To Use or Not To Use Your Insurance Coverage For Your Therapy:

There are certain inherent risks in the use of insurance coverage/managed care for psychotherapy.  I have decided to
present the information as I see it and then let you be the judge as to whether or not to use your health insurance.
There are many facets to insurance coverage for psychological services that your employer or agent may not have
told you.  They have not been negligent but often they do not know the status of how information is handled about
psychotherapy.  At the time you accepted your coverage you were required to sign a release of information about ALL
of your coverage and information about yourself.  That leaves a LOT OF LEEWAY for coverers to abuse the
information about you.  Some of the potential problem areas are the following:
Insurance companies can request and sometimes require therapists to send in your complete records, which
includes progress and case notes (the state of Texas requires therapists to keep notes on each session), test results,
diagnoses, lists of symptoms, and frequency of therapy sessions.  Very specific questions about problem areas are
frequently asked, which involve some to the following:  depression/moood problems, alcohol/drug usage, suicidal
ideation/intent/plans, abuse (physical, sexual, psychological) issues.  While you have confidentiality with your records
in my office, once they leave my office, I cannot guarantee what happens to them.  Many individuals feel their privacy
has been violated when their records have been sent to the insurance/managed care companies and are uneasy with
the idea that their personal records have been sent to a company with no one in particular as the recipient of their
records.
A related potential problem area is that other insurance companies may gain access to your files and information
such as diagnosis, treatment, and prognosis.  If you leave the company you are now with, and apply for medical,
disability, life, or mortgage insurance you may be denied coverage simply on the basis of your previous diagnosis.  
When applying for future insurance of any kind it is not unusual for an insurance company to request complete
records from therapists.  
If you should EVER consider such choices as government service, security clearances or positions involving the use
of any classified information, you may be denied employment because of your "psychiatric history".  If you consider
running for any political office, your use of psychotherapeutic services may be discovered through any number of
routes.  You cannot be assured of confidentiality if you use your insurance coverage.  
Your employer may have access to any information about your therapy, including diagnosis, case notes and the
frequency of your attendance.  Your banker or any person with whom you have business or financial dealing may also
gain access to your files.
I want you to know that there are rather severe limits on the degree of confidentiality you may expect in your
treatment if you use insurance coverage.  While I can promise you confidentiality of your records while they are in my
office, I cannot do that once information about you leaves my office.
I think  it is my responsibility to inform you of the possibilities.  You must be the judge as to your use of insurance,
given the very limited confidentiality you will have and the limits placed upon me in protecting your confidential
information by your use of insurance.
If you have concerns or questions about the above statements or issues related to it, please feel free to talk with me
about it.
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