In an age where there is much talk about "being yourself," I reserve to myself the right to forget about being myself, since in any case there is very little chance of my being anybody else.
Thomas Merton
Day of a Stranger,
Thomas Merton Reader, p. 431

Here are some common questions and concerns about insurance as a way to pay for my counseling services. If yours is not on the list, just let me know and I'll answer it.

Do you take insurance? 
How come you don't take insurance?
If you don't take insurance, what are your fees and how can I pay?

Do you take insurance?
I do not take insurance as payment for my counseling services. I am strictly private pay. If you would like to make an out-of-network claim with your insurance company, I will be glad to give you an appropriately coded receipt. I also offer a sliding scale fee structure for a limited number of clients who are experiencing financial difficulties. I would like to add that once you and I settle on a fee, I will not increase that fee in the future. For example, if we agree on a fee of $120/hr. (my current rate for a 60 minute session), your cost will be $120/hr. from that point on, even if I increase my rate for other new clients later.

How come you don't take insurance?
I have three major reasons for not taking insurance. These include me having to have a more complex business operation than I think is necessary, the potential loss of your confidential information, and last, but not least, the restrictions it places on the level of service I can provide you.

Maintaining a practice that accepts insurance payments would require me to have more complexity in the business affairs of my practice than I prefer. Either an additional assistant or outside contractor would be required to followup with the insurance company for payments, filing of claims, etc. This additional expense would increase my overhead and require me to see more clients. The result would be that I would not be able to give you and others as much attention as I desire.

The more people who handle your medical information, the more likely it is to fall into the wrong hands or show up somewhere you do not want it to. Federal and state laws (for example, HIPAA and HITECH) attempt to address those concerns, but they are not foolproof. In my practice you have more control over your medical records. I am the ONLY person who sees your records without your explicit written consent.

Different insurance policies have different limitations on how long a session may last and how many sessions you may have. I believe that the length of your sessions and how many sessions you have should be a decision that we mutually agree upon. In addition, some companies try to dictate what treatments are best for what condition or "diagnosis" they insist you have. The presence of insurance considerations in counseling is like the proverbial "elephant in the room" - the big presence that no one wants to talk about, but that has a big impact on what happens. The presence of that "elephant" can have a detrimental effect on the most important aspect of counseling - the client/counselor relationship.

Dr. Albert Fuchs, A Beverly Hills doctor, wrote an editorial for the Los Angheles Times that also appeared in the Austin American Statesman on April 9, 2008. It desctibes the problems that health care professionals face when we do accept insurance.

If you don't take insurance, what are your fees and how can I pay?
My usual rate is $120 for a full 60-minute hour. My sliding scale rate can go as low as one-half of my prevailing hourly rate, depending on your financial condition. Fees for writing reports, etc. are more fully detailed in my Informed Consent and Service Agreement (Texas) and Declaration of Practices and Procedures (Louisiana) forms. I accept payment in U.S. dollars, check drawn on U.S. banks, credit cards, or PayPal (see the front page of this website). Payment is due at the time I render service unless arrangements are made beforehand.