The Delicate Balance Between Caring and Charging
Out-of-network therapists often feel guilty about their rates and about how little insurance pays back. MySuperbills lets practices stay involved or hand off superbills entirely, so patients recover what they can without adding admin work for therapists.
A therapist I recently spoke with, Katherine, shared something she finds emotionally difficult. She had worked in different practice settings before deciding to remain out-of-network. She wanted the freedom to focus on her patients, without insurance dictating how long a session should be, how frequently someone could come in, or what treatment they could receive. But making that choice came with its own emotional challenges.
Talking about money is uncomfortable when you’ve chosen a profession built around helping people. How do you put a price on care? How do you charge what you need to sustain your practice while knowing that some patients may struggle to afford it? It’s a conflict many therapists wrestle with. Charge too little, and you risk working longer hours, seeing more patients, and eventually burning out. Charge what you need to make a sustainable living, and you may worry about the people who cannot afford your services. And yet, there’s a paradox here. Charging sustainable rates can also give therapists the flexibility to offer reduced fees or even pro bono care when someone truly needs it.
Katherine understands all of this. But understanding the economics doesn’t necessarily make the emotional side any easier. She was candid about something that stayed with me. If she charges $180 for a session and a patient receives just $80 back from insurance, she’d rather not know. Not because she doesn’t care about her patients’ finances. Quite the opposite. Knowing how little insurance contributes can make her feel guilty, even though she has little control over what the insurer pays.
But here’s where the perspectives diverge. That same $80 can mean something entirely different to the patient. Over four sessions in a month, that’s $320 back. It might help pay for another appointment, cover groceries, or simply make the next month’s expenses a little less overwhelming.
Sometimes, in trying so hard to care for others, providers end up carrying an emotional burden of their own. They want to make care accessible, but they cannot personally solve every patient’s financial circumstances.
There is a middle path between taking on insurance and leaving patients to navigate reimbursement alone. A therapist shouldn’t have to feel guilty about charging enough to stay in practice. And a patient shouldn’t have to feel guilty about needing financial relief. Both things can be true.
At MySuperbills, some practices want to work closely with us and stay involved in their patients’ reimbursement experiences. Others, like Katherine, prefer to simply hand off the superbills to us and leave the reimbursement process to us. Either way, patients get help recovering what they can from insurance, without adding another administrative burden to their therapists.
Neither has to carry the other’s financial burden.
MySuperbills is not a healthcare provider, insurance company, or legal advisor. We are a claim preparation and submission service. This article is general information, not medical or insurance advice.