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  • Writer's pictureAdam O'Neill

Affording Mental Health Services: Our Recommendations and Plan



One of the most frustrating aspects of healthcare, especially in the United States, is the financial element. I remember the days of my training in physical medicine (surgery, cardiology, neurology, etc.) where the aspects of billing and insurance only occasionally touched the practitioner. We all knew somewhere down the line money would have to change hands for our services but we assumed insurance would cover most (preferably all) or that funds would be provided through financial hardship applications and forgiveness.


Entering the field of psychiatry, all this changed. In mental health, it isn’t uncommon for money to change hands before a session begins or at the very least through an invoice after the session. This made me uncomfortable. In addition, insurance carriers have lowered reimbursements, increased requirements for services, forced shorter visits and length of stays, all of which have caused many practices (ours included) to be out-of-network and private pay.


There are benefits to being private pay: longer visit lengths, providers with smaller panels of patients, no need to submit visit notes which contain private and confidential information to insurance, the chance to practice openly Christian care without fear of denial of coverage, among others. Still, my heart is grieved by the high cost of receiving quality mental health care.


Given this, it is helpful to discuss the ways we have found patients can afford Christian mental health services and the steps we have taken to assist:


1. We partner with counselors/therapists to be our eyes and ears between sessions.


One of the most important aspects of psychiatric care is the safety of patients. One of the most protective factors is the presence of a therapist. Because therapists generally charge less per session, we have found that one of the most successful and affordable relationships is when patients see psychiatry at regular intervals that are less frequent than their counselor. With the patient's permission, counselors can reach out to their psychiatry provider when they see something concerning that may need the psychiatric provider's attention.


2. We frequently partner with churches who generously subsidize or fully cover services.


We are grateful to the many churches who trust our practice by sending referrals, coordinating care, and not infrequently subsidizing or fully covering care for Christian mental health services. We encourage patients to reach out to their pastors, deacons, or elders to discuss if there are funds set aside to cover mental health (often housed under “benevolence funds”). Please feel free to have pastoral staff reach out to office@aoavirginia.com if they are interested in providing support for their congregation.


3. We do our best to space out visits (while remaining medically safe) yet allow access to patients at a frequency that works best for them.


It is not our intention to needlessly recall patients for visits. We do our best to provide a range that would be appropriate for each patient (ie 2-4 weeks, 1-2 months, 3-6 months, etc) and allow the patient to select what they would be most comfortable with. This doesn’t mean that we are unavailable to meet more frequently, however, just that we are comfortable spacing out visits to the recommended length.


4. We accept HSA/FSA payments.


Although we are out-of-network providers, we are able to accept Health Spending Accounts (HSA) and Flexible Spending Accounts (FSA) cards for payment. For more information on these tax-saving programs see this article by Forbes.


5. We provide receipts that can be submitted for potential out-of-network coverage.


Should you decide you would like to inform insurance of mental health services, we are happy to provide receipts that can be submitted for potential out-of-network reimbursement. These receipts contain all the necessary information (i.e. provider information and tax information, billing and diagnostic codes) that insurance needs to apply the services to your out-of-pocket maximum and give reimbursement if applicable. It may be beneficial to contact your insurance company prior to initiating services to see what their out-of-network coverage includes, some also have a preference for in-person vs. telehealth services.


6. We can set up payment plans that fit your budget.


We know that paying for services outright is not always possible and that financial situations change. Please contact the main office if setting up a payment plan would be helpful for you.


The providers that work at Adam O’Neill & Associates pursued education and training in mental health because we care for people and want to see them living healthy and effective lives. We view the financial responsibilities of running a practice as a necessary (although frustrating) hurdle to work through with our patients. We also fully believe in the value of mental health services and trust that money invested in this area is money well spent. Your mental health is well worth it!



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