I am a cash only practice. I do not work with any insurance as an out of network or in network provider. If you require a statement of proof of services, I can provide one for you. I do not provide additional information to insurance companies such as W-9s, complete out of network provider approval forms, or provide clinical reviews or superbills.
Insurance doesn’t generally cover couples’ counseling anyway.
If your insurance company tells you that they do indeed cover couples therapy, they are referring to the situation where one person’s mental illness is what is being treated in therapy, and the partner is only present in support of the treatment of that condition. Insurance only pays for “medically necessary treatment” of a mental health disorder, such as Major Depressive Disorder or Generalized Anxiety Disorder.
In this situation, one person, the “identified patient,” is officially diagnosed with a mental illness, and the treatment needs to focus solely on this diagnosis. This diagnosis is sent to the insurance company where it becomes part of the patient’s permanent medical record. Also, only the identified patient is technically a client, and thus has a right to a duty of care, confidentiality, and access to the session notes. The other partner is not a client and would be there only in support and as “collateral” to the treatment of the patient’s condition, with none of the rights afforded a patient.
But in couples counseling, people are seeking help with communication, conflict, emotional connection, sexual intimacy, parenting, and more. These issues are not for “medically necessary” treatment of a mental illness. Both people are the focus of treatment, as is the couple as a unit. Billing insurance as if the couples’ sessions are treating just one individual is considered insurance fraud.