Choosing whether to use your health insurance for mental health services is entirely up to you. While insurance can make therapy more affordable, it also requires sharing personal health information with your provider. Understanding both the benefits and privacy considerations can help you make an informed decision.

How Insurance Affects Privacy

✔ Progress Notes & Treatment Documentation

• Therapists must submit progress notes, including diagnoses, treatment plans, and progress toward treatment goals, for insurance reimbursement.

• These notes verify that treatment is medically necessary and may include sensitive mental health details.

• Insurance companies may also request risk assessment audits beyond standard payment verification.

✔ Potential Confidentiality Risks

• Insurance companies have access to your mental health records, which could impact future coverage, premiums, or eligibility for certain services.

• Records may be shared with other healthcare providers or third-party entities for billing, audits, or coordination of care.

• Certain diagnoses, such as eating disorders, anxiety, or depression, could remain in your insurance file and affect coverage decisions.

Benefits of Using Insurance for Therapy

✔ Copays

• If your plan offers copays with no deductible, you pay a set amount per session for in-network providers.

✔ Out-of-Network Benefits

• Some insurance plans reimburse a portion of session fees if you have out-of-network coverage.

• You can call the number on the back of your insurance card to check the specifics of your coverage.

✔ Low In-Network Deductibles

• If your plan has a low in-network deductible, you pay the full session fee until the deductible is met.

• After meeting your deductible, your insurance may cover a portion of future sessions.

• Contact your insurance provider to confirm how your deductible affects coverage.

Opting for Private Pay: Increased Confidentiality & Control

If privacy is a priority, choosing self-pay instead of using insurance can provide greater confidentiality and flexibility in your treatment.

✔ Confidentiality

• No progress notes, diagnoses, or treatment details are shared with insurance.

• Your mental health records remain solely between you and your therapist.

✔ Control Over Your Treatment

• Insurance dictates session types, lengths, frequency, and treatment duration based on diagnosis. Private pay allows flexibility to tailor treatment to your needs.

• No in-network or out-of-network restrictions, giving you access to the therapist best suited for you.

✔ Avoiding Insurance Barriers

• No session limits or denials based on insurance policies.

• No deductibles or copays—you pay for sessions directly without meeting insurance thresholds.

• Guaranteed virtual therapy coverage, avoiding restrictions from certain insurance providers.

✔ Good Faith Estimate (GFE)

• With private pay, you receive a Good Faith Estimate outlining the expected costs of therapy based on your needs.

Making the Right Choice for You

Deciding whether to use insurance or private pay depends on your privacy preferences, financial situation, and treatment goals. If maintaining strict confidentiality and control over your care is important, self-pay may be the best option.

If you have questions about insurance, privacy, or treatment options, we’re happy to help you make the choice that best supports your mental health journey.

In addition to Self-Pay options, some of our therapists are in-network with the following insurance providers in the state of Florida:

• Aetna (Commercial Plans)

• Cigna

• Oscar

• Oxford

• United Healthcare

• UMR

We are NOT in-network with Medicare or Medicaid, even through private insurance plans. However, we do accept Employee Assistance Program (EAP) plans, but only through specific Cigna and Optum plans.

For all other insurances (such as Florida Blue/BCBS) or if you're working with a therapist who is not in-network with the listed insurance companies, we are happy to submit Out-of-Network claims on your behalf if you wish to seek reimbursement. Please contact the number on the back of your insurance card to confirm your coverage.

Insurance billing is processed through Headway. If you are a Headway client, please complete your information in their portal to allow for billing.

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We can discuss more detailed information about fees and insurance during our consultation.

While insurance may seem like a convenient option, many therapists choose not to accept insurance due to a few important reasons:

1. Limited Control Over Treatment: Insurance companies often dictate the number of sessions, types of treatments, and specific diagnoses they will cover. This can limit a therapist’s ability to provide the most effective and personalized care for each client. By not accepting insurance, therapists can offer more flexibility in treatment plans, focusing on what’s best for the individual rather than what’s approved by the insurer.

2. Low Reimbursement Rates: Insurance companies typically reimburse therapists at lower rates than their standard fees, meaning therapists would have to increase the number of clients they see or work longer hours to meet financial goals. This can affect the quality of care they are able to provide and may not be sustainable in the long run.

3. Administrative Burden: Insurance companies often require extensive paperwork, including submitting claims, getting pre-authorizations, and handling denials. This administrative work can take a significant amount of time and energy, leaving less time for clients and therapy itself. Many therapists choose to avoid this by operating outside of insurance networks.

4. Privacy Concerns: When you use insurance, your therapist is required to share personal information, such as diagnoses and treatment plans, with the insurance company. This can compromise your confidentiality and may influence future coverage or premiums. By opting out of insurance, therapists can offer a higher level of privacy and maintain the confidentiality of your sessions.

5. Focus on Client Relationships: Without the involvement of insurance companies, therapists can focus more on building a strong, direct relationship with clients. This ensures that the client’s well-being is the top priority, rather than being influenced by an insurance provider’s policies or financial constraints.

At Bloom, we understand the importance of accessibility and, despite the barriers of insurance, we have chosen to accept a limited number of insurance plans, while our private pay options allow us to maintain confidentiality, individualized care, and flexibility in your treatment.

Our rates reflect each clinician’s experience, credentials, and specialization.

Session fees vary based on the clinician and the type of session, ranging from 120 to 200 per hour.

To ensure the most effective treatment, regular attendance is essential. If you are unable to attend a session, you are required to provide 24-hour notice of cancellation. If you fail to do so, you will be charged the full session fee.

Late Cancellations and No-Shows:
✔ In the case of a late cancellation (within 24 hours) or no-show, you will be responsible for the full session fee. Insurance does not cover late cancellation or no-show fees, so you will be required to pay out-of-pocket..

Late Arrivals:
✔ If you arrive late to a session, the session will still end at the originally scheduled time, and you will be charged for the full session.
✔ A 15-minute grace period is given for late arrivals, for both in-person and virtual sessions. After this time, the session will be considered a no-show.

• Frequent Cancellations or No-Shows:
  Frequent late cancellations, no-shows, or late arrivals may require pre-payment for future sessions.

• Reminder Notifications:
  As a courtesy, Bloom sends email reminders 48 hours prior to your session. It is your responsibility to either keep the appointment or cancel within the 24-hour window, regardless of whether or not you receive a reminder.

We understand that financial concerns can be a barrier to treatment. To help, we utilize the Green Bottle Method, developed by Alexis Cunningfolk, to provide equitable access to services. To apply, please submit a request for a fee reduction.

Please note that reductions are subject to availability and financial need, as we do not receive additional funding to compensate for reduced fees, and we cannot guarantee a specific reduction until your application is reviewed.

We also recommend exploring mental health scholarships, grants, and programs, such as Fund Recovery and Project Heal, which provide financial assistance to you for our services. There may be other scholarships available for diverse populations or specific treatment issues to support your mental health journey.

If a significant fee reduction is necessary, we suggest looking into community or nonprofit mental health agencies that receive funding to offer services at a lower cost.

At Bloom, we prioritize your privacy, which is why we do not provide progress notes to insurance companies if you are not using in-network benefits. This allows us to maintain a higher level of confidentiality in your therapy sessions.

Out-of-Network Benefits

If you choose to use your out-of-network benefits, you can still receive mental health services from a provider who is not part of your insurance company's network. With these benefits, your insurance may reimburse you for a portion of the cost, but you will need to pay the full session fee upfront and then submit a claim for reimbursement.

✔ Superbills for Reimbursement: We can provide you with superbills (detailed receipts) to submit to your insurance company for reimbursement. Alternatively, we can file the claims directly with your insurance on your behalf.
✔ Full Payment Required: Please note that full payment for services is required at the time of your appointment, regardless of whether you are using out-of-network benefits or paying privately.

Next Steps for Using Out-of-Network Benefits

To use your out-of-network benefits, we recommend that you first contact your insurance provider to confirm the details of your coverage, including:

✔ The percentage your insurance will reimburse for mental health services.
✔ Any deductibles or limitations on mental health services.

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Once you have this information, please notify our administrative team, and we will coordinate with you to file claims on your behalf and ensure the process runs smoothly. This allows you to access mental health services while still maintaining control over the confidentiality of your treatment.

Under the "No Surprises Act" you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or are not using insurance an estimate of the expected charges for medical services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency medical services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit https://www.cms.gov/nosurprises or call 1-800-985-3059.