3 Insurance Paperwork Reframes for Therapists


Many therapists are frustrated with insurance coverage of mental health services. They are unhappy with having treatment decisions critiqued, (often but not always) receiving a lower fee than for private pay clients, and needing to submit specific forms for documentation.

These concerns (and many others) are all certainly valid and dissuade some from even dealing with insurance at all. Others begrudgingly choose to bill to insurance because they don’t feel their practice could be full with only private pay clients.

However, many therapists feel insurance is an important part of their practice. Some therapists even view insurance slots as their “sliding scale” slots and account for this in their business planning. I like this way of thinking because it provides the therapist with a positive mindset and reduces resentment toward the insurance company.

So, let’s continue with the positive thinking! Here are some common thoughts that pop up regarding insurance along with positive reframes for thinking about your paperwork and it’s relationship to insurance billing.

“I can’t believe insurance wants to look at my client’s (treatment plan, diagnosis, etc.)! Why won’t they just trust me to do my work?”

–Reframe: I’m so glad my client can receive quality therapy at a low cost to them. I’m glad there’s someone checking to make sure I’m doing my job well.

“Insurance pays such a small fee for my sessions!”

–Reframe: I’m glad I can use this hour to give back to my community by offering a service at my lower rate.

“I have so much paperwork to do for this community clinic!”

–Reframe: I’m thankful that community clinics are able to provide services for much longer timeframes than most insurance companies will compensate for. Unfortunately, that means I have a lot more paperwork to justify their extended treatment.

Notice that I’m not denying the truth in any of the more “negative” statements. Insurance does often pay lower rates than private pay. Insurance does require a certain level of documentation and often scrutinizes that documentation and/or treatment. However, these things are not necessarily bad in and of themselves.

I encourage you to carefully evaluate what thoughts came up for you around billing to insurance. Did you “poo-poo” my positive reframes? If so, I would question whether contracting with insurance is right for you. It’s certainly NOT for every therapist! And you know what? That's okay!

The decision to accept or deny insurance should be part of your business plan and in line with your professional goals. Know that insurance does require a much different level of documentation and oversight than regular private practice. It doesn’t have to be scary or overwhelming… but it will be if you have a negative mindset.

If you’re 100% sure you want to bill to insurance, sign up for my Private Practice Paperwork Crash Course. In a week’s worth of emails I review all the necessary documentation for private practice… and the last lesson is all about billing to insurance.

My goal is to help you make peace with documentation. If you still have any burning questions, leave a comment below and we’ll figure it out together. If you have your own reframes, feel free to post them here and share with your colleagues. Happy writing!