Pros and Cons of Private Health Insurance for Psychologists and CBT Therapists

Pros and Cons of Private Health Insurance for Psychologists and CBT Therapists

When deciding whether to register for private health insurance companies as a psychologist or CBT therapist practitioner there are a few things to consider. Different provider panels such as AXA, AVIVA, Bupa, WPA and Vitality vary somewhat in their criteria and arrangements when it comes to how they cover therapy.


It is important to know and familiarize yourself with how they work, how they could benefit you, and the possible limitations. Here is a list of factors to think about when registering with insurance providers to help you weigh up the positives and negatives involved when making your decision.







Disadvantages


Lower rates

Some insurance providers may limit the amount they allow psychologists or CBT therapists to charge and may not meet the standard rate you normally request. A lower rate can feel disheartening and some psychologists and CBT therapists feel that their full skills are not recognised due to this gap. In addition, some providers may not easily allow a change in your session rate over time and see your initial rate as a fixed contract, so it’s important you set your fees at the outset at an amount that allows some rooms for growth.


Always check the terms and conditions with individual providers and how these can change over time when you initially register, which will save frustrations down the line!

Limits to confidentiality

Having to provide information about your client to the provider and invoicing systems means there is an impact of the level of confidentiality between you and the clients. The insurer or invoicing system collects the client’s sensitive data such as diagnosis, address, billing information, age, gender, and address. In addition, you may be required to write treatment summary reports to request additional sessions, which will also contain detailed sensitive information about clients.


It’s therefore important that clients are made aware of what information may be shared with third parties under these circumstances and what they are or are not happy to be disclosed.

It can be time consuming

Time is not something therapists have buckets of. Researching and applying to individual providers can be extremely time consuming at the outset. It can also take weeks for an application to be processed. If there are problems with sessions or the client does a ‘no show’ you are left out of pocket and then have to chase the situation with the provider, awaiting their response instead of quickly resolving the situation as you would directly and moving on.


When you request re-authorisation of sessions, this can lead to pauses in treatment waiting for the provider to respond and agree, which can also be frustrating and have an impact on appointment scheduling with clients.

Less control

You obviously decided to work privately for a reason and are probably comfortable deciding the number of sessions and details about treatment with your client. After all you have the correct knowledge and experience to determine their needs. But when you use an insurer, they can impact these decisions around a treatment plan, which may not always fully meet the clients’ needs. For example, insurers may not cover couple or family sessions even if these are indicated within the formulation of the problem.


Also, the number of sessions is often restricted by the insurer and it may be difficult to offer longer-term therapy even if this may be necessary for someone with childhood trauma for example. Other aspects of the presenting problem may not be covered under clients’ policies, for example, assessment and treatment of neurodevelopmental issues. Clients may therefore need to fund parts of their treatment themselves as a result and it’s important this is raised with them where relevant to help with managing expectations.

Payment problems

When problems occur like delays with payment or authorisations of treatment, it can be tough to get in contact with the insurer to resolve it. There is a chance that payment can become delayed, and sometimes not even guaranteed (in the case of policy excesses). Spending precious minutes of your time on hold to figure out these issues can take up your valuable working time and can stop you from seeing the client again until the issue is sorted.


Try to find out at the outset of treatment if your client’s policy has an excess payment as you will need to seek this directly from the client when the insurance company won’t pay. Remember this excess will become due at the start of each client’s ‘treatment year’ so this may fall mid therapy and it’s important to pick shortfalls in insurance payments early to resolve this with the client before the therapy ends. Insurance companies do not help with recovering client excesses and shortfalls so be proactive with clients!

Advantages

There are of course significant benefits of accepting health insurance as a private psychologist or CBT therapist...

Gaining and growing client referrals

Since you can see people who will only look for therapists registered with their insurance provider, you can take on a much broader variety of clients. This is especially helpful if you are starting out in private practice because insurance providers acts as a referral base, supporting you in building your client list and reputation as a practitioner.


Choosing to register with an insurer is effectively a great way providing a mental health service to a growing demand of individuals who need it and can now find you through their health insurance. Some psychologists and CBT therapists may have roughly 50-60% of their caseload as insurance clients, so it is a big advantage to registering.

Clearer plan and structure for therapy

It can be easier to manage the structure and expectations of therapy when going through an insurance provider. You and the client understand the agreement at hand, know how many sessions they have at the outset which can often make it more important to clarify your treatment plan. When a client reaches their authorised session limit, it’s important to review and decide if you seek further authorisation, which again clarifies progress to date and ongoing goals for possible future treatment.


This approach can prevent therapy ‘drift’ and keep a clearer focus in the sessions, which ultimately improves the effectiveness of the sessions.

Invoicing is a breeze

Once you are set up on the right invoicing systems, claiming the session fee back is relatively straight forward. It removes the pressure of seeking payments from clients directly and, using a third party, somewhat removes the monetary dynamic from the client-therapist relationship. This way you don’t have to ‘chase’ your money and that most things will be taken care of.


Using straightforward systems like the Health Code means you can invoice all in one place and they will do some of the hard work for you, for example, validating authorisation codes and flagging issues early on.

Be warned, healthcode now charge a monthly fee for this service, so you may want to investigate how also to invoice insurance companies directly for free as an alternative.

Marketing and credibility

Being recognised by insurance providers puts your name and service you provide ‘out there’. It’s essentially free marketing, so they can instantly find you and see that you are a trustworthy professional that has been vetted by their insurance. The provider platform offers you a chance to stand out, especially if you have recently gone private and by being registered you automatically improve your credibility as a private practitioner.


You can add the insurance companies logos to your website so clients easily know you are registered with their provider and this will improve enquiry rates.

Take away…

Doing thorough research and ensuring you understand each individual insurance providers’ recognitions is important. Before making any decisions, figure out the agreement you would have between them and you as a provider, particularly understanding their fee and invoicing system. Understanding the limitations and benefits of insurance providers and being proactive in the process can prevent frustrations down the line with authorisation and payment issues.


Different providers offer different things, so try and work out what works best with your practice needs and which one will reflect and match the valuable service you provide. Working privately can be tough, so using a provider when starting out to boost your client list is very helpful. However if you like maximum flexibility in your practice, then self-funded clients may be the best method for you.

References

What Therapists Wish You Knew About What They Charge (healthline.com)


Can't Find a Psychologist Who Accepts Insurance? Here's Why | Psychology Today United Kingdom


Vitality - Terms Of Recognition (sgizmo.eu)




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