The initial evaluation for therapy and ongoing therapy sessions are around one hour in length. Therapy, including cognitive behavioral therapy (CBT), is usually once per week and lasts about three to five months, though some situations may require more or less frequent meetings, and can be shorter or longer in duration depending on the situation. After the first or second session, we can give you an estimate regarding how long your treatment should last.
The initial evaluation for medication is around 60 to 75 minutes in length, and follow-up medication appointments are around 30 minutes in length. Follow-up medication appointments typically occur every one to three months, but could be more or less frequent depending on the situation.
Psychological testing is usually scheduled over a period of a few hours, like in the morning or in the afternoon. Psychological testing usually includes an initial evaluation, followed by testing, and then a feedback session to review the evaluation results and report.
Insurance and Payment
We do not participate in any insurance panels. We are considered “out-of-network” providers and you may be able to request reimbursement from your insurance company for a portion of our fees. We can provide you with all the necessary paperwork to submit to your insurance company to request reimbursement. We are a fee-for-service practice and accept cash, check, and all major credit cards, including HSA cards with a credit card logo.
Why We Do Not Bill Insurance
As mentioned, we do not participate in any insurance panels. This means that we do not bill insurance companies for the services we provide to our clients. This decision was not made lightly. It has been our experience that billing insurance, or any third party for that matter, carries with it several challenges. Here are some of them:
1. Client Privacy
We understand how important your privacy is to you, and we take it very seriously. All health-related information is personal, and many would consider mental health related information even more sensitive. As mental health providers, we are connecting with our clients on some of the most private issues in their lives.
To pay for services, insurance companies require submission of that information. At minimum, they require the diagnosis, and some companies require treatment plan information and psychotherapy notes. So, this means that third party companies have your private information, and it is understood that this information is held on to “forever”, creating a permanent paper trail of your mental health treatment.
As with any sharing of information, there is a potential for that information to be used in ways not intended, or to be intercepted by unauthorized viewers. Especially these days, with the ongoing threat of cyber-hackers and information leaks, we choose to keep your private information completely confidential and within the walls of the therapy room.
2. Client Choice
Health insurance companies have limits to what they will pay for. They set limits to what diagnoses and problems they will allow to be treated, the type of treatment you can receive, and how many sessions you can have. These limits are usually predetermined by your insurance coverage, or “plan”, and do not consider any personal factors or relevance to what is going on in your life right now.
Additionally, your coverage is often decided by a person whom you have never met, who is not a mental health clinician, and who is sitting at a desk somewhere looking over your paperwork. Insurance companies will often not take into consideration the recommendation or opinion of your provider, even though your provider knows you best and is trained to help you with your problem. And when they do want the provider’s opinion, the provider must “justify” why you need the recommended services.
Finally, insurance companies will only pay for a “medical model” of treatment. And they decide what is a “medical model” of treatment. Unless the treatment model falls within the predetermined approach, they will not pay. We believe that you and your provider should decide which treatment method to use, and length of treatment needed, for the problem you are seeking help with.
3. Payment and Rates
Health insurance companies are notorious for not paying the provider on time and sometimes not paying at all. Or, if and when they do pay, it can take hours of phone calls, emails, and faxes from the provider to “get them” to pay. This of course, takes away from what the provider should be doing with his or her time, namely, taking care of clients.
Then there is the rate. The rate for mental health services is “negotiated” by the provider and insurance company. We could better say “haggled” between the provider and insurance company. The provider who wants to take insurance has to haggle over the price for their services, and ultimately accepts a rate that is lower than he or she would have expected.
The rate for services that is finally decided is often so low that the provider needs to see a very large number of patients per week in order to keep the lights on. Then, it takes a lot of time to “track down” payments from insurance companies. If the provider does this on his or her own, he or she can get “burnt out”, which affects his or her ability to provide care and attention to clients.
4. The Client is the Customer
At Dr. Messina & Associates, we believe in putting the client first. We offer a comprehensive, highly personalized, concierge model of mental health care from the initial phone call, to scheduling, and service delivery. We have an extremely high orientation towards customer experience and satisfaction. Because our clients pay us directly, there is a mutual understanding between us and our clients as to the nature of our relationship. We want you, our customer, to be happy with the services you receive.
Providers who accept insurance have to please the insurance company who pays them. So, who are they working for…you or the insurance company? We provide quality mental health services and are not subject to or dependent on third party oversight. We do not answer to a third party to direct your care. You work in collaboration with our experienced, licensed professionals, to direct your care.
We understand who our client, or customer, is and can accommodate the needs and requests of our clients without worrying about a predetermined set of rules governed by a third party.
In summary, we have chosen not to participate in insurance panel billing for the reasons stated above. We provide quality mental health care that is customer service oriented, private, and gives you the freedom of choice to direct your care along with your licensed mental health provider. We do not have the oversight of an insurance company, and so our treatment is directly tailored to you, and not to a predetermined set of rules. Our rates allow us to see less clients per week, and not become overloaded with endless paperwork and emails to insurance companies. This allows us to focus more on you to provide the individualized, quality care you are seeking.
That said, we understand and respect every person’s right to use their health insurance for mental health services. For this reason, we gladly provide our clients, upon request, with the documentation needed so they can attempt to receive reimbursement of our services from their insurance company. As stated above, our providers are considered “out of network”, and many insurance companies will provide some reimbursement depending on your plan.
Please feel free to ask our office staff any questions you have about insurance billing or about requesting reimbursement from your insurance company.