Your Privacy Matters: Why I Opt Out of Insurance Panels as a Private Pay Mental Health Therapist
When seeking therapy, most clients aren’t aware of what happens behind the scenes after a session ends. One of the biggest and often unseen challenges is dealing with insurance companies. Prior to starting my own private pay practice, I worked in an insurance-based group practice, where I saw firsthand the amount of time and effort spent justifying treatment, submitting paperwork, and ensuring that clients could receive quality care at an affordable rate.
However, this process often comes at a cost: client’s privacy and confidentiality can be compromised to meet insurance requirements. Private pay therapy offers a level of privacy and autonomy that insurance-based therapy simply cannot.
When clients pay directly for sessions, their medical records and treatment details are not shared with an insurance company. This means that your personal information is strictly between you and your therapist, which eliminates the risk of possible third party entities accessing information without your knowledge, but with your consent through the insurance company’s fine print.
Here are a few key ways private pay therapy offers greater privacy and autonomy compared to an insurance-based model:
No Mandatory Diagnosis
When using insurance, therapists are required to provide a mental health diagnosis in order to justify the need for treatment so that the insurance company can pay for sessions. This diagnosis becomes part of your permanent medical record and may have implications for future insurance coverage, employment, or legal matters.
With private pay, a diagnosis is not required. This allows therapy to focus on your needs, not the needs of your insurance company’s. This also ensures that your personal records remain confidential.
2. Your Therapy Notes Remain Private
Insurance companies regularly audit therapists’ notes to verify treatment necessity to ensure compliance with their standards and to make sure that you are still meeting criteria for your diagnosis. This means that details from your sessions like what you share, your progress, and even how you present to the session, could be reviewed by a third party without you knowing.
In private pay therapy, what you share stays between you and your therapist. It’s kind of like Vegas, (what happens in Vegas, stays in Vegas) giving you the freedom to be open and vulnerable without concern about where your information is actually going.
3. More Control Over Your Care
Insurance companies dictate the session lengths, the session frequency, and sometimes even the type of therapy you can receive based on reimbursement policies. This often results in shorter sessions, limitations on the number of visits, or denials for certain therapeutic approaches even if they would benefit you.
With private pay, you are in full control of your therapy journey. You decide how often you see your therapist, the length of your sessions, and the focus of your treatment. There are no insurance-drive restrictions, which allows therapy to be truly tailored to your individual needs rather than a standardized formula.
With insurance companies, the focus is not on you, it is focused on standardized guidelines and financial considerations. Private pay therapy shifts the focus back to where it belongs: you and your healing process.
While private pay is an investment, it is also a commitment to your privacy and well-being. To support those who wish to use their out-of-network benefits, I provide superbills, allowing clients to seek reimbursement from their insurance providers if they choose. However, I do not work directly with insurance companies—ensuring that your therapy remains a private, confidential space free from third-party interference.
If you'd like to get started talking to a private pay therapist, contact me for a free consultation today.
Sam Villarreal
Licensed Chemical Dependency Counselor and Licensed Professional Counselor Associate supervised by Melinda Porter, LPC-S
Parts Work: What is it?
Have you ever felt conflicted about a situation? Maybe torn between snuggling with your dogs in bed, but needing to get to work because you don’t want to disappoint your boss? Or on deciding to go to the gym to feel better, but that cappuccino ice cream has been calling your name instead? Everyone has different parts of themselves and your parts work together to protect you, your core Self.
You might have heard of parts work, inner child work, or of Internal Family Systems (IFS). These all encompass a way to work with our inner parts similar to bringing your entire family into therapy to learn how to better get along, have better balance, and overall have less conflict between its members. The more traumatic experiences someone goes through, the more polarized and imbalanced their parts tend to be. These parts communicate with us through our bodies via thoughts, emotions, sensations, or impulses.
There are a few categories of parts within a person.
Core Self: This is our natural essence and the north star to all of our parts. The Self emerges when you feel completely safe and centered and it embodies compassion, curiosity, calmness, creativity, clarity, and courage. Until the key parts below learn to trust the Self, it typically cannot take an active role in leading the inner system.
Exiles: These are the vulnerable parts of ourselves that are usually younger in age that hold distressing feelings and beliefs that are learned from experiences we’ve endured. These are the feelings of shame and despair coupled with the beliefs of “I’m bad”, “I’m not good enough”, “I’m shameful”, or “I don’t matter” that are always lurking underneath the surface.
We have two types of protector parts, which protect us from our exiles getting activated in distinctly separate ways.
Managers (A proactive protector): This is our resident inner critic, their main job is to run your life, keep your schedule, and make sure you stay “acceptable” by society’s standards. Some examples of how manager parts manifest in our life are people pleasing tendencies, perfectionistic qualities, anxiety, and general overachieving. Managers protect us by keeping everything in line so that we can try our best to control and prevent anything bad from happening that could result in humiliation or abandonment from others, which could activate our exiles.
Firefighters (A reactive protector): This is our ‘douse the pain’ button, their main job is to numb and deflect when anything hits too close to home. Some examples of how firefighter parts manifest in our lives are behaviors like addiction, binge eating, overspending, doomscrolling for hours, having anger issues and self-harm. Firefighters protect us by distracting, creating diversions, and automatically reacting to things so that we can create distance from our pain (our exiles pain) because it’s too hard to face.
Every part is valuable within the system and all parts try their best to protect and keep you safe. Sometimes they can be at odds with each other on how best to go about keeping you safe, which can feel like inner turmoil. Once your parts get to know and trust the core Self, the Self will naturally keep things running smoothly by intervening in conflicts and helping to negotiate things between parts. This work offers a route to resolve inner conflicts, bring balance to our inner world, and promote self-compassion.
An important first step toward this form of healing is to get curious about your different parts. If you resonate with this holistic view of our minds and would like to learn more, please schedule a free consultation with me using the contact form on the site. I would love to get to know you and your parts.
Sam Villarreal
Licensed Chemical Dependency Counselor and Licensed Professional Counselor Associate supervised by Melinda Porter, LPC-S