Protected Health Information (PHI)
General information on using health insurance vs. self-pay
*As we do not accept insurance for services, this is just general information that helps you be an informed consumer. We do not diagnose or provide direct clinical services that would be constituted as therapy. We do not do therapy in this model because it is an educational model.
In general…
Paying for services out of pocket minimizes the exposure of your protected health information (PHI). Please see the informed consent for Notice of Privacy Practices for how we use your PHI. Whenever you use insurance benefits to cover healthcare, the provider, with your consent, has to release certain types of information to the insurance entities in order to a) verify your eligibility for coverage, b) pre-authorize services (if applicable), and c) to process claims to obtain payment. As a result, the provider informs the insurance companies of the nature of the issues you struggle with, diagnosis, treatment plan, and prognosis. In the event of Self-pay, your therapy remains completely private (with the exceptions to confidentiality such as in suicidal or homicidal ideation, etc.). Once such diagnosis code is recorded by the insurance, it becomes part of your permanent healthcare record. Self-pay means no reports of your treatment are shared with your insurance and all records remain with the provider. **If you are on psychiatric medications or have ever been then you already have or had a diagnosis but you should be aware of this information when using insurance.**
Since there are certain types of therapy or specific conditions that may not be covered by insurance, we are providing support for your general healing and mental health care. We are a wellness and educational institute that is supportive of your overall healing journey. A lot of what I do is outside the realm of what insurance companies are willing to reimburse, even though they are evidence-based. Self-Pay allows you to stay in control of your treatment and we will work with you to get the services that you need.
Furthermore, the advantage of Self-Pay includes the fact that no records exist in the Medical Information Bureau (MIB). MIB records of your therapy could potentially compromise your ability to get a current or future life, health, disability, or long-term care insurance. Self-Pay, thus, involves no psychiatric diagnosis code and allows you to have autonomy over your health choices.