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  • Tammi Imel

Why I Don't Charge A Small Fortune

Many therapists have transitioned to "self pay only" practices over recent years, choosing to opt out of the confusing, often time-consuming battle with insurance companies for reimbursement for their services. I understand this. High income is something that many people desire.

Also, insurance companies fight for every penny of profit that they would rather keep, instead of spending on their members who pay high dollar for their coverage. It's frustrating for therapists and consumers to interact with health insurance companies. Finally, in over 20 years of practice, I cannot give even one example of insurances companies providing increased reimbursement for therapists. Imagine working for 20 years for the same companies and not getting a raise!

A good therapist works hard for their clients. I invest, on average, an additional hour outside of our scheduled hour each week on my clients' cases. And when I say "outside of our hour" -- I do mean a full hour of therapy services -- not 45-50 minute sessions. It is not unusual for me to spend well over an hour with clients in their sessions.

I genuinely care about my clients, and they know that and comment on it. Instead of filling up my schedule to increase my income, I keep my case load small. I don't feel like I am providing good service if I cannot bring to mind the nuances, details, and treatment plan of each client that I provide services for.

I believe that counseling should be accessible to persons in need. When clients share with me that they have better therapeutic experiences with me than they had paying another therapist $250 an hour out of pocket, it encourages me to keep doing battle with insurance companies, to continue to keep self-pay prices reasonable, continue focusing on the quality of therapy sessions versus the quantity of sessions per week, and to continue being accessible to my clients when they are in need.

There is no judgment here for high-priced therapists. In my 20+ years experience, there's also not much difference in services.

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