The lowly counselling receipt. Or is it?

I warn you, this may just be the most boring article I’ve every written. I’m sorry about that.

It’s just that I’ve been thinking a lot about counselling receipts lately, after having several scenarios arise about their purpose and use. And those who know me, know that I’m detail-focused when it comes to certain aspects of my counselling practice, and I am an unashamed counselling nerd, so when questions arose, it seemed only natural to write about this topic!

The following information may be most relevant to counselling clients who are seeking reimbursement through a workplace extended health plan or are submitting their counselling receipts for income tax purposes. Also, an obvious point: I’m writing this from a Canadian perspective.

Anatomy of a Counselling Receipt

Counselling receipts typically have a few key components:

1. The Client’s Name

The name written on the receipt is the person who received the service.

Why is this important?

Those seeking to claim the counselling service through their insurer, or on their taxes, will need to specify who received the service, therefore the receipt must reflect this.

2. The Service Being Delivered

Typically “counselling,” “clinical counselling,” “counselling session” or “counselling services.” Some counsellors may write “psychology services” or “social work services,” to more specifically reflect their professional designation, particularly if the client is covered for that designation through their workplace health insurance. “Group therapy” if the client is participating in group counselling, may also be written. Some mental health service providers may get a little more granular and delineate if the counselling session is in-person or via phone, video or more generally, “online.”  There are other descriptive possibilities too, such as “report writing” or  if a different service is being provided such as clinical supervision.

Why is this important?

The counsellor can only write a receipt for the service that they have delivered to the client. Also, if the client applies for reimbursement through their extended health plan, if they have one, insurers are specific about which services are covered and which are not. For tax purposes, only certain services are claimable. For example, clinical social work services are claimable, while non-clinical or administrative social work services are not.

3. The Length of the Service

The duration of the appointment.

Why is this important?

Not all counsellors do this, but it is a good idea, particularly if the counsellor offers different session-length options.  Some extended health provides may even require that this be specified in order to be eligible for reimbursement.

4. The Cost of the Service

The counsellor’s rate for the service delivered.

Why is this important?

Particularly, with regard to extended health plans, clients have a maximum amount that is allowable in a calendar year. Some Insurance companies will also have a maximum amount that they are willing to reimburse a service—the term “reasonable and customary fee” is often used.

If the counselling received is also eligible as a medical expense for tax purposes, clients will also need keep track of the money spent on their counselling.

Counsellors will also keep a copy of each receipt, as it is represents a record of their income.

5. The Date

This is the date that the counselling occurred on, not the day that the receipt was issued (if different).

Why is this important?

Clients can only claim for counselling services which have already occurred and cannot submit claims with their insurer for services that have not taken place or not yet taken place. If a client has prepaid for a series of sessions, they would only be able to submit a claim after the completion of each session.

Dates also factor into how many counselling dollars can be claimed for in a year and of course, taxes are filed yearly.

6. The Counsellor’s Contact Information

Counsellor’s name/practice name, address, email address and phone number. This information should be included on the receipt.

Why is this important?

Any third party who receives the receipt may choose to verify that the counsellor and their practice exists (and is not fake). Insurance companies will also use this information to contact counsellors, such as when they are doing “spot checks” to verify that counselling sessions actually happened.

7. The Therapist’s Counselling Credentials

These often look like gobbledegook to the lay person, but are are series of initials which stand for the degree and professional affiliation that the counsellor has. While I’ve already written extensively about this topic, common (but not exhaustive) examples of counselling degrees include:

PhD –  Doctor of Philosophy

MSW – Master of Social Work

MA – Master of Arts

M Ed. – Master of Education

MC – Master of Counselling

And common (but not all) designations in British Columbia:

R.Psych – Registered Psychologist

RSW – Registered Social Worker

RCSW – Registered Clinical Social Worker

RCC – Registered Clinical Counsellor

Why is this important?

Insurance companies only reimburse counselling expenses from counselling service providers that have a professional affiliation (college or association) that is approved by the insurance company; counselling services provided by unregulated counselling professionals would not be eligible. Plans will list which counselling professionals are covered and some extended health plans provide no coverage for counselling whatsoever. For those claiming counselling as a health expense, the Canada Revenue Agency will recognize only counselling provided by authorized medical practitioners: In British Columbia, registered psychologists and registered social workers/registered clinical social workers.

Some insurers may also specify which academic degree the counsellor must possess. For example, social work counselling services may be covered but only if the social worker has a Master’s degree. I personally have actually been asked for copies of my degree by several insurance companies! Some insurers will keep a database of all approved practitioners, requiring the counsellor to apply for this approval.

8. The Counsellors Registration Number (Administered by their Professional College or Association)

Why is this important?

All legitimate registered counselling professionals will have a registration number attached to their name, which—providing it is a legitimately issued number—proves that they are registered with the professional college or association they claim to be affiliated with. The registration number also enables a quick lookup of the therapist on the website of their professional college; such a lookup should also tell you whether the therapist is in good standing with their college or association. This is important because counselling is not regulated in British Columbia!

9. The Counsellor’s Signature 

Authorizes that the service listed on the receipt has been provided. This is more typical with hand-written receipts. Most modern receipts are written with the counsellor’s full name, credentials and registration number, which is typically considered sufficient.

How Are Receipts Issued?

Some counsellors continue to use and issue paper receipts with carbon copies, which contain the above information. Most counsellors have switched to issuing electronic receipts via email, which increase efficiency and provide an easy way for clients to access previous receipts, through a lookup in their inbox. If you do not want to receive emailed receipts, be sure to let your therapist know.

If a client has paid for their counselling online, receipts may or may not be sufficient for reimbursement with an insurance company. If the counsellor has specific healthcare software, such as the Jane App, receipts generated will include all the essential information for reimbursement. However if payment is made through a platform like PayPal, which is not purpose-made for health care, receipts generated by most credit cards or payment services are not sufficient for reimbursement with an insurance company, as it does not include all of the information listed on the receipt issued by the counsellor; be sure to receive an official receipt from your counsellor.

If you lose your receipt and need another one, counsellors may issue another one for the date that the session occurred; this receipt may be marked as a duplicate, particularly if it handwritten.

How Are Receipts Submitted?

After you have paid your counsellor for your session, your counsellor should provide you with an official receipt that you then submit to your insurance company for reimbursement, if you have this option.

Most insurance companies request that clients submit their counselling receipts online, with a quick turnaround for payment. Some extended health insurers will require a pdf of the receipt, others do not. Be sure to check.

Less commonly, clients may choose to submit their claims through the mail. In such a case be sure to submit the actual receipt (if your therapist handwrites them) and not a copy or scanned image, which is generally never accepted by the insurance company.

Some insurance companies also give clients the option to submit their claims in person, if this is preferred.

Fraud and Other Unsavoury Practices

This is a massive topic beyond the scope of this article. In brief, counselling, like any other industry, is not immune to fraud. Fraud can be perpetrated by clients acting alone, therapists acting alone, or the client and counsellor colluding together.

Counselling fraud may include, but is not limited to:

• Claiming/submitting counselling sessions that did not occur
• Changing the type of counselling service provided (for example, individual instead of group therapy)
• Altering the dates on receipts
• Receipts issued or claimed for a false amount
• Receipts issued to persons whom the counsellor has never met or provided counselling for on the date of service

Fraud could result in serious consequences such as:

• Legal action
• Clients being banned from receiving extended health benefits
• Counsellors being blacklisted by insurance companies
• Counsellors being reported to their professional college and association and facing discipline/removal
• Clients’ future claims intensively scrutinized
• Disciplinary action by employers
• Investigation by the Canada Revenue Agency (CRA)

Disclaimer

This article is not meant to replace professional, industry or legal advice and is intended for a general audience. Specific questions should be directed to a professional who is familiar with your situation and/or benefits, such as your human resources department, insurance company/claims administrator or the CRA.

Egads, more than I ever thought I could write about the humble counselling receipt!