Why Aspire Counseling Is a Private Pay Practice (And What That Actually Lets Us Do)
At Aspire counseling, we are a private pay practice. We don't bill insurance directly.
Do we accept your insurance of not is usually the first thing people want to know when they reach out, and I understand why. It's a real consideration, and I'm not going to pretend it isn't.
But I want to explain the actual reasons behind that decision, because it isn't about money the way people sometimes assume. It's about what we're able to do for you once insurance isn't in the room.
What does private pay actually mean at Aspire Counseling?
Private pay means you pay our practice directly rather than us billing your insurance company. You can still use out of network benefits, an HSA, or an FSA. What changes is that your treatment plan gets decided by you and your therapist instead of by a company that has never met you.
Here's what that difference looks like in practice.
How does private pay change your actual treatment?
Here's a real example. A lot of our clients meet for 90 minutes every other week instead of 45 minutes once a week.
Why? Because we noticed something. Some people need a chunk of time to settle in, to catch up on the week, to get comfortable before they can go anywhere deep. If the session is 45 minutes, they're just starting to get somewhere when it's time to stop. With 90 minutes, they get past the catch up and into the actual work.
That's not a scheduling preference. That's a clinical decision, made by a therapist and a client who figured out together what works.
An insurance company would not approve that. The session length, the frequency, the number of sessions, the diagnosis that has to be attached to justify it, all of that gets decided by someone who has never met you.
The same is true of our week long trauma therapy intensive, where a client meets one on one twice a day for five days using CPT delivered in a massed format. CPT is Cognitive Processing Therapy, one of the most researched treatments for PTSD. Delivering it in a massed format means compressing months of weekly sessions into a single week. It's one of the most effective things we offer, and there's no insurance panel in the country that would authorize it as designed.
Everything here is about the clinician and the client figuring out what actually works. That's the whole point.
Where does our team's time and energy go?
I talk to a lot of practice owners. In insurance based practices, one of two things is happening.
Either every clinician is spending hours each week on billing, claims, prior authorizations, and appeals. Or the practice has hired a company or a person to handle all of it. And that cost doesn't disappear. It gets passed along to clients, just less visibly.
My colleagues in insurance based practices complain constantly. Claims denied out of nowhere. New rules designed to make it harder for clients to actually use the benefits they're paying for. Requests for clinical records that feel like a real invasion of client privacy. Companies deciding how many sessions someone gets to have.
We don't do any of that.
What that means practically is that our team meetings look different. We're not spending them reviewing the latest changes in insurance regulation. We spend them talking about clients. Our clinicians consult with each other constantly. Someone brings a case they feel stuck on and four other people who know that treatment approach weigh in. We bring in outside specialists when we need to.
The focus is entirely on client care. That's the biggest thing.
Does private pay mean therapy takes longer?
No. It's often the opposite. We have no session limits, and our clients frequently finish faster than they would at an insurance based practice, because our clinicians spend their energy on treatment instead of fighting for authorization.
Our goal is to work ourselves out of a job. I know that sounds like something you'd put on a poster. But it's true, and it shapes how we practice.
Therapy here has an endpoint. That matters enormously for how you should think about the cost.
In our consultation meetings, we celebrate clients who graduate. A therapist will say something like, "Remember that client I asked for your input on a few months ago? She discharged last week. Her PCL-5 score went from 58 to 19, and she drove to her mom's house by herself for the first time in four years."
That's the moment we're all working toward. Not a client who stays forever. A client who doesn't need us anymore.
When you compare cost, don't compare our rate to a copay. Compare what it actually costs to get better and be done, versus what it costs to sit in therapy that's moving slowly for a very long time.
How does this let us stay specialized?
Because we're not built around volume and insurance panels, we can be genuinely specialized rather than taking everyone who walks in.
Our clinicians are trained in specific evidence based treatments. EMDR, CPT, ERP, TF-CBT, ACT, DBT. Those are real trainings with real requirements behind them, and they are not interchangeable.
For something like OCD, it can make a real difference to work with someone who understands exposure and response prevention. ERP is the treatment where you gradually face what your brain says is dangerous while resisting the compulsion or reassurance that usually follows. A clinician trained in it knows how reassurance seeking and avoidance keep the whole cycle going. That's not something every therapist who lists "anxiety" on their profile knows how to do well.
I know private pay is an investment. And I also think it's worth considering the value of working with someone who has specific experience with exactly what you're describing.
Can you still use your insurance benefits?
Often, yes. Being out of network doesn't mean insurance can't help. Most PPO plans include out of network benefits, and we use Thrizer to handle the claims for you. Before you commit to anything, Thrizer can look up your estimated benefits and tell us what reimbursement is likely to look like for your specific plan.
We'll walk you through it. A lot of people are surprised.
There are two ways it can work:
Before you've met your out of network deductible. You'd pay our full rate. Thrizer submits the claims so those sessions count toward the deductible, at no extra charge to you.
After your deductible is met. Thrizer Pay lets you pay just your portion at each session. Thrizer fronts the rest and waits on the reimbursement for you.
One thing I want to be careful about, because this is where practices sometimes oversell: that portion is co-insurance, not a copay. It's a percentage, and the exact amount depends entirely on your plan. We're not going to tell you it works like being in network, because it doesn't.
You can also use an HSA or FSA card for sessions, just like a credit card.
What if we're not the right financial fit?
Our goal isn't to sell therapy to someone who genuinely can't afford it. That wouldn't be good for you and it wouldn't sit well with me.
We do have lower rate options in house. Clinicians earlier in their careers work under close supervision from our most experienced people, which honestly means you get two clinical brains on your case at a lower cost. If that's what makes therapy possible for you, tell us and we'll talk about it.
And if we're still not the right fit financially, we'll say so plainly. We keep a vetted referral list of practices and clinicians we actually trust, including people who take insurance. I'd rather point you somewhere good than convert you into a situation that sets you up for stress you can't absorb.
Frequently asked questions about private pay therapy
Do you take insurance at all?
We don't bill insurance directly. We're out of network, which means we can help you submit claims for reimbursement through Thrizer if your plan includes out of network benefits.
Can I use my HSA or FSA?
Yes. You can use an HSA or FSA card for sessions the same way you'd use a credit card.
Will I get a superbill?
Thrizer handles the claim submission for you, so you don't have to mail in a superbill yourself. If you'd rather have documentation for your own records, just ask.
Do you have session limits?
No. How long you're in therapy is decided by you and your therapist based on your goals, not by an outside company.
Does private pay mean my records stay private?
It means we're not sending clinical records to an insurance company to justify continued treatment. That's one of the bigger privacy differences between in network and out of network care.
How do I find out what reimbursement I'd get?
Reach out and we'll have Thrizer run an estimate for your specific plan before you commit to anything.
Begin Therapy in Columbia or Lee's Summit, MO
If you're weighing whether this is worth it, I'm happy to talk it through with you. Tell us what's going on and what you're looking for, and we'll give you an honest answer about whether we're the right place.
Call our Columbia office at 573-328-2288 or our Lee's Summit office at 816-287-1116. We see clients in person at both locations and online throughout Missouri.
Whenever you're ready for effective care and lasting change, we're here.
