POINT OF VIEW

Therapy has insurance troubles

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I have been a psychotherapist for more than 35 years, with offices in the Bronx and Manhattan. During this time, I have found that working with insurance companies is becoming increasingly more difficult — for my patients and myself.

One central area of concern relates to the process of medical credentialing — at least in New York City — which, for health providers, is the process of getting accredited to be “in-network” with insurance companies. It’s also known as “getting on insurance panels.”

These days, it is close to impossible to get on a panel in New York City. When approached, they say that they are full and not taking new clinicians. I don’t quite understand why that is the case, and no one has been able to give me a satisfactory explanation. I don’t understand how that helps the insurance companies, and it certainly doesn’t help clinicians or people who are seeking psychotherapists.

One person who called me said that she had called 20-some clinicians, and no one was taking new clients. Some didn’t even return the call. I used to be on a panel, and somehow they reversed the numbers of my Social Security number. I tried to rectify the problem, but they kept saying I had given them the wrong information, even though I had the paper trail to show that it was their mistake.

And so I was dropped from their network, and my clients were no longer covered.

I was not able to become reinstated. At this point, I only participate in one panel out of loyalty to my patients. If I dropped their insurance, they would not be able to afford treatment. That would not be good.

Over the years, they have been able to work on letting go of very difficult childhood trauma and move toward crafting a better life for themselves.

However, they still need the support that psychotherapy provides, and it would not feel ethical to drop them. It is also surprising and upsetting to me that when I started working with a major insurance company in the early ’80s, the fee for treatment was $75, and the client paid either nothing or $10. Since then, the fee has dropped to $55, yet clients must pay $15 or $20, depending on their plan.

Another troubling development is the fact that I spend more and more hours in phone calls to insurance companies to contest missing claims, lack of coverage, or dispute missing content on claims — none of which is typically accurate, meaning that the claim was properly filed.

With one client, I’ve not received payment from the insurance company in more than six months, and they keep requesting the same information over and over, which they claim they have not received — which I have provided.

It is egregious that mental health (my daughter is a medical doctor, and she complains of similar issues) is becoming a boutique business because people can’t afford to pay their clinicians, and clinicians can’t afford to take insurance.

Even clinics are now charging more and more because they cannot survive on insurance payments, grants and government funding.

I wish I knew what to do to remedy the situation, but I don’t. I have a big “fix it” part, and I am forever outraged and discouraged by this situation, which hurts everyone, except the insurance companies.

The author is a psychotherapist with offices in Riverdale and Manhattan.

Monique Lang

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