Can you do a single case agreement with your insurance? That's what L did for me and she doesn't accept insurances. It works as if she is in network: I just pay my copay and the insurance pays the rest. The only difference is that she has to get re-approved every 3-4 months. But my insurance has approved every time. I'm actually worried about when she comes back because I don't think she submitted for pre-approval during her leave and that might cause a problem.