At Mom Over Matter LLC, we are committed to providing the best care for women and mothers struggling with their mental health. Due to the barriers and restrictions created by health insurance companies, providing the best care means that we do not work with private insurance plans.
Administrative Burden: working with insurance companies reduces practitioner time with clients, increasing burnout and creating barriers to reimbursement. Not taking insurance allows for a focus on client care.
Low Reimbursement Rates: insurance companies offer lower reimbursement rates, forcing therapists to take on an excessive number of clients to sustain their practices. This creates a quantity-over-quality mindset, leading clients not to receive the best possible care. Insurance rates do not account for time spent on essential non-billable activities, such as treatment planning, documentation, care coordination, continuing education, and consultation.
Restrictions on session number, frequency, and length: insurance plans limit the number of sessions and typically only reimburse for up to 52 minutes per session. This is why most providers offer a “50-minute hour” as the standard session length. EMDR processing sessions require more time to maximize effectiveness and client safety. It is most effectively delivered via extended sessions (75-90 minutes) or intensive formats, in which clients are seen for shorter periods more than once per week. Insurance companies rarely reimburse either option, making it difficult for clinicians to deliver EMDR in a way that is safe and effective for each client.
Restrictions on therapeutic interventions: EMDR and IFS are somatic therapies that some insurance providers consider experimental. Many carriers will only reimburse for more traditional therapies, such as CBT. This limits the therapist’s ability to tailor treatment plans and sessions to the client’s actual needs rather than what the insurance company is willing to pay for.
Reduced Autonomy and Confidentiality: insurance companies require detailed clinical information and a diagnosis of a mental health disorder to process claims. Ironically, the required diagnosis often imposes additional restrictions from the insurance company, limiting the types of therapy or the number of sessions based on the diagnosis code. This gives the therapist less autonomy to tailor treatment to the client’s needs. It also prevents clients who do not technically meet the criteria for a mental health diagnosis from accessing care. Understandably, many clients do not want sensitive information about their mental health and their private lives to be in their official medical records. Not taking insurance gives clients complete autonomy over what information they share with other providers and allows clinicians much-needed flexibility with diagnosis and treatment planning.
