Today I’m going to tell you a sad story that I’m hearing all too often.

A therapist gets a records request from an insurance plan, asking for documentation for 6 months of sessions the health plan has already paid. While the therapist’s notes pass their review, the treatment plan does not meet their standards.

Because of this one thing, the health plan asks for ALL the money back for those sessions. And we’re talking thousands of dollars.  They may even expand the inquiry, asking for more notes, hoping to find those treatment plans deficient, also.

I tell you this story to drive home how important your treatment plans can be when you work with insurance.

Therapists seem to fall into three groups when it comes to treatment plans:

1. You don’t write them (you may not really know what a treatment plan is, or don’t have time)
2. You write them, but don’t have confidence that they are any good, or never update them after the first session.
3. You write them, and THINK they are good, but they may not be good at all

The bottom line? Most of us don’t know how to write the type of treatment plan that an insurance plan would support — and this can be costly.

So, what is the biggest mistake therapists make when writing treatment plans? Not choosing “medically necessary” goals.

First, let me say that with all clients, treatment plan goals should be about where the client wants to get by the END of therapy, not focused on the therapy process. For this reason, AVOID goals like:

• Build rapport
• Create safe space
• Create compassionate container

Second, when choosing goals, for self-pay clients, goals can simply be about personal growth and increased insight. But when it comes to insurance clients, the bar is higher. Insurance plans want to see goals that are aimed at reducing the symptoms of the client’s diagnosis as your primary treatment goal. They also want goals that are measurable, to gauge progress.

So, with insurance clients, AVOID goals like:

• Find meaning in life
• Understand emotions
• Build self-esteem / self-confidence / self-compassion
• Better sex life / better intimacy
• Help client make career choices
• Help client with communication

Don’t get me wrong: These are all wonderful goals that we all work on as PART of all therapy, and are also fine for self-pay clients. But medical insurance only pays for services where one of the primary goals is reduction of medical symptoms related to a diagnosis (thus, the treatment is deemed “medically necessary”). For insurance to cover it, therapy can’t simply be growth-oriented, or just desired by the client.

I know. This isn’t the way we think about therapy goals, or the way our clients talk about their goals. So, you may just need to learn how to write your goals in a different way. While a client’s presenting issue may be to improve his relationship with his wife, the treatment plan goal might be expressed that you are working to decrease their level anxiety or depression so that there is a reduction of impairment in the client’s primary relationship (depending on the client’s diagnosis).

So, what kind of goals would be approved by insurance? I share lots of sample treatment goals, and give you sample, downloadable treatment plan templates in my pre-recorded webinar “How to Write a 10-Minute Treatment Plan.”  It’s a great skill to have, one that will serve you well in your career.  Check out this training (and other helpful trainings and resources) at  www.theinsurancemaze.com/store.