Fees, finances and why I do not accept insurance

Just before I started working for myself, actually for you, the customer, I became significantly disillusioned by the sheer volume of paperwork that was required by both insurance companies and government funding agencies just to sit down with a client and say:  “I am glad you are here.  So, what would you like to talk about today?”

If you have not noticed, government agencies and insurance companies have some very peculiar and particular ideas about what and how much information needs to be collected, collated, copied and filed before services can begin.  I really believe that if someone is interested and willing enough to walk through my door, then they already have a pretty good idea about what they would like to talk about.

Over the course of our professional interaction, we may get around to some pretty personal details over the course of our conversations and counseling sessions, or we may not,  it depends more on you than on a government or an insurance form.

One thing that I learned in my previous career as a chef was that the customer is always right and the reason for that is that they are the ones paying the bill.  If I made them a lousy meal or they had a terrible experience at my establishment, then they did not come back, and they told their friends about it. I am bringing the same approach to my counseling practice because I believe that it works.

Some time ago, I was working for a state-funded treatment agency, serving predominantly a criminal justice population sentenced there for substance abuse treatment as part of their probation or parole.  There was a pilot program where the participants paid a nominal fee for each group and individual counseling session that they attended.  Initially, I though that it would not work as they did not have much money and had many other financial obligations.  I was wrong, dead wrong.  The clients that paid something for their treatment had far more favorable outcomes than those that did not.  They missed fewer sessions, were late less often, had fewer positive drug tests and lower rates of relapse and re-offense.   By paying for their treatment, they placed value on it, making it important to them made it work better for them.  Why they stopped the pilot, I do not know; looking back on it, without keeping up relapse rates, treatment businesses might have been afraid of working themselves out of business.

Another reason that I do not accept insurance is that it takes an awful lot of work to file  a claim, ensure payment and negotiate with declined requests for payment.  As a sole provider, I do not want my clinical judgement clouded by a fight that I had with an insurance company over a client’s bill.

The other thing about employer sponsored insurance that I detest is the lack of privacy and confidentiality inherent in the billing system.  In many cases, human resources, owners, managers, their secretaries and supervisors know who is using what type of insurance.  If the insurance company, or any other payer wants to see clinical records, very often they are allowed to, otherwise they do not pay.

Short of you threatening to harm me, yourself or another human being, I am generally not required to report to anyone, anything you may say to me.

Anyway, if you have read this far, you must be interested in what I though would be fair, honest pricing, for fair, honest work.  So, here goes:

  1.  DOT/SAP Assessments $425.  This includes an initial assessment, co-ordination of a referral to treatment or education program, re-assessment and providing a follow-up testing program for employers.
  2. Non-DOT Assessments $150.  This includes an initial assessment and a written summary.  I think that it would be well worth while to find out from an independent source just what appears to be wrong and what may be an appropriate and diligent course of action.  I will be writing a whole post about this later.
  3. Individual Counseling  $50/hr.  Whatever you want to talk about regarding a substance use issue.  I have also talked with couples, partners and family members about strategies, plans and expected outcomes.
  4. Court testimony  $250/day, plus expenses.  I have qualified as an expert witness in a number of courts.  A lot of child custody proceedings have an element of “he said/she said” regarding substance use.  Having an expert opinion can be invaluable.
  5. No shows $25.  My time is worth money to me and my family.  I will gladly reschedule almost any appointment, without a fee, if you call ahead of time.
  6. Substance Education Group $30/hr.  I do not presently have a group schedule; however, if you are interested in this, we can develop one to fit you, at these rates, just know that other persons, with similar conditions may be present.

Anyhow, I am seeking to make a living out helping others to make changes in their lives in regard to their use of substances.  I really believe that treatment that has no cost has no value and treatment that has no value is of no use and may even prolong problems.

 

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