By Matthew Goldenberg D.O.
One of the first questions I am often asked by prospective patients is, “Do you take my insurance”? The quick answer is no, I do not accept any insurance in my private practice.
However, that does not mean patients cannot use their insurance to cover the cost of their appointments in my private practice in Santa Monica, California. The longer answer is that I am a psychiatrist (*see below for the conditions and symptoms that I treat), but I am not “in-network” with any insurance plans in my private practice. What that means is that I am an “out of network provider” for patients with PPO insurance plans.
For patients with PPO insurance, I can provide a “superbill”, so that they can seek reimbursement (for the cost of the appointments) from their insurance company. Many of my patients utilize their “out of network” benefits by paying me in the office at the time of their visit and then they submit a claim to their insurance company to be reimbursed for some or all of the cost of the visit.
***If you have a PPO insurance plan and are interested in discussing becoming a new patient, I have a list of questions you can ask your insurance company. Please schedule a free phone consultation appointment to discuss more by phone. You can click the link above to schedule a free phone consultation or call the office at 424-276-0777.***
Not accepting insurance in my private practice allows me, as the doctor and mental health and addiction specialist, to care for my patients in the way that my patient and I decide is best. Specifically, we have full control over the frequency and duration of office visits and also modalities of treatments that we can employ. Patients will find the office visits are unrushed, I am rarely behind schedule, we have the time to answer questions and I am not so busy I cannot return phone calls and emails between visits.
While there are many benefits to not utilizing insurance to see a psychiatrist, one large drawback and negative to not accepting insurance in my private practice, in Santa Monica, California is that many individuals who need treatment cannot accord to pay “out of pocket”. In a time of growing demand for mental health treatment, I am ever mindful of how I can still assist those who are in need of care.
I recently came across an NBC News article that had several suggestions for low cost mental health resources. For example, if you are looking for therapy, many therapists work on a “sliding scale”. If you contact a therapist in your area that does not accept your insurance, you can ask them if they work on a sliding scale. If they do, they would be willing to find a rate that you are able to afford based on your income. Many therapists keep several lower cost appointment slots, you just need to ask to find out if one can be available for you.
Another low-cost option for both therapy and psychiatry are psychiatry training programs where residents (who have completed medical school and are currently in specialty training) are supervised by experienced clinical instructors and provide care at lower costs.
If you cannot find a therapist or residency program near you who works on a sliding scale, federally funded health centers can also be a good low-cost option. They charge what you can afford, based on your income. Find a federally funded health center near you.
An additional helpful and free resource in your community are support groups and mutual help meetings. You can search online for support groups (i.e. there are groups for individuals with bipolar disorder, groups for those who are suffering from grief etc.) For those with substance use disorders, or who are questioning if they have an addiction, AA and NA meetings are everywhere and they are free. AA can provide you with the structure, support, accountability and camaraderie you need to overcome addiction.
There are also new and highly accessible apps that can provide low cost alternatives through your smartphone. Some provide access to tele-psychiatry and/or therapy, others provide accountability and access to resources.
Even those with insurance may find the cost of some medications prohibitive. Many of my patients are surprised to find out the many pharmaceutical companies have cost assistance programs for those who cannot afford medications. I came across this article recently which provides links to many of the pharmaceutical assistance programs, which can make medications much more affordable.
If you or someone you know are looking for help with affording mental health and/or addiction treatment, I hope this article has provided some useful resources.
On the Web: docgoldenberg.com
The Huffington Post Articles: https://www.huffingtonpost.com/author/mattgoldenberg-950
*Matthew Goldenberg D.O. is an addiction psychiatrist, which means he is a mental health and addiction expert. He maintains a small private psychiatry practice in Santa Monica, California. The conditions Dr. Goldenberg treats include depression, (major depressive disorder, MDD), bipolar disorder (mania and hypomania, aka bipolar depression), anxiety disorders (such as panic disorder and panic attacks; obsessive compulsive disorder, OCD; Posttraumatic Stress Disorder, PTSD); Attention Deficit Hyperactivity Disorder, ADHD; insomnia and sleep problems; addiction (alcoholism, drug addiction aka substance abuse and substance dependence); behavioral addictions aka process addiction (food addiction, gambling addiction sex addiction etc).