Behavioral Health Insurance: A Q&A with Bruce Goldberg

We want your energy focused on healing, not decoding benefits, so we sat down with our co-owner, Bruce Goldberg, to answer questions we all have about insurance.

How would you describe our role in helping clients understand and use their insurance?

Bruce Goldberg: We’ve always been insurance-friendly. If you have coverage, you should be able to use it. Our team verifies benefits up front and explains, in plain language, what’s covered and what isn’t. Benefits can change, so we encourage people to know about their plans. Because we’re in-network with almost all major insurers, if your plan covers the service, we can usually accept it.

What are the most common challenges people run into?

Bruce: Deductibles and co-pays. Over the last decade, many plans have shifted to higher deductibles. Folks sometimes expect “insurance covers everything,” then discover out-of-pocket costs. Employers also change plans from year to year—clients aren’t always aware. We walk through expected costs before care starts, so there are no surprises.

How do we help someone determine if their plan covers IOP or PHP?

Bruce: We handle the benefits check. Since mental health parity, commercial plans generally align behavioral health coverage with medical coverage. There usually aren’t hard caps like there used to be—medical necessity guides approval.

• IOP (Intensive Outpatient Program) for Mental Health or SUD: Often doesn’t require prior authorization if medically necessary.
  
• PHP (Partial Hospitalization Program): Usually requires authorization. We obtain that and keep you updated. If an insurer initially approves a shorter span (5–6 days), we submit clinical updates to extend when appropriate.

What misconceptions do people have about behavioral health coverage?

Bruce: People often assume limits are more restrictive than they are—or they worry about being fully honest because they think nothing will be covered. In reality, insurers need a clear clinical picture. A diagnosis isn’t a label; it’s how insurance knows what it’s paying for. Sharing what you’re experiencing—depression, anxiety, trauma, coping needs—helps us document medical necessity and match the right level of care.

How do we get approvals quickly?

Bruce: We have staff dedicated to authorizations, especially for PHP. We aim to secure approvals within 24 hours whenever possible, and we communicate decisions clearly. If more days are clinically needed, we update the insurer promptly.

Anything else we do to help clients get the most from their benefits?

Bruce: We view insurers as partners, not adversaries, and we’re in-network with almost all major plans. If you want to call your plan directly, great—we’ll coordinate. The goal is simple: get you the care you need with as little friction as possible.

You’ve been in this field for nearly 30 years. How has coverage changed?

Bruce: It used to feel like “us vs. them.” Over the last 10–15 years, it’s become a partnership. Insurers recognize the value of outpatient mental health—it helps people earlier and often prevents higher-level care. We meet regularly with Michigan plans to share feedback and solve problems together.

Do those relationships actually speed up care?

Bruce: Yes. Insurance can be complex, and knowing the right contacts shortens the path to answers. Hiccups are less common now, but when they happen, those connections help resolve things quickly.

Can you share a time when that made a real difference?

Bruce: We coordinated an out-of-state placement for someone who needed a higher level of care that was not available in Michigan. We worked with the insurer on a single-case agreement and had travel arranged in about four hours. Knowing the process—and the people—made it possible.

If someone has just been told to look for PHP, what should they do first?

Bruce: Reach out. We’ll verify your insurance, do a quick clinical assessment, and help you start at the right level of care—often the same week.

Start Your Clinical Assessment → https://www.riversbendpc.com/lets-get-started/

This Q&A is general information and not a substitute for personalized benefits verification or clinical advice. Coverage varies by plan and medical necessity.