Before we dig into today’s topic, let’s get one thing straight: if you walk through our doors for therapy, or even just bravely hit “submit” on our online inquiry form, your privacy is treated like gold with us. We’re sticklers about confidential records. We don’t ship your life story, your secrets, or your anxieties off to some mysterious insurance cubicle without a mountain of paperwork, a legally sound reason, and your knowledge every step of the way. So, if you’re already a client (or thinking about becoming one), breathe easy. We’ve got safeguards, we’re vigilant, and we take this seriously.
That said, the reality for mental health professionals across the country is a little…well, messier.
Imagine you come to therapy ready to work through your anxiety or unpack that complicated previous relationship. You deserve a safe space to process, right? That’s how it should be. But thanks to a loophole in the HIPAA law, sometimes insurance companies want to see those private notes, not to help with payment but to “educate” us clinicians. And they don’t mean yoga classes or a friendly TED talk.
At The Relationship Elevation and Learning Institute (The REAL Institute for short), we’re on a mission to keep the therapy space sacred. Our work with kids, adults, and families in Folsom is all about healing, growth, and trust. Not about opening up your personal history so some stranger at an insurance company can give it a thumbs up or thumbs down. We fight tooth and nail to protect your privacy.
You may be wondering, where’s the harm in sending session notes to insurance companies? Surely, they’re asking for a reason…right? Speaking plainly for a moment: insurance companies make more money when they pay for less care. They go fishing in charts for reasons to say, “nope, not covered.” And courts are starting to notice, in Kentucky, one court told GEICO they couldn’t just skim records and deny benefits with the flick of the red pen. That’s not evidence of need. Here in California, a judge outright called insurer-chosen peer reviewers “quacks” when their only skill seemed to be saying “no” to care requested by actual treating professionals. And in Texas, someone rubber-stamped denials without even glancing at the real records. When these seemingly flippant denials happen, it is the patients who lose, as progress stalls, and everyone trusts the system a little less.
Sometimes, clients ask, “Aren’t there laws to stop this?” Adkins v. Life Insurance Company of North America is a great case to show just how murky this area of law is. A patient tried hard to see if financial incentives influenced denials, but the court said no dice. Insurance company decisions are still shrouded in mystery, almost as if they’re protecting the recipe for Coca-Cola rather than patient well-being.
When challenged, a common reason the insurance companies provide for the request of these records is for what they call “provider education.” But this doesn’t really make sense if you stop and think about it. They people actually providing care (i.e., your therapist, counselor, doctor, etc.) are the ones who have gone through years of specialized school, tough exams, and supervised clinical practice to get licensed. That license means they’ve proved their skills and have to keep learning and renewing that education to keep treating you. So, why do they need to comb through you’re private records in the name of “education”? It’s your licensed provider who needs to stay up-to-date and informed on the new developments in their specialty; not the company just paying the bills.
So here’s my soapbox moment. Therapy records are sacred. They’re not classroom handouts or sticky notes for cutting costs at a board meeting. If insurers want access, it should be for real fraud or clear legal claims. Never for something as slippery as “provider education.” Anything else is just a contributor in eroding trust. Call me sentimental, but in therapy, trust is everything.
If you’re struggling, curious, or are just wanting to feel heard, our doors are open. At The REAL Institute, privacy is a promise, and every story is welcome. Healing happens here, not under a magnifying glass.
Jessica LePage-Smith, LCSW, is the founder and CEO of The Relationship Elevation and Learning Institute in Folsom, dedicated to helping people grow through the power of authentic connection. Learn more about her at www.therealinstitute.com.
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