Why don’t you take insurance?

Reader, welcome to the second in a series of blog posts designed to answer your most pressing questions about Potomac Psychiatry, our policies, our procedures, who we are, how we will treat you, and more. Choosing the right health care practitioner, especially one helping you through your mental health challenges, can be a daunting task. This series is our attempt to take the guess-work out of that decision-making process. We want to provide you with the clearest, up-front information about our practice and, if you do choose to make an appointment, why we think you will be happy with the choice you made.

When folks call us to inquire about treatment, the first question they often ask is: Why are your rates so high? We covered our answer in our last blog post. The question that frequently follows is: Why don’t you take insurance? Given how these two questions are so related, that’s the question we’ll be covering today. We hope that by the end of this post, you feel empowered to make a decision about your treatment—and we hope you know that our staff is here to help you, even if that means referring you to someone who is in your insurance network for ease of care.

Our Insurance Policy

In our office, the way a prospective patient call often begins is with this question: “Do you take X insurance?” Of course, everyone is hoping for a “Yes” in response. In our prospective patient’s minds—and perhaps in yours, too—a “No” answer conjures a sinking feeling in the pit of your stomach, and a dispiritedness that more phone calls, inquiries, and investigations undoubtedly await, whether to other doctors, or to the insurance company itself. A “No” answer, in other words, equals a big, fat headache—not really what people are looking for when they’re in the midst of a crisis or in mental pain.

Reader: We know how you feel. But empathy in a situation like this isn’t enough, and that’s why we want to tell you exactly why our “No” is actually better for you.

The reason why we do not accept insurance is as simple as insurance is complicated: the less paperwork and forms our staff fills out, the more time we have to focus on your needs. It’s for this reason, in fact, that 45% of psychiatrists don’t participate in insurance networks! Now, let me be clear: We also don’t think you should be the one to fill out those forms and deal with the paperwork. We believe the burden of administrative tasks lies with the insurance companies themselves. The way we accomplish this is by enabling you to submit an insurance reimbursement form clearly, easily and directly.

How to get Reimbursed

After speaking to our staff, many of our clients forgo insurance altogether—to them, it becomes clear that our treatment services are so effective, and often require far fewer sessions than a normal practice, that the out-of-pocket cost doesn’t add up as quickly as they thought (the reason for this is described in our prior post, “Why are your rates so high?” Bottom line: we simply have the tools to treat you more quickly, saving you time and money!) For clients who prefer to go through the reimbursement process, however, we make that process as seamless as possible.

Here’s how it happens: After your appointment with one of our trained psychiatrists, you’ll pay cash, credit, debit, or check. After you do so, all you need to do is ask our front desk staff (or, in the coronavirus era, call or email them directly) for an insurance-friendly printout that you can file directly with your insurance company. This claim form will have all the information you and your insurance company will need for reimbursement, including your insurance ID number and any specific requests from your insurance. Once you have this, you’ll just sign the form and mail it out—and once your insurance company receives this form, they will reimburse you accordingly.

If you’re feeling anxious about how much will be reimbursed, don’t worry: our staff is here for you to act as a middleman between you and your insurance company to get those questions answered. Potomac Psychiatry has a hardworking administrative team dedicated to helping you take care of anything you might need outside of clinical sessions with your doctor. They are able to provide the reimbursement codes your insurance company will ask for in order to determine what percentage of our fee you will get back. Your insurance company can often help clarify their processing times, so you can have a realistic timeline of when that reimbursement will be coming to you. They also answer your calls in real-time, help you schedule appointments, submit medication refill requests to the doctor, help fill out any paperwork or forms you might need (i.e. school forms, FMLA form, work note, etc.), answer any billing questions, submit any prior authorizations your insurance might require to cover a medication, help order your lab work and genetic testing, and set up any assessment testing you might need. Our administrative team is just one call, email, or text away and they will do whatever it takes to lessen the stress and anxiety you already feel in your daily life. You can count on our team to make sure everything is as clear as possible regarding cost of treatment before you begin.

How Does Our Policy Help You?

Our doctors aim to provide the best possible treatment for our patients. By forgoing insurance, we are not constrained by the rules and regulations that insurance companies sometimes have that can direct treatment. This can include rules about what medications are covered, the frequency or types of appointments, and other details that can be very limited for patients looking for a full recovery. It is especially limiting for a high percentage of our patients who come to our practice after struggling with their mental health for a long time, some having tried every medication or treatment method that is typically recommended. We can offer appointments within days of calling, our doctors make themselves very available to patients, often outside business hours, and they make sure that the medications prescribed are the best ones for the patient rather than the ones the insurance companies prefer.

Reader, I hope this blog answers your insurance questions—but if any other questions have arisen from reading this post, please give us a call or send us an email. We are always available to help you out and provide further explanation.


Related Information

Frequently Asked Questions
Psychiatric Staff at Potomac Psychiatry
Success Stories
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