Why Our Practice is Out-of-Network with Insurance Companies
Welcome to this educational resource backed by medical research & inspired by questions from hundreds of our past and current patients. You’ll find helpful info on mood, anxiety, depression, mental illness, hormones, treatments, and resources. — Anna Glezer, MD
Providing comprehensive mental health care demands a personalized, tailor-made approach. Many members of my team and I have witnessed countless cases of mismanaged care in various clinical settings, driven by insurance dictates and limitations.
As such, we do not follow the one-size-fits-all treatment guidelines dictated by most insurance companies as they may significantly compromise the individualized care that our clients deserve.
Key Reasons Why Our Practice is Out-of-Network
The first, and most important, set of reasons deals with the many impediments to maintaining the highest standard of patient care that our team prides itself on:
Insurance companies can limit the number of visits you are allowed and also dictate the type of therapy we must offer/provide. In some cases they can even limit the amount of time patients have per visit.
Insurance companies tend to prioritize symptom management over addressing underlying issues and promoting long-term well-being. This can lead to a focus on medication management rather than comprehensive therapy and support.
Insurance companies frequently require prior authorizations for medications, treatments, and even initial evaluations. This process is time-consuming, requires extensive documentation, and can delay necessary care for patients.
Many of the types of treatments we offer at Women’s Wellness Psychiatry, which are integrative and holistic, may be seen as unconventional by insurance payors, and therefore not sufficiently reimbursed. This can include visits that focus on lifestyle medicine, nutrition, nutraceuticals, and many others.
The second set of reasons deals with the complex administrative and business aspects, which can significantly jeopardize our ability to run a profitable business and continue our care to current and future patients.
Insurance companies often offer significantly lower reimbursement rates than the provider's standard fees. This can make it financially unsustainable for us to maintain a practice, especially with rising overhead costs (rent, utilities, staff, etc.), and overall skyrocketing costs of being a business in California.
Negotiating higher rates with insurance companies is time-consuming and almost always unsuccessful when you are a solo practitioner or small group practice.
The complexities of communicating regularly with insurance companies and adhering to their documentation and other requirements are often time-intensive. We believe that this time would be best spent working 1:1 with patients.
Reducing this administrative burden also allows our clinic to recruit the most talented clinicians who are passionate about patient care.
Insurance companies can take weeks or even months to process and pay claims, creating cash flow problems for the practice. This delay can make it difficult to cover operational expenses and invest in practice improvements.
How we try to help
While we do not participate in any managed care networks, many PPO insurance plans do provide out-of-network coverage for mental health services provided by licensed professionals. It is your responsibility to remain informed about the presence or absence of insurance coverage for our work together.
We do not bill insurance companies directly, but will provide a statement (called a Superbill) that can be used for filing claims for reimbursement. We can also recommend companies that can assist you with filing claims with your insurance company.
Lastly, because filing reimbursement claims with insurance companies is a really frustrating & time-consuming process, Women's Wellness is now registered on Reimbursify, an app for your phone that makes it quick & easy (under a minute!) to file claims, get paid, and keep track of prior submissions all in one place.
A few additional points on Reimbursify:
Submit any and all out-of-network receipts -- and your first claim is free. All subsequent ones are just a small fee per submission
No paperwork or countless forms to fill out -- just a few inputs & scan the claim with your phone
-If a claim gets rejected, you'll know exactly why, and resubmissions are always free
Fully secure & HIPAA compliant
Please note that Reimbursify is a completely separate company and is not in any way affiliated with Women’s Wellness Psychiatry.
In Conclusion
Our decision to be out-of-network is driven by a commitment to providing the highest quality of care for each of our patients. By avoiding the constraints of insurance companies, our practice offers significantly more personalized, flexible, and holistic treatments and helps to ensure our ongoing business viability.
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Personalized, holistic psychiatric care that treats your unique needs.
Over the past nine years, I’ve built a team of exceptional Reproductive & Holistic Psychiatrists and Psychotherapists who share this philosophy. Together we’ve helped hundreds of patients in our communities and look forward to helping you achieve your wellness goals!
~ Anna Glezer, MD - Founder; Reproductive Psychiatrist
