Why fee-for-service?
There are several advantages to paying for psychotherapy sessions out-of-pocket (also called fee-for-service or self-
pay), a few very important ones include:
1) Privacy-- When you are not going through an insurance company for mental health services, your private health
information stays in my office. I am the only person who has access to it except under specific circumstances which
are outlined in the Informed Consent packet and discussed in the first session. Insurance companies have numerous
people examining your files at various stages. There are people that authorize payment, track your progress, audit
psychotherapy practices, input data, print bills, and so on.
2) Control-- The number of sessions you may attend when you pay out-of-pocket is up to you. Often, insurance
companies will authorize a certain number of sessions. They usually require some proof that progress is being made.
They also reserve the right to stop paying for sessions for a variety of reasons. Insurance companies probably want
you out of therapy as soon as possible. The problem is that they might decide you’re ready to be on your own
regardless of whether you or I agree with them.
3) Your Future-- Did you know that you can be denied insurance benefits for a previous mental health diagnosis? If
you use your insurance to pay for mental health, your practitioner MUST designate a diagnosis for your issue (e.g.
major depressive disorder, generalized anxiety disorder, bi-polar disorder). If you wish to purchase health insurance
in the future, your mental health records will be reviewed and you and your family maybe denied coverage. Paying
out-of-pocket ensures that no insurance company ever knows you were seen by a therapist.
What are my options?
Some clients prefer not to use their health insurance for the reasons stated above, or other reasons. They pay cash,
check, or charge at the time of service.
Some clients utilize their Out-of-Network Benefits to pay for therapy. In this case, the client pays the session fee to
the therapist directly, the therapist issues an invoice which the client submits to their insurance company, then the
insurance company reimburses the client for all or a certain percentage of the session fee. Some insurance companies
allow clients to apply to their deductible the amount spent for therapy. Also, some employers allow the use of flexible
spending accounts, medical savings accounts, or health reimbursement arrangements.
How do I find out about my benefits?
To determine if you have Out-of-Network Benefits, call the number on the back of your insurance card. The customer
service representative will be able to answer your questions. They may want to know my credentials which are listed
here. Be sure to ask what documentation they require in order to reimburse you.
To determine if you may utilize a flexible spending account, medical savings account, or health reimbursement
arrangement to pay for therapy, call your employer's human resources or benefits department. Be sure to ask what
procedures you must follow and what documentation they require in order to reimburse you.
Call me if you have further questions: 763.355.4675
There are several advantages to paying for psychotherapy sessions out-of-pocket (also called fee-for-service or self-
pay), a few very important ones include:
1) Privacy-- When you are not going through an insurance company for mental health services, your private health
information stays in my office. I am the only person who has access to it except under specific circumstances which
are outlined in the Informed Consent packet and discussed in the first session. Insurance companies have numerous
people examining your files at various stages. There are people that authorize payment, track your progress, audit
psychotherapy practices, input data, print bills, and so on.
2) Control-- The number of sessions you may attend when you pay out-of-pocket is up to you. Often, insurance
companies will authorize a certain number of sessions. They usually require some proof that progress is being made.
They also reserve the right to stop paying for sessions for a variety of reasons. Insurance companies probably want
you out of therapy as soon as possible. The problem is that they might decide you’re ready to be on your own
regardless of whether you or I agree with them.
3) Your Future-- Did you know that you can be denied insurance benefits for a previous mental health diagnosis? If
you use your insurance to pay for mental health, your practitioner MUST designate a diagnosis for your issue (e.g.
major depressive disorder, generalized anxiety disorder, bi-polar disorder). If you wish to purchase health insurance
in the future, your mental health records will be reviewed and you and your family maybe denied coverage. Paying
out-of-pocket ensures that no insurance company ever knows you were seen by a therapist.
What are my options?
Some clients prefer not to use their health insurance for the reasons stated above, or other reasons. They pay cash,
check, or charge at the time of service.
Some clients utilize their Out-of-Network Benefits to pay for therapy. In this case, the client pays the session fee to
the therapist directly, the therapist issues an invoice which the client submits to their insurance company, then the
insurance company reimburses the client for all or a certain percentage of the session fee. Some insurance companies
allow clients to apply to their deductible the amount spent for therapy. Also, some employers allow the use of flexible
spending accounts, medical savings accounts, or health reimbursement arrangements.
How do I find out about my benefits?
To determine if you have Out-of-Network Benefits, call the number on the back of your insurance card. The customer
service representative will be able to answer your questions. They may want to know my credentials which are listed
here. Be sure to ask what documentation they require in order to reimburse you.
To determine if you may utilize a flexible spending account, medical savings account, or health reimbursement
arrangement to pay for therapy, call your employer's human resources or benefits department. Be sure to ask what
procedures you must follow and what documentation they require in order to reimburse you.
Call me if you have further questions: 763.355.4675
Disclaimer: The contents of this site and all the pages herein are intended for informational purposes only and are subject to change without notice at any time. None of
the information in this site is intended to be taken as advice therapeutic, legal, or otherwise. At no time does use of this site nor communication through this site constitute a
therapeutic relationship between the user and therapist. Kari L.M. Silverberg, MA, LAMFT and Theraspire Counseling Services, PLLC assumes no liability for the
content of this site or damages that may result from use, reference to, reliance on, or decisions resulting from its use. Use of this site establishes your consent to the
provisions of this disclaimer. Copyright 2006. All rights reserved.
the information in this site is intended to be taken as advice therapeutic, legal, or otherwise. At no time does use of this site nor communication through this site constitute a
therapeutic relationship between the user and therapist. Kari L.M. Silverberg, MA, LAMFT and Theraspire Counseling Services, PLLC assumes no liability for the
content of this site or damages that may result from use, reference to, reliance on, or decisions resulting from its use. Use of this site establishes your consent to the
provisions of this disclaimer. Copyright 2006. All rights reserved.
