Benefits of Not Filing a Claim
with Your Insurance Company
for Mental Health Care

If an individual or family seeks counseling from a mental health professional and they want their insurance company to pay for it, then the mental health professional must provide a diagnosis that will become part of your permanent Personal Health Information.  Just like your medical provider must say whether it is a broken bone, strep throat, or some other ailment, a mental health provider must provide a quickly determined diagnosis of your problem.  There are certainly cases where that diagnosis on a patient's file is beneficial; for example, there are certain types of psychological disorders that must be treated with prescription medications and for those meds to be received, a diagnosis must be made.

However, there are other times when having a diagnosis is not necessarily in your best interest. 

By default, insurance companies take a medical model approach to both physical and mental health which requires a diagnosis of a disease or ailment followed by a concrete treatment plan.  So, for example, if you're feeling depressed, then there is a list of different types of depression from the mental health diagnostic manual that can be chosen as a diagnosis by a mental health provider.  From there, with a medical model that says that there is something wrong with your brain, you are normally given a prescription treatment (and rarely some cognitive and behavioral treatment) and the label of "depression" is now a part of your permanent health record.

But what if that depression is the result of a spouse who has just left you, the loss of a parent, or a seasonal disorder due to the fact that you just, "don't like winter?"  Is the permanent diagnosis and medical-model treatment required for your brain and body to feel better?  Not necessarily.  It is true that the brain of someone experiencing depression exhibits various hormonal fluctuations.  However, a medical-only model believes that the only thing to be treated is the hormonal changes in the brain that a person suffering from depression exhibits.  Yes, it is true that the brain displays chemical imbalances, but did the hormone changes create the depression or was it the understandably sad and stressful event(s) that caused the neurochemical variances that led to the depressive state?  I know it sounds like a chicken and egg debate, but the fact is there is not a consensus within the medical field nor is there an overwhelming body of evidence that the medical model is the best way.  And a person who is struggling with depression due to very difficult circumstances in their life can learn a variety of methods for curing that depression in a way that provides for better long term results than medications can bring -- and they avoid a diagnosis on their record that could haunt them in the future as they look for a job or attempt to get new health insurance coverage.

Please note that we are not trying to talk you out of needed medication.  Our goal is simple:  whatever your struggle that has led you to seek counseling, I want you think about the long term consequences of involving your permanent health care record.  We want you to receive the care that you need in the best way possible.

If you want us to give you a receipt that you can file with your insurance company to seek reimbursement, we will be happy to do so.  We just want you to be aware of what that entails.

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Dr. Tim A. Gardner, LMHC
11805 North Pennsylvania Street
Carmel, Indiana  46032   USA