Engaging in a course of psychotherapy requires significant emotional, time, and economic commitments. It is important that each patient understands how my office operates.
My business operates on a cash-based model, where payment is due at the time of service. We take cash, personal checks, and credit/debit cards. Why do I do this? While cash-based private practices of psychiatry are not yet common in the Portland area, surveys show that nearly 50% of all solo outpatient psychiatric practices throughout the USA are cash-based.
Good reasons why I do this: I worked for the first twenty years in my private practice with insurance companies. I found myself becoming ethically conflicted by having to deal with a third party in what should be a very private, confidential, and trustworthy relationship between me and my patient. There was also much extraneous and unnecessary paperwork to fulfill, which detracted from the time and energy I wish to use engaging with patients in a therapeutic manner.
As a “preferred provider”, I often found that insurance companies could restrict my best professional treatment recommendations for any individual patient. This is a conflict of interest and goes against my medical ethics and values.
I am a strong advocate for the privacy of one’s personal medical information; this ethic is breached when insurance companies enter the field, if only to the extent that they know you are a patient. However, if you do have mental health insurance and have out-of-network benefits, my office will go all the way to provide you with paid receipts and any other paperwork needed which you may submit directly to your insurance company for direct reimbursement at out of network rates.
A cash-based system ensures the highest degree of confidentiality and trust. It limits my overhead and allows me to focus my energies on each patient and to deliver the best care without constraints.