Copyright 2021 Dr. Rachelle Robinson
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It’s important to know that insurance companies use a medical model which means therapists have to provide a diagnosis proving “medical necessity.” If the insurance company determines that the diagnosis meets medical necessity, only then will they grant coverage.
Once the insurance company is given your diagnosis, that will become part of your medical record. The insurance company can request entire conversations we’ve had, copies of documents or notes—as much information as they want. This could become an issue down the road when it comes to specific employment opportunities or life changes that involve legal matters, like going through a divorce.
Sometimes the goal of being in therapy isn’t about receiving a diagnosis. Particularly when it comes to family therapy or coping with life transitions. I don’t believe anyone should be forced into a diagnosis in order to receive therapy.
I believe you have the right to keep your medical records confidential. Whether or not you choose to use out-of-network coverage is up to you. I just want you to feel comfortable in how you choose to move forward.