Handling Insurance Queries in Cash Pay Therapy

As a private practice coach and practice owner, I often receive questions about my decision to run a cash-only therapy practice. I’m frequently asked how I address this topic with therapy clients who inquire about using their in-network insurance benefits.

In this blog post, I’ll walk you through exactly how I discuss out-of-network therapy with my clients and give you a step-by-step to help you along the way. Whether you are a seasoned therapist or new to the cash-pay model, understanding how to articulate your business model while respecting client needs is crucial.

Handling Insurance Requests in Therapy

My decision to operate a cash-pay practice isn’t about being against insurance or denying clients access to utilize their benefits. I fully appreciate the value of insurance coverage for therapy services.

When a potential client asks if I am in-network with their insurance provider, I respond transparently, explaining that I don’t take insurance directly. When it comes to discussing payment with clients, I have a scripted response that I find helpful. I say,

“I charge _ for a 50-minute session, and I accept cash, checks, and credit cards at the time of the appointment. I do not bill insurance; however, I provide you with a superbill at the end of each month that you can submit to your insurance company.

Before booking an appointment, I suggest calling the number on the back of your insurance card, inquiring about your ‘out of network’ therapy benefits, and learning how to submit an out-of-network reimbursement claim.

If you want to find a provider who is in-network with your insurance company you can feel free to email me the list of providers covered by your instance and I’d be happy to let you know if I recommend any of them!”

Now, why do I take this approach? Let me break it down for you. Firstly, I focus on maintaining a therapeutic relationship built on trust and respect. I don’t believe in pressuring clients into paying a higher fee than they are comfortable paying.

Secondly, I have confidence in the value I bring to the table as a therapist. Clients who resonate with my approach and can afford my cash rate recognize the worth of investing in their mental health journey.
Quite often clients come to therapy asking for someone in their network.

I’ll help them find a therapist in their network and sure enough a few months later they end up back in my office commencing on how much they appreciated that I was actively trying to help them find the right fit rather than pressuring them.

Offering Alternatives: Superbills and Mentaya

Speaking of superbills, sometimes clients ask what they are. My scripted response is,

“A superbill is a detailed invoice outlining the services a client received. Therapists may need to generate a superbill when they are not on a client’s insurance company’s panel.”

The client submits the superbill directly to the insurer, giving the insurer all the information they need to pay the claim.

Additionally, I’ve partnered with MENTAYA, a service that helps clients submit their superbills for out-of-network benefits. MENTAYA simplifies the reimbursement process, offering clients a hassle-free way to access their insurance benefits while still receiving the quality care they deserve.

I often let clients know,

“If you need help submitting your superbills I also work with a company called Mentaya that will charge you a 5% fee but do all the work for you. Let me know if you’d like me to send you the information.”

Responding to Insurance Questions with Confidence

Finally, when clients inquire about why I don’t accept insurance, I have a response ready. I say,

“Thank you so much for asking this important question. Unfortunately, many therapists, including myself, can’t afford to accept the reimbursements that insurance companies offer while still providing the quality of care we believe our clients deserve.”

In essence, there’s no need to resort to convincing clients to pay a cash rate. There are alternative strategies for building a successful practice while maintaining integrity and authenticity. It’s all about fostering trust, communicating value, and staying true to your practice ethos.

I hope you find these insights helpful as you navigate your own private practice journey. If you have any questions or want to chat further about this topic, don’t hesitate to reach out. Wishing you success and fulfillment in your practice!