therapy that’s covered by their insurance plans. Of all practicing medical professionals, therapists are the least likely to take insurance. Only 55 percent of therapists accept insurance plans, compared to 89 percent of other health care providers, like cardiologists, dermatologists and podiatrists, according to a 2014 study.
That’s a big problem, since approximately 1 in 5 Americans will experience some sort of mental health disorder in a given year, according to the National Alliance on Mental Health Illness. Many will also seek counseling for divorce or grief.
Treatment is highly individualized, but experts agree that talk therapy is the gold standard for treating psychiatric problems. A 2015 study revealed that cognitive behavioral therapies were just as effective as antidepressants for treating depression.
So why is therapy so unaffordable for so many people? And why don’t more mental health professionals work with third party payers? It turns out several factors contribute to making therapy unaffordable ― many outside individual clinicians’ control.
Insurance systems don’t support therapists’ diagnoses.
Poor insurance coverage for therapy is largely a reflection of how society views mental health.
Insurance companies tend to see things more from a medical perspective ― where if you get sick, for example, then you take a blood test, they figure out what is wrong with you, they give you a medication and then you are all better.
But with mental health a lot of times what we are trying to do is preventative maintenance-type work, and it makes it a lot more difficult to justify medical necessity with insurance companies.
Even when insurance companies consider a mental health diagnosis a valid billable condition, the coverage may only be temporary. Insurance companies do not cover marriage counseling, relationship counseling, family counseling and grief and loss.
More and more insurance plans we see either have a high co pay or a high deductible. So technically, people do have mental health coverage, but they are paying for most or all of the cost out of pocket anyway.
All of the major insurance companies are closed to enrollment for Licensed Therapists in the Tampa Bat area, including Brandon, St. Pete and Tampa. We receive calls all the time from potential new clients complaining they can not find a therapist in their insurance network.
Another thing insurance companies do that most people don’t know about is sub contract the mental health portion of a policy to another insurance company. I had an instance recently where a client had Blue Cross and Blue Shield insurance but Cigna actually covers the mental health portion of the policy. In most cases of sub contracting the mental health portion of a policy, they sub contract to a much smaller insurance company that pays extremely low and has very few Mental Health Providers in network. A good example is Hillsborough County School Teachers and Employees. They have Humana for the medical part, but they have MH NET for the mental health part of their policy. MH NET requires authorization, treatment plans to get authorization every 8 sessions, you have to fill out a paper form that they “conveniently never receive” and they pay $40 per session. Therapists literally spend more time collecting their $40 than they do therapy with the client.
Therapists honestly can’t afford to accept insurance.
The gap between a therapist’s hourly fee and the reimbursement rates they receive from insurance companies can be massive.
I’ve seen it lower than $50 a session. We charge $120 a session, so that would be a major blow in terms of income for us.
We can’t sustain our practices when that kind of value is put on mental health.
While $120 per session sounds steep, it helps cover rent, the cost of business and malpractice insurance, advertising, administrative staff, office equipment and credit card processing fees. Many therapists have also accrued massive student debt. Therapists have to get a Master’s Degree, at minimum, then do a 2 year Registered Internship and pass a State Board Exam to become a Licensed Therapist in Florida.
Therapists are health care professionals that all have master’s degrees or higher. Many have doctorates, medical degrees, and [have] graduated from specialized institutes for the teaching of psychotherapy.
Lawyers, accountants and architects generally make $120-$400 per hour or more. One should expect to pay the same for therapy from a competent, highly trained professional.
Therapists are in a no-win position. Therapists are almost forced to charge the patient directly because they are not able to be reimbursed at equitable rates as their counterparts that have M.D. or D.O. behind their name.
More equitable rates across all insurance companies would allow patients to have greater choice and access in terms of their health care decisions.
Filling out insurance paperwork is a full-time job.
It’s a Catch-22: To keep overhead low, many therapists don’t hire staff or assistants. But without them, the job of working with insurance companies is overwhelming.
Many people who work in mental health don’t have the volume of patients that primary care [physicians] might have. They might see seven or eight patients max in a day, where a primary care doctor might see as many as 40 patient’s a day and also have dedicated staff who handle billing and who are very familiar with what the requirements are with all the different payers out there.
Submitting a bill to an insurance company can involve jumping through an array of hoops including justifying your services to an insurance representative, providing status report updates and getting on the phone with providers to track down late payments.
This can be particularly complicated because not everyone who sees a therapist has a diagnosable mental illness.
Common reasons for coming to therapy, like couples counseling and grief counseling, are typically not covered by insurance.
We do try to provide lower cost therapy at Star Point Counseling Center by utilizing a sliding scale based on household income. This way people who are needing therapy can get the help they are looking for without going into debt.
Please visit us at starpointcounselingtampa.com or call us at 813-244-1251 if you have insurance questions.
HAPPY 5TH BIRTHDAY TO STAR POINT COUNSELING CENTER. It was 5 years ago today Clarissa Crystal-Belle, LMHC, Co Founder/ Executive Clinical Director and Author saw her first client in a small rented office with an office chair and a card table. I know it is not the proper setting for a professional office but this client didn’t care, they just wanted to get in to see her. Sam DiFranco Co Founder/ Executive Business Director was managing Star Point Counseling Center from the lobby with a brief case and a lap top computer. We grew exponentially into multiple office and a counseling team of over 10 therapists helping thousands and thousands of clients. 5 years, where has the time gone! We look forward to helping thousands and thousands more clients in the future.
I just watched game 7 of The NBA Championship Finals with the series tied at 3-3 and the game tied with less than 3 minutes left in the game. Golden State Warriors were up 3 games to 1 and the favorite to win the championship and only needed to win 1 more game out of the next 3 games to win the NBA Championship. Lebron James, arguably the best player in the world today, had a tough time in this series in the first 4 games. Lebron James watched The Godfather movies part 1 and 2 over and over before game 5 of the NBA Finals. Lebron learned from “The Godfather” to be calm and cool in all situations just like “The Godfather”, during the remaining 3 games of the NBA Finals from these 2 movies. Lebron James went on to lead the Cleveland Cavaliers to a huge victory in game 5 of the NBA Finals, he credited his leadership in that game to “The Godfather”, not the intimidation and threatening ways to get what you want, but the calmness and coolness of “The Godfather” and to the structure of “The Family”. Only, Lebron’s “Family” was The Cleveland Cavalier’s Team. Lebron James took on the role of “The Godfather” and lead his family, The Cleveland Cavaliers, to victory in games 5, 6 and 7 to win the NBA Championship.
So, what is family? Is it parents, or a parent raising children blindly without leadership, or is it someone taking on the role of leadership in a calm, cool, nurturing way leading the way for 1 person, or a group of people to become something or someone more than what they are? A family can be blood relatives, a team of players, a team working together for a common goal or a group of people with common beliefs. If you are a parent and have children don’t you want to step up to the plate and “lead” your children with calmness, coolness and a nurturing way so your children can become something or someone more than what they are today, reaching or surpassing any goals they have for themselves? Ever since “The Godfather” came out in 1972 everyone worldwide has repeated phrases from the move, we have all head them. The real message from “The Godfather” is family is paramount and you always have your family members back, no matter what, no matter what they say or do, you have your family members back and give them your support, and vice versa, family is someone you can always trust and count on for support, no matter what.
If you would like to learn to be a “Godfather” for your family, or would like to learn leadership skills for your family, team or group then please call Star Point Counseling Center at 813-244-1251. starpointcounselingtampa.com
Star Point Counseling welcomes new counselor Carrie Schroeder. Carrie graduated in 2011 from the University of West Florida in Pensacola, Fl. Carrie is currently a Registered Mental Health Counselor Intern working towards licensure. She is under the clinical direction of Clarissa Crystal-Belle.
Carrie is just one of many great therapists we have on staff here at Star Point Counseling Center. For more information on our staff and counseling services, visit our website at http://www.starpointcounselingtampa.com.
Star Point Counseling Center would like to welcome Marissa Gerci, RMHCI to the team. Marissa obtained her M.A. in Counseling from Argosy University, and also has a B.S. in finance. She has experience in many areas including depression, anxiety, and trauma counseling. Marissa will be working at both the Tampa and Brandon locations. Call our office and schedule an appointment with Marissa today, 813-244-1251. Or visit our website at www.starpointcounselingtampa.com!
Sam DiFranco is the Co-Founder and Executive Business Director at Star Point Counseling. Sam’s energetic attitude and motivation to help others has lead to the openning of two counseling centers that employs over 10 licensced therapists and interns. Sam is also working on opening a third counseling center which we are hoping to have up an running by the end of the summer. Sam also completes many phone intakes with clients to place you with the right therapist for your emotional, as well as your financial needs. We thank Sam for all of his contributions to Star Point Counseling and we look forward to all of the opportunities he is openning up for us!!
Bill Hogan, LMFT is a Licensed Marriage and Family Therapist (LMFT). He received his MA from the University of South Florida and BA in Psychology from the University of West Florida. Since 1983, Bill has been a Licensed Marriage and Family Therapist and is also a certified parent educator, practicum supervisor, and developer of mental health programming.
Bill was formerly the Program Manager for the Department of Children’s Services where he managed Tampa’s Haven W. Poe Runaway Shelter and residential programs for children with emotional problems and pre-delinquency issues. He has worked for almost 40 years with Children and Families at all levels from child caring, counseling, supervision, and program development. He has retired from program responsibilities and returned to family counseling and therapy as well as marriage counseling practices at Star Point Counseling Center in Brandon and Tampa, FL.
Bill is just one of the many therapists we have on board here at Star Point Counseling Center. We are happy to have him as a member of the team. For more information on our experienced and skilled team of therapists and interns visit our website at http://www.starpointcounselingtampa.com. Or, call Sam at 813-244-1251 to set up an appointment!
Sam DiFranco, as previously mentioned, has been an integral part of the success of Star Point Counseling. Sam plays many significant roles in the company such as interviewing quality therapist to join Star Point Counseling, bookkeeping, payroll, negotiating new leases for the offices. With all of these responsibilities, Sam still manages to balance life outside of Star Point. He is involved in 3 recreational hockey leagues, and works as the Captain for two of these teams. He enjoys spending time with his mother, and playing “penny poker.” Sam’s enthusiasm for cooking hasn’t left either, as he still enjoys creating new meals regularly! A big thanks to Sam for all that you do!
We would like to welcome Amanda Tatko and Rafael Corsi to our Counseling Team at Star Point Counseling Center. Amanda will be earning her Masters Degree in about two weeks and then she will become a Registered Intern Counselor. Rafeal is a Registered Intern Counselor and will be taking the exam to be a Licensed Mental Health Counselor in March.