Paying for Treatment
The old saying, “You get what you pay for,” is more true, now than ever!
Health insurance premiums and coverage have changed dramatically in the past several years regardless of whether your plan is through an employer or purchased independently. Everyone is paying more for insurance premiums, deductibles, co-payments and out-of- pocket costs — and those increases are predicted to continue.
The cost of treatment may seem like it limits the ability to seek care from qualified clinicians, especially for issues like eating disorders that require specialized knowledge in assessment, diagnosis, therapeutic interventions, nutrition, metabolic effects and medical complications. But, don’t let assumptions about cost limit your options!
The financial aspects of treatment are as important as the treatment that is provided. Both require serious consideration when choosing a clinician, so educate yourself in order to make an informed decision:
Going In-Network: Not What It Used To Be
Beware: You could end up paying more for an in-network provider! It can no longer be assumed that it is more cost-effective to stay in-network. It’s better for your insurance company when you use network providers because they pay those providers low reimbursement rates and, therefore, the insurance company saves money. You still pay the same premium whether you go in-network or not.
When LPS checks insurance benefits on behalf of current or potential patients, we check both the in-network and out-of-network benefits. It used to be that in-network benefits provided a considerable cost savings, but over the past two to three years, in-network deductibles and co-payments have substantially increased. Now, there is only a nominal difference between in- and out-of-network benefits for the majority of insurance companies.
Not only does the short-term cost of treatment need to be considered, the long-term costs also need to be factored into choosing a clinician to treat you or your loved one. It may cost more in the short-term to see a recognized specialist. But, when treating complicated and recalcitrant problems like eating disorders, do you want to spend your money on a random therapist without training or expertise who will likely extend the length of treatment because they don’t really know what treatment requires? Consider how much more that will contribute to both the financial and emotional costs over time!
We Will Discount Treatment
We know how stressful it is to try and seek treatment, find a qualified specialist and manage the costs of care. We make every effort to simplify all aspects of the process for you. As an independent, specialized clinic we provide direct service, so you can speak with Dr. Lees or Tricia, the Office Manager, for any questions you may have. You won’t wait for 20 minutes on hold, get stuck in voice mail systems, get transferred multiple times to the wrong extension or have to explain and re-explain your situation to people who can’t help you!
When a new patient calls for treatment, we check insurance benefits, calculate whether it will be more cost-effective to use those benefits or to self-pay and present that information before the first session. We will always let you know what the less expensive option will be.
Why Pay More?
When choosing to self-pay, we will discount the cost of treatment. Because deductibles are now very large and are usually not met unless there is a major medical procedure or hospitalization, many of our patients are choosing to self-pay. If claims are filed with an insurance company, legally, standard rates must be charged. Most mental health clinics and hospital systems will not offer discounts because they only submit claims to insurance for reimbursement.
Charges submitted to the insurance company get applied to your deductible first, then you get charged the full rate until (or if) you meet the deductible. Why pay the full rate toward a deductible that most likely won’t get met when you could pay less? Why pay the full rate for a general therapist who you can only ‘hope’ knows what they’re doing when you could pay less and get specialized care from a psychologist who is a recognized expert?
More than half of our patients are now choosing the self-pay option in order to get the expert care they need in a private, home-like setting where all aspects of care are a priority. Because psychotherapy is a health care expense, it can be paid for with health savings accounts whether insurance is used or not. Health care expenses may also qualify as an itemized deduction on your tax return. In addition to offering the self-pay option, we will also set up reasonable, interest-free payment plans.
It is worth checking out your options and we would be happy to help you! There is no harm in getting information about the clinical and financial choices that may make all the difference in your treatment, health and wellness!