How Health Insurance Billing Works

If you're using insurance:
• I bill your insurance company directly
• You’re responsible for whatever your plan doesn’t cover
• If a claim is denied, you’ll be expected to pay the full rate

If you're not using insurance (or doing an out-of-pocket session):
• You pay the full fee at the time of service
• I can provide a superbill for you to submit to your insurance for possible reimbursement

What’s a Superbill, and How Do You Use One?

If you’re paying out-of-pocket for therapy, you might still be able to get some of that money back through your insurance. That’s where a superbill comes in. A superbill is a special type of receipt I can provide that includes all the details your insurance company needs to consider reimbursing you for out-of-network therapy.

This document basically says: “Hey insurance company, I saw this licensed therapist, I paid them directly, and here’s the proof. Will you cover any of it?”

Employee Assistance Programs (EAPs)

I work with select Employee Assistance Programs on a case-by-case basis. These are typically short-term counseling packages offered by your employer. Just know: EAPs are usually limited to a few sessions. If you want ongoing work or deep transformation, we’ll need to talk about next steps after those sessions end.

The IRS may allow you to deduct medical expenses

Counseling session payments may be tax-deductible as a medical expense if they qualify under IRS guidelines. To deduct them, you must itemize your deductions and your total unreimbursed medical expenses must exceed 7.5% of your adjusted gross income. Always consult a tax professional to confirm eligibility. Learn more here.

If I’m in-network with your insurance, why would you ever choose to pay full price?

Here’s why some clients do:

MUCH MORE PRIVACY

When you use insurance, I’m required to share certain information with your insurance company, including a mental health diagnosis and sometimes notes or treatment plans. Paying privately means, no diagnosis on your permanent medical records, no insurance company tracking your sessions, total control over your confidentiality. If privacy matters to you, private-pay is the cleanest option.

INSURANCE UNPREDICTABILITY

Insurance companies change the rules all the time, usually in ways that make your care harder to access. You might think you're covered, then find out your deductible hasn’t been met so you owe the full amount anyway, your plan only allows a limited number of sessions, the claim was denied for a random reason.
Even if you think you know what benefits you have they can change your services at any time. They can stop covering certain types of therapy without notice, require new pre-authorizations or paperwork, reduce the reimbursement rate, and even decide that your progress and relief of symptoms means you "no longer need therapy" and cut off coverage.

When you pay out-of-pocket, you avoid all of that. You know exactly what you're getting, every time. No sudden policy changes. No treatment dictated by algorithms. No third party calling the shots.

Artificial Intelligence (AI) and your personal information:

You might think a real person is reviewing your therapy claims, but more and more, that’s not the case. Insurance companies are now using artificial intelligence (AI) to make automated decisions about what gets covered and what doesn’t. It means your mental health care is being reviewed, not by a licensed professional, not by someone who understands trauma or healing, but by a machine learning model trained to cut costs at all costs.

These AI systems:

  • Automatically flag or deny claims based on incomplete patterns

  • Decide how many sessions you “should” need based on statistical averages, not your actual progress

  • Reject or delay claims using vague, coded language to avoid accountability

  • Are designed to maximize profits, not outcomes

These systems get it wrong all the time. But you may never know why, unless your therapist fights the denial, resubmits documents, and waits through weeks (or months) of silence.

When you pay out of pocket no robot decides when your healing is “enough”.