What out-of-network care means, and how it can lead to deeper, more flexible support
At Rose + Thorn Counseling in Columbus, Ohio, we offer therapy as an out-of-network provider — and that’s intentional. It’s not about making things harder. It’s about protecting the kind of care we believe therapy should offer: private, flexible, and built around the client — not the system.
If you’re wondering why that matters or what it means for you, here’s what we want you to know.
Care That Doesn’t Require a Diagnosis
Most insurance companies require a formal diagnosis in order to approve therapy for reimbursement. In some cases, a diagnosis is clinically appropriate — and when it is, we’re transparent about that.
But not every concern needs a label.
Many people seek therapy for patterns, transitions, relational pain, burnout, or a quiet sense that something isn’t working. These concerns are valid — even if they don’t fit within a billing framework. By working privately, we’re able to meet you where you are without having to assign a diagnosis if one doesn’t apply.
Privacy Without Oversight
When therapy is billed through insurance, your clinical information — including diagnosis and session details — is often reviewed or stored by your provider’s network. That becomes part of your broader medical record.
Some clients are comfortable with that. Others aren’t.
When you pay privately, your care stays between you and your therapist. We don’t report anything to outside entities or share your information beyond what’s legally or ethically required. That level of privacy gives many clients the space to be more honest — and more at ease.
Therapy That Isn’t Rushed or Restricted
Insurance companies may limit the number of sessions they’ll cover, require justification for continued care, or pressure therapists to follow predefined timelines.
That pace doesn’t fit everyone — and in many cases, it short-circuits the kind of work therapy is meant to support.
As a private pay therapist, working outside of insurance allows us to collaborate more freely: weekly or biweekly, short-term or long-term, depending on what’s most useful for your life — not someone else’s protocol.
A System That Wasn’t Built for This Kind of Work
Insurance is built to serve many needs — but it wasn’t designed to support nuanced, relational, or spiritually-integrated care. It was built to treat diagnoses efficiently.
At Rose + Thorn, we believe therapy is about more than reducing symptoms. It’s about being seen. It’s about understanding what’s shaping your thoughts, relationships, and identity — and moving forward with clarity and strength. That kind of work doesn’t always fit into a checkbox.
What If Cost Is a Concern?
We understand that therapy is an investment — financially and otherwise.
Some of our clients:
- Use HSA or FSA funds to pay for sessions
- Request superbills and submit them to their insurance for possible reimbursement
- Choose biweekly sessions, consultative work, or short-term support during seasons of transition
We’re open to discussing what makes sense for your situation — with transparency and no pressure. To learn how to submit a superbill for out-of-network reimbursement, feel free to check out our guide on superbills.
Frequently Asked Questions
Is out-of-network therapy covered by insurance?
Not directly. You pay upfront and may be eligible for partial reimbursement, depending on your plan.
Can I still get therapy if you don’t take insurance?
Yes. Many clients pay out of pocket, use HSA/FSA funds, or request a superbill to submit claims themselves.
Why would a therapist not take insurance?
To provide more privacy, avoid forced diagnoses, and offer flexible care outside of insurance restrictions.
If You’re Unsure, That’s Okay
Not everyone is familiar with private pay therapy — especially if you’re used to providers that work directly with insurance. If this model is new to you, or you’re unsure whether it’s the right fit, that’s completely normal.
We work with clients in-person in Columbus, Ohio, and online throughout Ohio, and many have had similar questions at the start.
You’re welcome to reach out. We’ll walk you through what this kind of care looks like, what your options are, and how to decide what makes the most sense for your needs.