Our Approach to Payment and Insurance
Why We Are Not In-Network With Most Insurance Plans
from the Founder, Dr. Katherine Durrant
When I first opened this practice, I joined a few insurance networks, believing it would make care more accessible. Instead, I learned how difficult that system is for both clients and clinicians. Many claims went unpaid, and reimbursement rates came in far below what was needed to survive. Insurance companies do not allow providers to negotiate contracts before signing an agreement, and the rates we are then locked into are often about half the actual cost of providing high-quality care in a comfortable setting. I eventually had to hire an attorney to end a contract.
Working within insurance contracts means accepting low reimbursement rates and, consequently, high caseloads and shortened appointments—conditions that can leave clinicians overextended and clients underserved. We prefer a private-pay model so our clinicians can work at a sustainable pace, prepare fully, and remain steady and attentive with each person they meet. This model also allows us to provide care based on clinical judgment rather than insurance definitions of “medical necessity,” which typically require a diagnosis and documented functional impairment. Many people come to therapy for growth, support, relationship challenges, or major life transitions, concerns that may not qualify under those strict criteria but matter deeply. By remaining independent of most insurance networks, we are able to provide the care that is truly needed—for as long as it is helpful—without pressure to shorten sessions, limit treatment, or fit clients into narrow diagnostic categories. We do participate in Medicare and in select Western New York Independent Health plans whose structures support sustainable, high-quality care.
Our fees reflect the actual cost of offering thoughtful, research-informed treatment and maintaining welcoming, comfortable offices. We hold this with humility and respect, fully aware of the commitment clients make when they choose to invest in their mental health.
Using Your Out-of-Network Insurance Benefits
Even though we are out-of-network with most health insurance plans, many clients are still able to use their insurance benefits. We can submit invoices or provide superbills that you can submit for partial reimbursement.
To understand your coverage, ask your insurer:
• What is my out-of-network deductible?
• What percentage of the fee is reimbursed?
• Is preauthorization required?
We are always happy to help you navigate these questions.
What You Can Expect From Our Model
• Longer appointments when needed
• Thorough assessment and diagnosis
• Evidence-based treatment planning
• Consistent care with the same clinician
• Thoughtful preparation before each session
• Timely communication and collaboration with other providers
Our goal is to offer care that is steady, attentive, and unhurried.
Access and Support
We know cost is a real concern. Some clinicians offer a limited number of reduced-fee or pro bono slots, and we maintain referral lists for lower-cost options, community clinics, and practices that accept a wider range of insurance plans. We want every person to land in the right place, even if that place is not with us.
Frequently Asked Questions
Why don’t you bill insurance?
The administrative demands and low reimbursement rates reduce the time and presence we can offer clients.
How do out-of-network claims work?
We provide a superbill or submit invoices directly to your insurance provider; you submit it to your insurer for potential reimbursement.
Why are your fees higher?
Fees reflect the actual cost of sustainable, high-quality care and allow clinicians to remain attentive, prepared, and well-supported.
Our Commitment
Protecting clinicians' well-being protects the quality of your care. A sustainable pace, fair compensation, and ongoing training create the conditions for therapy that is steady, compassionate, and effective. Our decision to stay out-of-network is ultimately about honoring the work—and honoring you.