LET’S MAKE THE PRACTICAL PART CLEAR
Therapy already asks you to bring enough uncertainty into the room.
Figuring out how to access it shouldn’t require deciphering insurance language, wondering what something will cost, or trying to understand what a platform has to do with the therapy itself.
I currently work with clients through Tau Mental Health and Authentic Arch Counseling @ Headway.
Those pathways help organize things like insurance, payment, scheduling, documentation, and the administrative side of care.
They don’t determine how much of you gets welcomed into the room.
Whichever pathway we use, I’m still interested in the same thing: understanding what brought you here and doing thoughtful work together.
Choosing how to pay for therapy shouldn’t require choosing how much of yourself gets welcomed into it.
What does change is worth understanding.
Depending on the pathway and your individual circumstances, therapy may involve using insurance, paying privately, or receiving documentation that may help you seek reimbursement through out-of-network benefits.
Those options aren’t interchangeable.
Insurance plans have their own networks, deductibles, copays, coinsurance, and rules. Private pay works differently. And having out-of-network benefits does not automatically mean your plan will reimburse every service or reimburse the full amount.
I want you to understand those differences before you make the decision—not discover them afterward.
TWO ADMINISTRATIVE PATHWAYS
Tau Mental Health
One administrative pathway for working with me, with payment and insurance options determined by the services and arrangements available through Tau.
Authentic Arch Counseling @ Headway
Another administrative pathway for working with me, with eligible insurance and private-pay arrangements administered through Headway.
You don’t need to know which pathway you need yet.
We’re going to walk through what each means before I ask you to make any decision.
The platform handles part of the administration. It doesn’t become the therapy.
You’re still meeting with me. The values we’ve been talking about throughout this website don’t change depending on which administrative pathway makes sense for you.
So before we talk about copays, private-pay rates, reimbursement, or paperwork:
let me show you the two places where the administrative side of our work can live.
Two pathways into care ↓
TWO PATHWAYS. ONE THERAPEUTIC RELATIONSHIP.
There are two pathways into care with me.
Tau Mental Health and Authentic Arch Counseling @ Headway handle different parts of the administrative side of working with me.
That can include things like eligibility, payment, billing, documentation, and the systems used around your care.
But neither platform gets to define our therapeutic relationship.
You are not choosing between two versions of me.
You are choosing the administrative pathway that makes the most sense for your circumstances.
Tau Mental Health
Through Tau Mental Health, I can work with clients using the payment and coverage arrangements available through that pathway.
If Tau is the route we use, Tau handles important administrative pieces around your care while I remain the therapist you meet with.
We'll look at whether this pathway fits your location, coverage, payment needs, and other practical considerations before you begin.
Tau may be part of the administrative side of:
insurance or payment arrangements available through Tau
billing and payment processing
required administrative documentation
scheduling and practice-system functions
applicable out-of-network documentation or processes
The exact options available to you depend on your individual circumstances.
Authentic Arch Counseling @ Headway
Authentic Arch Counseling @ Headway is another administrative pathway for working with me.
Depending on your circumstances, Headway may be used for eligible insurance or private-pay care and handles parts of the administrative and billing process around our work.
Again, the platform is not a different therapy practice experience sitting across from you.
You are still working with me.
Headway may be part of the administrative side of:
eligible in-network insurance arrangements
private-pay billing where applicable
eligibility and benefit information
billing and payment processing
invoices and administrative documentation available through the platform
Your actual insurance eligibility and financial responsibility depend on your individual plan and circumstances.
WHICHEVER PATHWAY WE USE
There are administrative differences between these pathways.
There should not be a different version of you required for either one.
I don't become less affirming because insurance is involved.
Your relationship structure doesn't become less welcome because a claim is being submitted.
Your identity doesn't become an administrative inconvenience.
And choosing private pay doesn't purchase a more attentive version of me.
The pathway changes the administration. It doesn't create a hierarchy of care.
Knowing where the administrative side of care can live is only the first part.
The next question is usually much more practical:
What exactly do “insurance,” “private pay,” and “out-of-network” mean for me?
Let’s make the payment language understandable ↓
A LITTLE LESS INSURANCE-SPEAK
Insurance, private pay, and out-of-network are not the same thing.
Insurance language has a remarkable ability to make something fairly ordinary sound much more complicated than it needs to be.
So let's translate.
There are a few different ways the financial side of therapy can work. Which ones are available depends on the administrative pathway we're using, your insurance plan, and your individual circumstances.
Understanding the difference helps you know what you're agreeing to before therapy begins.
Using in-network insurance
If I am participating with your specific insurance plan through the pathway we're using, services may be billed as in-network.
Your plan determines what you owe. Depending on your benefits, that could involve a copay, coinsurance, deductible, or another form of client responsibility.
In-network does not mean free, and it does not mean every plan is accepted.
Paying privately
Private pay means the session is paid for without submitting that session to an insurance plan for in-network payment.
Depending on the pathway and circumstances, private-pay care may be available through Tau or Authentic Arch Counseling @ Headway.
Private pay changes how the session is paid for. It does not remove the clinical, legal, ethical, or recordkeeping responsibilities that come with therapy.
Using out-of-network benefits
Some insurance plans include benefits for care received outside the plan's network.
Depending on the arrangement, you may pay for the service and receive documentation that can help you request reimbursement from your insurer.
Your insurance company decides whether the service qualifies, how your deductible applies, and whether—and how much—it reimburses.
A superbill or qualifying invoice supports a reimbursement request. It does not guarantee reimbursement.
SO WHAT IS A SUPERBILL?
A superbill is a detailed document showing information about therapy services you've received. It may include information such as the provider, service date, service code, fee, and diagnostic information when required for the reimbursement process.
If your plan includes out-of-network behavioral-health benefits, you may be able to submit appropriate documentation to your insurer and request reimbursement.
The important word there is “request.”
Providing documentation does not mean I can promise what your insurance company will do with it.
In plain language:
1. You check your benefits.
Ask whether your plan includes out-of-network outpatient mental-health benefits.
2. You receive care through the appropriate pathway.
We establish how your sessions will be paid for before beginning.
3. You receive the applicable documentation.
The exact document and process depend on the administrative pathway.
4. You submit it if appropriate.
Your insurer reviews the claim or reimbursement request under your plan.
5. Your insurer makes the reimbursement decision.
That decision belongs to the insurance company—not to me, Tau, or Headway.
One difference worth knowing now.
When health insurance is billed for psychotherapy, a mental-health diagnosis is generally part of the information used to establish medical necessity and process the claim.
Out-of-network reimbursement requests may also require diagnostic and service information.
Paying privately without submitting a session to insurance can change what information is sent to an insurer for payment—but it does not mean therapy happens without clinical documentation or without the ordinary legal and ethical limits of confidentiality.
We'll look at that distinction more carefully next.
Before relying on insurance benefits, I strongly encourage you to verify them.
Useful questions include:
Is this provider/pathway in-network for my specific plan?
Do I have a deductible for outpatient mental-health services?
What is my copay or coinsurance?
Does my plan include out-of-network mental-health benefits?
Is there a separate out-of-network deductible?
What percentage of the insurer's allowed amount is reimbursed?
Do I need prior authorization?
How do I submit an out-of-network reimbursement request?
If the answer sounds confusing, write down what they tell you. Insurance language has a habit of becoming much friendlier once we can look at the actual words together.
Now we have separated how therapy gets paid for from where the administrative side lives.
There is another difference worth understanding before you choose:
what insurance involvement can mean for the information connected to your care.
Let’s talk about privacy ↓
PRIVACY WITHOUT THE FINE-PRINT FOG
Therapy depends on being able to talk about things that may not fit neatly into the rest of your life.
So it makes sense to ask what happens to that information.
Your therapy is confidential whether you use insurance or pay privately.
Confidentiality still has legal and ethical limits, and clinical records still exist. What can change is which information needs to be used or disclosed for payment and administrative purposes.
I want to explain that difference without making insurance sound dangerous or private pay sound magically invisible.
THE DIFFERENCE ISN’T “PRIVATE” VS. “NOT PRIVATE”
When insurance pays
When insurance is billed for psychotherapy, information necessary to process the claim is shared through the applicable administrative and insurance systems.
That generally includes identifying information, dates and types of services, charges, and diagnostic information used for billing and medical-necessity purposes.
That does not mean your insurer automatically receives a transcript of what you said in therapy.
Other disclosures or record requests can occur in particular circumstances and are handled according to applicable law, authorization requirements, contracts, and professional obligations.
When you pay privately
When a session is paid privately and is not submitted to insurance for payment, an insurance claim for that session is generally not part of the payment process.
That can mean less information needs to be disclosed to an insurer for payment purposes.
It does not mean there is no clinical record, no diagnosis when clinically required, or no limits to confidentiality.
The same professional, ethical, documentation, and legal responsibilities continue to apply.
WHAT CONFIDENTIALITY DOES MEAN
I treat what you share in therapy as confidential and handle your information according to the privacy, professional, ethical, and legal requirements that apply to my work.
Confidentiality, though, has limits.
There are circumstances in which information may need to be disclosed without your ordinary authorization—for example, when disclosure is required or permitted by applicable law in connection with certain safety concerns, abuse or neglect reporting obligations, court or legal processes, or other legally recognized circumstances.
I don't want “confidential” to function as a vague promise. I want you to understand what it means.
We will review the applicable privacy practices and limits of confidentiality as part of beginning therapy.
When you seek OON reimbursement
If you use out-of-network benefits, information must generally accompany the reimbursement request so your insurer can evaluate it.
That may include identifying information, service dates, procedure codes, charges, provider information, and diagnostic information.
Seeking reimbursement therefore involves sharing information with your insurer even though the session was not billed as an in-network service.
Exactly what is required depends on the insurer and plan.
The question I want you to be able to ask is:
“Who needs this information, why do they need it, and what happens if I choose a different payment pathway?”
That is a much more useful question than simply asking which option is “more private.”
Your story is bigger than a billing code.
When insurance is involved, diagnostic and service information may be necessary for payment.
That information has an administrative purpose.
It is not the whole story of who you are.
A diagnosis can help organize treatment, communicate clinical information, and meet payment requirements when applicable. I don't believe it should become shorthand for your identity, your worth, or the full context of how you arrived here.
Tau and Headway have privacy responsibilities too.
Because Tau Mental Health and Headway participate in the administrative side of care, information handled through those systems is also subject to the privacy practices, terms, authorizations, and legal requirements applicable to those organizations and services.
Before using either pathway, you should receive or have access to the relevant privacy information for that arrangement.
AAC's privacy practices do not replace Tau's or Headway's own privacy notices where those organizations are involved.
You now know more about where care is administered, how payment can work, and what those choices can mean for information connected to your care.
The next question is wonderfully concrete:
What might this actually cost?
Let’s talk about the numbers ↓
LET’S TALK ABOUT THE NUMBERS
Money is part of therapy whether we like talking about it or not.
I would rather be clear about it.
If I control the fee, I want you to know the fee.
If an insurance company determines part of what you owe, I want you to know what questions to ask and where the uncertainty actually lives.
You should not have to guess which parts of the cost are known and which depend on your benefits.
Let’s make the numbers clear.
WHEN THE FEE IS SET DIRECTLY
Published private-pay fees
Initial Intake — $250
45-minute session — $175
60-minute session — $200
These are the current AAC direct-pay rates I use as the baseline when I am setting the fee directly.
If a Tau or Authentic Arch Counseling @ Headway arrangement uses a different rate structure, I will make that clear before you schedule.
The important thing is that the fee should be known before the service—not discovered afterward.
When insurance is involved
I cannot quote your final insurance cost just from knowing the name of your insurance company.
Your responsibility may depend on:
whether the pathway is in-network for your exact plan
your deductible
whether that deductible has been met
your copay
your coinsurance
the plan's allowed amount
authorization or benefit rules that apply to your coverage
Two people with the same insurance company can still owe different amounts.
WHEN YOU’RE USING OUT-OF-NETWORK BENEFITS
Out-of-network reimbursement works differently from in-network billing.
You may be responsible for paying the session cost first and then requesting reimbursement from your insurer using the appropriate documentation.
Your plan decides:
whether you have OON behavioral-health benefits
whether an OON deductible applies
what the plan considers the allowable amount
what percentage of that amount it reimburses
whether the service and documentation meet its requirements
Your reimbursement may therefore be less than the amount you paid—and it may be zero if your plan does not cover the service.
Suppose a session fee is $200.
That does not mean an insurer reimbursing “60% out of network” will automatically send you $120.
The insurer may first apply an OON deductible and may calculate reimbursement using its own allowed amount rather than the amount you actually paid.
That is why I would rather help you understand the structure than promise you a reimbursement amount I do not control.
Before you rely on an insurance estimate
Ask the plan or administrative pathway to verify the benefits that apply to your specific coverage.
If possible, confirm:
whether the provider/pathway is in-network
what your deductible is
how much of it remains
your copay or coinsurance
whether authorization is required
whether you have OON benefits
your OON deductible and reimbursement rules
Write down the date, what you were told, and any reference number they provide.
WHEN YOU’RE NOT USING INSURANCE
If you are uninsured or choose not to use insurance for your care, federal law may give you the right to receive a Good Faith Estimate of the expected charges for scheduled services.
A Good Faith Estimate is not a promise about exactly how long therapy will last.
It is intended to help you understand the expected cost of care based on what is reasonably known at the time.
If the expected course or frequency of care changes, the estimate may need to change too.
My goal is not to promise that every insurance calculation will be predictable.
My goal is to make sure you understand:
what I know, what the platform knows, what your insurer controls, and what still needs to be verified.
That is what financial transparency looks like to me.
You now have the pieces separately:
pathway
payment
privacy
cost
Next, I want to put them together in one place so you can actually compare your options without scrolling back through the whole page.
Let’s compare everything side by side ↓
PUTTING THE PIECES TOGETHER
Here’s how your options compare.
You don't need to remember everything we just covered.
This section brings the main differences together so you can see where Tau Mental Health and Authentic Arch Counseling @ Headway overlap—and where they may work differently.
Think of this as a decision aid, not a promise that every plan or circumstance works exactly the same way.
SIDE BY SIDE
Tau Mental Health
Authentic Arch Counseling @ Headway
Administrative pathway
Administrative and billing functions handled through Tau's systems and processes.
Administrative and billing functions handled through Headway's systems and processes.
Payment arrangements
Insurance, private-pay, and applicable OON-related arrangements available through Tau, depending on your circumstances.
Eligible insurance and private-pay arrangements through Headway; applicable documentation may support OON reimbursement requests where appropriate.
Insurance
Depends on Tau's available arrangements and your specific plan.
Depends on Headway participation and your specific plan.
Private pay
May be available depending on the Tau arrangement.
May be available through Headway when appropriate.
Out-of-network-related documentation
Applicable OON processes or documentation may be available through Tau, depending on the arrangement.
Headway does not process OON benefits directly. Private-pay documentation may be available for a reimbursement request where appropriate.
Billing
Handled through Tau's administrative systems.
Handled through Headway's administrative systems.
Therapist
Philip A. Bower, LICSW
Philip A. Bower, LICSW
Clinical approach
AAC's same identity-affirming, trauma-informed, non-pathologizing clinical approach.
AAC's same identity-affirming, trauma-informed, non-pathologizing clinical approach.
What you may owe
Depends on the payment arrangement, applicable rate, and insurance benefits when used.
Depends on private-pay rate or insurance benefits and cost-sharing when insurance is used.
When this pathway may make sense
When Tau's coverage, billing, payment, or administrative arrangements align best with your situation.
When Headway's eligible insurance or private-pay arrangements align best with your situation.
This comparison is a guide, not a guarantee of eligibility, coverage, reimbursement, or final cost.
Insurance plans, platform arrangements, and individual benefits can change. Before beginning, we will confirm the practical details that apply to your care.
WHAT DOESN’T FIT IN A TABLE
A comparison can help with logistics.
It cannot tell you which option will feel most manageable financially, which insurance tradeoffs matter most to you, or whether you would rather keep a particular session outside insurance.
Those are personal decisions, not columns I can fill in for you.
What I can do is help you understand the practical differences without pushing you toward the option that is easiest for the practice.
And if you are looking at all of this and thinking:
“I still don't know which one I need.”
That's okay.
You do not need to arrive at Session Requests having solved your insurance and payment structure on your own.
You don’t have to figure this out alone ↓
YOU DON’T HAVE TO SOLVE THIS BEFORE YOU REACH OUT
You don’t have to figure this out alone.
If you know which pathway makes sense, great.
If you know you want to use insurance but aren't sure where, that's okay too.
If you're considering private pay or out-of-network benefits and still have questions, we can talk through that.
And if all you know is “I think I want to work with Philip, but I have no idea how the administrative side should work,” that is enough to begin.
You do not need to become your own billing department before asking for therapy.
WHAT HAPPENS NEXT
Tell me what you know.
You can tell me whether you're hoping to use insurance, pay privately, or simply need help understanding the options.
We look at the practical fit.
We'll consider the pathway, payment arrangement, insurance questions, and scheduling factors that apply to your situation.
You decide whether to continue.
Once you understand the practical side, you can decide whether working together feels like the right next step.
Still have practical questions first?
The FAQ covers common questions about therapy, scheduling, payment, and getting started.
Paying privately or not using insurance?
You can also review the Good Faith Estimate information before reaching out.
You do not need to choose a pathway simply because it is the one I mention first.
You do not need to use insurance simply because you have it.
You do not need to pay privately simply because you value privacy.
And you do not need to understand every billing term before you contact me.
What matters is that you understand enough to make a choice that fits your circumstances.
The practical side should support the therapy—not become another thing you have to survive.
Philip A. Bower, LICSW
Authentic Arch Counseling
Virtual psychotherapy for adults in Massachusetts, Maine & Washington