Most of my patients use their insurance to see me and are able to afford the fees with the help of insurance.
How this works
When you see Dr. Kassir, he asks for payment in full at the time of the meeting, as cash or personal check. He will give you a special kind of receipt for your payment. You may then submit this receipt to your insurance company, usually with a claim form. Your insurance company will send you reimbursement directly.
Generally speaking, PPO plans will reimburse a portion of the fees, while other types of insurance (such as HMO or EPO plans) do not reimburse for services provided by out-of-network physicians. The amount of reimbursement depends on your specific insurance plan and who provides it. Most plans pay about half the fees. More infrequently, a plan may pay more (e.g. 100%) or less (e.g. 25%). You may have to meet a deductible before you receive payment.
Why Dr. Kassir is an out-of-network physician
In summary, my decision to be an out-of-network provider helps you get well faster, save time, use less medication, and have fewer professionals involved.
I have chosen not to accept insurance because I want to deliver the highest quality of care tailored to your specific needs, without an insurance company influencing the time I can dedicate to your care or the type of treatments I can provide. Insurance companies tend to limit the time and types of treatment that can be provided by a doctor by applying financial incentives to doctors to see as many patients as possible, and to end treatment quickly. This often results in abbreviated sessions for each patient, and might result in ending treatment before you feel ready.
Since I don’t work with insurance companies, I am free from this kind of influence and take the time to provide integrated treatment. Integrated treatment means I am free to combine “talk therapy” (psycho-therapy) with medical evaluation (and medicine, if necessary) in the same session. This saves you time because you see only one professional instead of two. Also, you will have the opportunity to receive my psychotherapeutic services, benefiting from my expertise and special training in psychotherapy.
Integrated treatment is usually more rapid and effective in solving problems and, if medication is needed, it may lead to less medication being necessary. This is because we are treating the problem from several directions (psychotherapy and medication) instead of just one (medication). Furthermore, I am able to take the time necessary to listen and understand all contributions to your problem, whether they are biological, medical, psychological, environmental, or social. This is essential when you want to solve the root of the problem, and not apply just a temporary or incomplete solution. Not infrequently, psychotherapy is enough, and we can treat the problem without medication at all.
The decision about when treatment is complete is up to you. You know when you feel better. Your insurance company cannot pressure us to end treatment before you feel ready since I have no obligation to them. My obligation is entirely to you.
Finally, I believe you should always be able to control whether, when, and to whom you will release your own private medical information. When your doctor takes insurance (or if you send receipts to your insurance to seek reimbursement) your medical information such as your diagnosis and the procedures performed are sent to your insurance company. In some cases, your insurance company is allowed to share this private information with other parties. This may affect your ability to buy individual disability or life insurance coverage later. These concerns notwithstanding, often using insurance is more economical and is frequently necessary.
Fortunately, the Affordable Care Act (ACA) requires healthcare insurance companies to cover pre-existing conditions. If and when the ACA is repealed, the new law may or may not require coverage for pre-existing conditions, but time will tell.
in the meantime, as
part of the ACA, states like California have set up their own "exchanges" where people can shop for insurance and compare plans. For more information, visit California's marketplace.
Patients who know their rights under the parity legislation are better equipped to protect their rights. In March 2017, the American Psychiatric Assocation updated its "Parity Poster" entitled "Fair Insurance Coverage: It's the Law." Written for lay people, the poster clearly describes your rights under the parity laws and the steps to take if you think your rights are being violated.