Off Script, unfiltered.
Essays and observations from working clinicians. Mental health, broader than a diagnosis.
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Jump to what you came for, instead of scrolling. 12 topics, each linking to every essay tagged with it.
Children, Sports, and the Developing Mind
Think about the last time a kid came home from practice and something was just different. Quieter. More settled. Not because sports fix everything.
Sep 25, 2025
Single Case Agreements (SCA): How to Get Out-of-Network Coverage at In-Network Rates
Here is the situation almost nobody tells you about. You finally find a psychiatrist or a therapist who actually fits, who actually has openings, who actually understands what…
Aug 27, 2025
Why So Many People Are Rethinking Their Careers Right Now
Most people do not decide all at once that their work no longer fits. It usually starts smaller than that.
Aug 25, 2025
ACA Marketplace Plans: Picking One for Mental Health Coverage
If you’re self-employed, between jobs, contracting, running a small business, or stuck with an employer plan that costs more than your rent, the ACA marketplace is where you…
Aug 24, 2025
ICD-10 Coding for Psych: The Crash Course Nobody Gave You
Here is something nobody told you in grad school, residency, or your post-grad fellowship: the diagnostic codes you slap on a claim are not a clinical…
Aug 21, 2025
Documenting Medical Necessity in Psych Notes
What "medical necessity" actually means, legally Medical necessity is not a vibe, it is a legal standard, and the people who decide whether you met it are…
Aug 19, 2025
ERISA vs State-Regulated Plans (Why It Matters When You Appeal)
If you have ever fought a health insurance denial for a psychiatric medication, an inpatient stay, or a residential program, you have probably noticed…
Aug 16, 2025
Beating Prior Authorization Denials in Psych (The Clinician’s Survival Guide)
Why prior auth exists, and why your psych patients get hit twice as hard Prior authorization (PA) is the process where, before an insurance company will…
Aug 13, 2025
Medicare for Patients Under 65 (SSDI Disability + Mental Health Coverage)
Medicare is not just a senior thing, and that surprises a lot of guys Most people grow up thinking Medicare is the program your grandfather is on. You…
Aug 11, 2025
HDHPs, HSAs, and Mental Health Coverage
What an HDHP actually is, in plain English Every fall during open enrollment your HR portal lights up with a plan called something like "Choice HSA 3000"…
Aug 8, 2025
Getting On Insurance Panels: The Credentialing Game
If you’re a licensed clinician and you’ve been circling the question of whether to get on insurance panels, you’ve probably gotten a lot of advice that’s either cheerleading…
Aug 6, 2025
Medicaid for Mental Health Care in Oregon and Washington
If you’re an adult in Oregon or Washington and you’re scraping by, there’s a real chance Medicaid covers you, and a real chance it covers more of your…
Aug 3, 2025