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:
1. 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