All I will say is I no longer take insurance of any ilk, including Medicare and Medicaid, in my private practice, nor will I provide a receipt that has the information needed for some one to submit an out-of-network claim to their insurance. I have been able to drop my standard fee by 40% as a result of that decision because of the lower administrative cost of doing business. I can also now choose to charge people lower fees based on their ability to pay without having to bill them for a larger fee that hangs over their heads to satisfy regulators and insurance contract agreements. This has relieved people of the fear my estate might come after them for unpaid bills carried on the books when I die.