Would you feel uncomfortable

If your therapist knew how much you paid a session? My therapist knows I pay $40 a session. She didn’t say anything until I brought up having a lot of therapy and medical bills I was trying to figure out how to pay. I was not asking for anything. I was just mentioning the fact that I had a lot of bills. But now that I know she has access to that info and can find out what my balance is and stuff I feel kinda odd. I feel like that’s almost a confidentially issue and the only people who should have that info is the billing department. But maybe I’m just totally wrong.

My T knows because I pay her directly. She doesn't have office staff. Former T I paid directly also. The strange T I saw for 4 sessions I paid directly also. The only T I haven't paid directly was the one I saw as an adolescent. But yeah, my therapist knows. And she knows how much my insurance reimburses her for.

I would find it far stranger if she didn't know and if I had to interact with admin staff.

Ok. I didn’t know because when I was there in person I only talked to admin staff about bills and I’d pay them and now the bills just come to my house. I didn’t know therapists knew that stuff as well as admin staff.

My T is in private practice and knows how much I pay. I'd think it was strange if a T did not know what their clients were paying. And I think it's better that the T and client are upfront about money aspects, it might help keep the relationship professional and helpful to the client.

It’s their livelihood so why wouldn’t they know how much clients pay. You pay them, so why would it be confidential? It’s their pay check so knowing it at least somewhat is kind of part of the deal

Even if a billing department takes care of it, still therapists have a basic idea of it

Ok I just really didn’t know any of this. I’m sorry.

Man I hate creating threads on this sub.

Why would you hate creating threads? I like your threads. You always have good questions. You had a valid question, you got an answer. There is zero wrong in it

What do you hate about it?

I just don’t always understand everyone’s tone and I often feel like I’m saying something wrong or that I was dumb not to have already known things.

We are all here saying dumb things and we are all misunderstanding and misinterpreting. However, this is probably not our only experience of this forum otherwise we wouldn't keep posting. It's fine for our communications to be imperfect, there is no need to be harsh on yourself.

No - I tossed money on the woman's table. I want them to face the idea they are handed money to perform a service

I’m clueless of such matters I leave my insurance info upfront in Admin. So I’m glad you asked the question. I seriously don’t know how the system works. Also some people with issues aren’t focused so much with cost but with a reliable T or Dr. For some I’m sure “like me” it causes a great deal of anxiety.

If it's an agency that has a sliding fee scale, the therapist might not know how much you pay. Or if the agency handles fifteen different types of insurance through the billing department, and your therapist doesn't handle that, then she or he quite possibly doesn't know how much you pay.

I didn't think it was a stupid question at all.

I like your posts Mountaindewed, I always enjoy reading what you have to say. No question is stupid. No one knows everything. I myself am often confused about stuff that seems clear to others. Sometimes people are saying something and I have no idea how to respond even if it's basic small talks about everyday stuff and I just freeze and can't produce a coherent sentence.
That's why I like this forum, it's a place where we can talk opernly and no one is going to laugh.

I have only ever worked with therapists who work in private practice. They all exonerated somebody else to do their billing but recoverable the explanation of benefits from the insurance company andI pay them directly. Long term T and I had a discussion about how few T take my insurance because of the low reimbursement rate compared to others. However, was fine with yhr rate as her goal was not to make a lot of money.

However, I work witha psych hospital as well as clinic. Many of the providers do not know what individual clients have for insurance or pay. They receive a set salary regardless of what the client pays. The only time a psychiatrist actually cares about a client's insurance is when being mindful of the cost of prescriptions they are prescribbing. They want to be sure they are not prescribing something a client cannot afford.

Looks like all the Ts are different in how they take payment. Mine is a private T, they don’t have any admin people...he has set his own price for a session but I just pay them whatever I can afford (not much lately) in cash.

L is private practice, so I pay her directly. So I don't have to deal with the weirdness of paying her, she has my card on file and just charges it at the end of the day.

I've had to have several discussions with her about fees, and it makes me super uncomfortable. I don't like that aspect of our relationship even though I understand it.

It is uncomfortable for me as well. Honestly, I think my T is just as uncomfortable as I am. We discuss it only when necessary. I have come to realize that while she is a great therapist, she is a bad business person. It has always taken her a bit to cash checks that I handed her. With the pandemic it is much worse. She is horrible at going to th post office to pick up her mail, then cashing them and then sending me receipts. She sent me a receipt at the very beginning of the pandemic. She has said she needs to get me a receipt. She has also been billing my insurance a lot less often. She bills every appointment just for a bunch of appointments all at once.

for a while I did not realize whether or not my treatment providers knew ow much I paid. insurance paid them not me. so I did not pay attention nor discuss the financial end. I just handed over my insurance information at the reception desk and that was that. never saw a bill, my treatment providers and I never discussed the issue.

then one day I was in therapy and my treatment provider at that point asked me how much I was paying. I remember telling her "dang if I know, you tell me lol" she laughed and admitted she had no idea herself. she was part of a mental health agency who had an accountant / financial department that dealt with all the insurance, payments and billing. the agency she was at, she also didnt get to hand pick who her clients were, they had someone else doing the intake, then the intake information goes to the supervising personnel and that person checked to see which treatment providers had a full case load and who had openings and bam your assigned to the one with openings. the therapists were not even in charge of their own scheduling of clients. boy what an eye opener. a therapist who didnt get to choose their clients, set their own schedule or set their own billing and payments.

do not feel bad that you didnt know mountaindewed. I know many agencies in the USA that now have the kind of mental health agency where the treatment providers have no idea what the payments are per client vs those who are on a pay per sliding scale and so forth. with obama care many things changed and one of those was mental health agencies having different departments / personnel then the therapist handling the billing and payment, scheduling, intake of insurance and so forth.

and to be honest the only reason I know my present treatment provider knows how much her accounting firm is charging me is because she had to have my signature on some forms for the insurance company.

you are not alone, now that america is a country like others where everyone must have health insurance this is one of the things that clients and treatment providers sometimes leave up to accountants and billing/ payment departments.

I wonder what else info she has. She’s always typing away on her computer about stuff. She knew my mom was over the age of 65. I never told her that. My mom was older when she had me so it’s not like a ton of people my age have moms who are over 65. It just makes me paranoid sometimes the info these people can get.

Has she met your mom and just made a guess? She really shouldn’t have any access to your mom’s age or any other info. That’s creepy.

So, to respond to your original question, with ex-T, I started seeing her at a particular rate. She didn't take insurance, but they had office staff who handled submitting claims to clients' insurance companies (a rarity apparently). She apparently raised her rates a couple times while I was seeing her, but I was kept grandfathered at the original rate. One time, the receptionist wasn't there, so she ended up charging my card. I told her what rate I was paying, which was apparently $30 under her current session rate. She was like, "Wow, you're getting a good deal!" Which made me feel awkward. I'd been seeing her like 5 years at that point.

You are young. Are you on your parents' insurance? If so, very possible that birthdates of the insured are somewhere on the policy information.

My current T is a solo practitioner who also doesn't take insurance, so he handles all financial stuff. I've negotiated a price decrease a couple times for various reasons (once when my insurance changed how much they reimbursed, for example--I get some out-of-network benefits). It was terribly awkward, and I felt really bad about asking him for a discount, but he offered it willingly. And said how his practice is set up so that he can offer discounts to certain number of clients. When I asked him about an extension to the reduced rate, I again felt really bad, but he was fine with it and extended it considerably past what I'd requested timewise.


I just think the financial aspect of therapy can be difficult. Because it's this person supporting you, caring about you, which feels good, but then there's the financial aspect. Which is a reminder that you're a client, that it's a professional relationship (the way my T classifies it). It was hard when I was seeing him at first, because with ex-T (and ex-MC--same practice), a receptionist generally handled the money aspect. But with my current T, he doesn't have office staff, so when I was seeing him in person, I'd hand him a credit card at some point during session. So it felt more transactional. We did the payment at the end for a long time, as that's how he normally handles it, but then I requested we do that at the beginning instead, and it felt better. Because it wasn't "OK, had this intense, emotional session, now I'm paying you." Now it's all virtual, so he just charges my card and send me the paid invoice for insurance purposes, often on another day. So easier to separate in my mind again.