We often get asked, will my insurance cover this? How can I afford ongoing therapy treatment? Thrive Relational therapy strives to provide quality counseling, accessible and affordable to as many folks as possible. For this reason, we offer both insurance coverage options and private pay services. We recognize that counseling for individuals or relationships is an investment in many ways, and one that shouldn’t be stopped by the ability to afford services. Abiding by our social justice lens, we hope to engage in offering services for individuals, couples and relationships for as many as possible, while staying within our ethical and professional guidelines.
Insurance is a great use of financial savings, it’s important to understand all the information around the use of insurance. When billing insurance for individual or couples counselling what is required:
Diagnosis: Mental health coverage is considered to be medically necessary. For this qualification to be met, a diagnosis must be on file. You have a right to know and understand your diagnosis. Your diagnosis is part of your permanent medical file and cannot be removed once given.
Treatment planning: Following the guidelines and restrictions for use of medical insurance, treatment planning, goal setting and evidenced based interventions are required. This may require for your therapist to check in with you and continue to set goals up.
Diagnosis for couples therapy: There is not current diagnostical criteria or code to bill for couples counseling, While we continue to advocate for increased understanding from the medical field related to relationship counseling, we are unable to change this. For this reason, many insurances and plans won’t cover couples counseling. Some insurance can be billed under family counseling, however it is based on a “identified patients” diagnostic criteria. If we are billing insurance for couples counseling, please know one of you will have a diagnosis.
Third party access to records: When billing insurance, your insurance company has the right to have access to your therapy records. It is rare, but sometimes an insurance company will audit. In this case, I am required to turn over my notes and treatment planning along with diagnosis criteria to prove medical necessity for services.
We currently can bill insurance through Aetna and Pacific Source.
Private pay or self pay services has some benefit over insurance use. These include:
When using insurance, a provider must give the client a diagnosis. This diagnosis is part of your medical record and cannot be undone. With private pay therapy service, we aren’t required to give a diagnosis, and won’t unless asked to do so.
No therapy limits
Some insurance panels only cover a certain number of sessions. With private pay therapy you can choose how long you wish to stay in counseling, without the stress of a third party payer dictating this.
Because we aren’t billing insurance for services, we also aren’t required to send our treatment goals or notes to a third party. This ensures further privacy for you as a client.
Our rates vary based on therapist and service provided. We strive to be clear and transparent about how much each service: individual, couples, infidelity, and sex therapy cost. We charge $160 for counseling sessions. We accept all major credit cards, HSA’s (Health Spending account), checks and cash.