Insurance and third party billing is some of the most confusing, complex, overly-bureaucratic nonsense that human beings have ever had to navigate to get their services paid for. Here is how some of it actually works.

How Insurance & Billing Works at Shadow Diver Counseling

Yes, I accept health insurance—sometimes. But it’s not as simple as handing over your card and walking away. Here's what you need to know.

I currently accept insurance for one-on-one counseling sessions, and some group sessions—both in person and online.
That means:
✔ You can use your insurance for weekly therapy sessions and clinical groups
✖ You cannot use insurance for intensives, workshops, or non-clinical group programs.

If you want to attend a Hammer Session (intensive), a workshop, or a non-clinical group, those are private-pay only. No exceptions. However you can ask for a SuperBill (more on that below).

Copay, Deductible, Coinsurance — and Why It Might Cost More Than You Think

Using insurance for therapy is not the same as “free therapy.” Even when you use insurance, you may still owe money—and it depends on a few key terms.

My full rate for one-on-one counseling is $200 per session.
However, if you’re using insurance, I’m required to accept a lower, pre-negotiated rate with the insurance company—called a contracted rate. That rate depends on the insurance company. It could be $120, $140, $160—each plan is different.

Copay
A flat fee your insurance requires you to pay for each session.
Example: If your copay is $30, you pay $30 each time you come in—regardless of what my pre-negotiated insurance rate is.

Deductible
This is the total amount you have to pay out of your own pocket before your insurance starts covering anything.
If your deductible is $1,500 and you haven’t met it yet, you’ll be responsible for the entire insurance contracted rate (not my full $200 rate—but still, it adds up).

Because insurance companies aren’t in the business of paying for your care if they don’t have to, they reset the deductible yearly. Resetting the deductible each year gives them a clean slate—and makes you responsible for costs again, until you hit that number this year. So even if you paid thousands out-of-pocket last year and just hit your deductible in December… come January, you’re back at zero.

Coinsurance
Once your deductible is met, your plan may still require you to share the cost.
Example: If your coinsurance is 20%, and the insurance rate for a session is $140, you’d pay $28 and your plan would cover the other $112.

What’s a Superbill—and How Do You Use One?

If you’re paying out-of-pocket for therapy, you might still be able to get some of that money back through your insurance. That’s where a superbill comes in. A superbill is a special type of receipt I can provide that includes all the details your insurance company needs to consider reimbursing you for out-of-network therapy.

This document basically says: “Hey insurance company, I saw this licensed therapist, I paid them directly, and here’s the proof. Will you cover any of it?”

If you want to try getting out-of-network reimbursement, let me know and I’ll get you what you need.

How Health Insurance Billing Works

If you're using insurance:
• I bill your provider directly
• You’re responsible for whatever your plan doesn’t cover
• If a claim is denied, you’ll be expected to pay the full rate

If you're not using insurance (or doing an out-of-pocket session):
• You pay the full fee at the time of service
• I can provide a superbill for you to submit to your insurance for possible reimbursement

Employee Assistance Programs (EAPs)

I work with select Emplyee Assistance Programs on a case-by-case basis. These are typically short-term counseling packages offered by your employer. Just know: EAPs are usually limited to a few sessions. If you want ongoing work or deep transformation, we’ll need to talk about next steps after those sessions end.

Charity-Sponsored Counseling

If you're getting funding from a nonprofit, religious group, or community organization, I’m open to coordinating payment with them—but this must be arranged ahead of time. I do not offer retroactive discounts or billing agreements.

Do you hate this as much as I do? There is a solution!

Choose to pay out of pocket even when I accept your insurance.

If I’m in-network with your insurance, why would you ever choose to pay full price?

Here’s why some clients do:

MUCH MORE PRIVACY

When you use insurance, I’m required to share certain information with your provider—including a mental health diagnosis and sometimes notes or treatment plans. Paying privately means, no diagnosis on your permanent medical records, no insurance company tracking your sessions, total control over your confidentiality. If privacy matters to you, private-pay is the cleanest option.

INSURANCE UNPREDICTABILITY

Insurance companies change the rules all the time—usually in ways that make your care harder to access. You might think you're covered, then find out your deductible hasn’t been met so you owe the full amount anyway, your plan only allows a limited number of sessions, the claim was denied for a random reason.
Even if you think you know what benefits you have they can change your services at any time. They can stop covering certain types of therapy without notice, require new pre-authorizations or paperwork, reduce the reimbursement rate, and even decide that your progress and relief of symptoms means you "no longer need therapy" and cut off coverage.

When you pay out-of-pocket, you avoid all of that. You know exactly what you're getting, every time. No sudden policy changes. No treatment dictated by algorithms. No third party calling the shots.

AI TREATING YOU LIKE YOU ARE A LIABILITY (BECAUSE TO THE INSURANCE YOU ARE ONE)

You might think a real person is reviewing your therapy claims—but more and more, that’s not the case. Insurance companies are now using artificial intelligence (AI) to make automated decisions about what gets covered and what doesn’t. It means your mental health care is being reviewed—not by a licensed professional, not by someone who understands trauma or healing—but by a machine learning model trained to cut costs at all costs.

These AI systems:

• Automatically flag or deny claims based on incomplete patterns

• Decide how many sessions you “should” need based on statistical averages—not your actual progress

• Reject or delay claims using vague, coded language to avoid accountability

• Are designed to maximize profits, not outcomes

These systems get it wrong all the time. But you may never know why—unless your therapist fights the denial, resubmits documents, and waits through weeks (or months) of silence.

When you pay out of pocket no robot decides when your healing is “enough”.