One of the most commonly asked questions when I meet with parents is, “Do you accept insurance?” And, my simple answer is no. But, it is much more complicated than that and requires more of an explanation.
As a play therapist who specializes only in children, I feel that sometimes a better title for me is “Child Advocate.” No matter the custody battle, divorce agreement, family situation, current circumstance or previous history, my allegiance to and focus is always on, first and foremost, the child.
As a result, I am very careful about what I choose to share with parents, so as not to break confidentiality with the child. What conversations I will conduct in front of a child, to protect their ears from topics that they shouldn’t hear. And maybe most importantly, what information is given to third-parties about what I do with my clients. Here are three significant reasons for not accepting managed care or insurance at my practice.
Number of Sessions
Insurance companies authorize a prescribed number of therapy sessions, based on metrics, averages, and formulae. But they don’t take into account that each child is different. Each one comes with a different story. Each one walks the journey of therapy at his or her own pace. Each one responds differently to playing. And that it takes as much time as it takes – not eight sessions or less.
When billing insurance, treatment codes and diagnostic codes are required. Treatment codes typically indicate what kind of therapy was conducted and how long the session lasted. This helps them determine what their pay rate is for that particular session. Diagnostic codes are required so that they can justify paying for the session; anxiety issues, behavioral issues, familial issues, etc. More often than not, kids don’t meet diagnostic criteria for anything. Or if they do, play therapy is all they need. But I would still have to pick from a list of codes, and decide which one fits “best.” Kids don’t need a code to get better – they just need the time, tools, and opportunity.
Permanent Mental Health Record
Any procedure, treatment, or diagnosis remains permanently on a mental health record. So, a four year old in therapy because of a divorce is documented as having “emotional issues.” Then for the rest of their childhood, this is accessible to anyone with rights to look. If your child wants to be considered for a school club, such as National Honor Society, the selection committee can check. If your child might want to become a cadet in JROTC or ROTC, Lieutenants have access. Future dreams for a Police Department, military academy, or US Military? All leaders are fully within their rights to check on mental health records, dating back to childhood. Kids become labeled. And all they really needed was someone to walk with them through a tough time in their life.
I realize that there are benefits to insurance, and I am aware that some families cannot afford to pay out of pocket for therapy. However, as part of my commitment to protect children, advocate for them, and to act in their best interest first, foremost, and always, I choose not to bill insurance for the reasons mentioned above. And when kids finish play therapy treatment with me and have successfully worked through difficulties, parents appreciate that the only thing that they take away from it is a happier kid with nothing to tie them to the past struggles.