At our practice, we believe deeply that mental health care should be accessible. One of the most meaningful ways we try to live out that value is by accepting insurance—so that therapy isn’t only available to people who can afford to pay out of pocket.
What many clients don’t see is how much work, advocacy, and risk that decision requires.
Over the past several months, group practices and clinicians across Arizona—especially those contracted with Blue Cross Blue Shield (BCBS), the largest insurer in our state—have been navigating sudden policy changes that threatened access to care for thousands of clients. While some of these changes may be paused or reversed for now, the experience highlighted something we’ve known for a long time:
Accepting insurance is not a neutral or collaborative process.
It is often a battle.
What Clients Rarely See Behind the Scenes
When people hear that a therapist or practice doesn’t take insurance, the assumption is often that providers are being greedy or inflexible. The reality is far more complicated.
Insurance companies can:
- Change policies with little notice
- Retroactively take back payments for sessions that happened months or even over a year ago
- Admit billing errors were their fault—and still delay returning funds
- Reduce reimbursement rates with no negotiation
- Deny care that was previously authorized
- Create administrative requirements that increase costs while reducing access
Meanwhile, premiums and deductibles continue to rise for clients, while reimbursement for mental health clinicians continues to shrink.
Why We Stay In-Network Anyway
Despite all of this, we continue to fight to accept insurance because we believe our clients deserve to use the benefits they work hard to pay for.
As a practice, we:
- Spend countless unpaid hours dealing with claims, audits, denials, and appeals
- Monitor policy changes that could affect your care
- Advocate directly with insurance companies when access is threatened
- Absorb rising overhead costs—rent, payroll, training, licensing, compliance, technology
- Offer reduced rates and flexibility when we can
- Push back when changes would harm clients or clinicians
We do this not because it’s easy or profitable—but because access matters.
When Insurance Denies Care or Requests Payment
When insurance companies deny claims or retroactively take money back, it can sometimes result in a balance owed by the client. We know this is frustrating and confusing—especially when you’ve done everything “right.”
We ask for grace in these moments.
Please know:
- These situations are rarely due to clinician error
- We advocate whenever possible
- Denials are often the result of opaque, shifting insurance rules
- We are navigating the same system you are—just from the provider side
We will always communicate transparently, work with you when possible, and treat these situations with care and respect.
How Clients Can Advocate for Their Mental Health Benefits
One of the most powerful forces for change is insured members speaking up. Insurance companies respond far more quickly to pressure from clients than from providers.
You can help by:
- Calling your insurance company when care is denied and asking why
- Requesting written explanations of policy changes
- Filing formal complaints with your state insurance regulator
- Contacting elected officials about how these decisions affect real people
- Asking insurers to explain how mental health parity laws are being upheld
- Sharing accurate information when clinicians are blamed for systemic failures
Your insurance is not a favor—it’s something you pay for. Mental health care is not optional or expendable.
This Is About Survival—and Access to Care
This isn’t about greed.
It’s about sustainability.
It’s about protecting access to therapy before it quietly disappears.
Providers can only absorb so much. Clients can only pay so much. Communities can only lose so many clinicians before care becomes inaccessible—especially in underserved and rural areas.
Real change will require transparency, accountability, and collective advocacy.
We are committed to continuing this fight—for our clients, our clinicians, and the future of mental health care. Thank you for trusting us, for using your voice when you can, and for understanding the invisible labor that goes into keeping therapy accessible.
Access to care is worth protecting. And we’re not giving up.
