How is it ok that no therapists take insurance?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It is terrible. People need to advocate for better insurance coverage for mental health, PT, OT, and speech. The insurance companies are the problem. There should be government involvement and oversight that holds the insuranes accountable and regulates that Americans have insurance coverage for mental health, PT, OT, and speech.

Also, the professionals need to be held accountable. If you are a mental health provider, PT, OT, or speech therapist and do not accept insurance- that is WRONG. Although the licensure says "it is ethical," everyone knows it is WRONG. You are part of the problem. I am a therapist and I have refused to work for the private, for-profit companies for over 20 years. It is also a conflict of interest because the "patient" is your payor source/customer.

People- please advocate for your insurance. Please leave negative reviews for providers who do not accept insurance.

By this standard it is a conflict of interest to take high deductible plans too since the patient is paying OOP part or for all of the year.

You don’t make sense and understand insurance or copays.

I think you don't understand high deductible plans. Until they meet their deductible those patients are paying the full cost of the session. Please feel free to share how that is meaningfully different from a patient paying an out of network provider.

In any case I actually think that if insurance does not reimburse providers enough for them to take
insurance and provide effective care, they should not take insurance. Insurance has to pay if no in network providers exist.

I think the argument that not taking insurance is unethical is ridiculous and you sound like a shill for insurance execs. You want your high salaries and the providers to work for lower than market pay.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It is terrible. People need to advocate for better insurance coverage for mental health, PT, OT, and speech. The insurance companies are the problem. There should be government involvement and oversight that holds the insuranes accountable and regulates that Americans have insurance coverage for mental health, PT, OT, and speech.

Also, the professionals need to be held accountable. If you are a mental health provider, PT, OT, or speech therapist and do not accept insurance- that is WRONG. Although the licensure says "it is ethical," everyone knows it is WRONG. You are part of the problem. I am a therapist and I have refused to work for the private, for-profit companies for over 20 years. It is also a conflict of interest because the "patient" is your payor source/customer.

People- please advocate for your insurance. Please leave negative reviews for providers who do not accept insurance.

That’s just evil.

My favorite PT is cash only. He researches, sees patients, and trains other PTs. He’ll often work 4 days in the office, fly out of state to conduct a three-day training, and then fly back for another full work week. He fixed my child’s brain swelling with gentle manual manipulation. The specific releases were discovered a few months ago. His skills are rare and his time is valuable. I’d much rather pay cash to free up his time to see more patients.

Many therapists “skills are rare” and “time is valuable”
And “services exceptional.” It’s discriminatory to only accept private pay and not allow others the opportunity to access that care through insurance.

If they accept private pay only, they can and do make clinical decisions that are influenced by your money, not necessarily what is best practice clinically or ethically. That’s the conflict of interest piece.

People should be advocating through government and insurance for better insurance coverage.

Exceptional service providers basing clinical & ethical decisions on where their money comes from. When money comes from insurance companies, certain expectations are tied to the money. When expectations tied to receipt of that money interfere with making sound clinical decisions, then ethically a provider has no choice but to stop accepting payment.

This is not discriminatory, it is ethical, and actually recognizing this is part of what makes them exceptional.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It is terrible. People need to advocate for better insurance coverage for mental health, PT, OT, and speech. The insurance companies are the problem. There should be government involvement and oversight that holds the insuranes accountable and regulates that Americans have insurance coverage for mental health, PT, OT, and speech.

Also, the professionals need to be held accountable. If you are a mental health provider, PT, OT, or speech therapist and do not accept insurance- that is WRONG. Although the licensure says "it is ethical," everyone knows it is WRONG. You are part of the problem. I am a therapist and I have refused to work for the private, for-profit companies for over 20 years. It is also a conflict of interest because the "patient" is your payor source/customer.

People- please advocate for your insurance. Please leave negative reviews for providers who do not accept insurance.

That’s just evil.

My favorite PT is cash only. He researches, sees patients, and trains other PTs. He’ll often work 4 days in the office, fly out of state to conduct a three-day training, and then fly back for another full work week. He fixed my child’s brain swelling with gentle manual manipulation. The specific releases were discovered a few months ago. His skills are rare and his time is valuable. I’d much rather pay cash to free up his time to see more patients.

Many therapists “skills are rare” and “time is valuable”
And “services exceptional.” It’s discriminatory to only accept private pay and not allow others the opportunity to access that care through insurance.

If they accept private pay only, they can and do make clinical decisions that are influenced by your money, not necessarily what is best practice clinically or ethically. That’s the conflict of interest piece.

People should be advocating through government and insurance for better insurance coverage.

Exceptional service providers ARE basing clinical & ethical decisions on where their money comes from. When money comes from insurance companies, certain expectations are tied to the money. When expectations tied to receipt of that money interfere with making sound clinical decisions, then ethically a provider has no choice but to stop accepting payment.

This is not discriminatory, it is ethical, and actually recognizing this is part of what makes them exceptional.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It's not 1 word. Assessment is a very different type of service. How is it that you're in this line of business and you don't know it?

Do - you sound like you work for an insurance company and are trying to justify putting people through the wringer.

I've been a SN mom for 2 years now, dealing with insurance, waitlists, providers, assessments and services. This is one of the first things I learned post-diagnosis, since everything needed an assessment to get the services started. And frankly, this is not rocket science. If you're as thorough as you claim you are, it shouldn't have been an issue.

NP. Yes, this is the attitude that makes professionals want to accept your insurance to save you money. Well done.

Let's not be coy here. It's not any individual attitudes that influence the decisions by providers whether to accept insurance or not. It's money - revenue optimization and reimbursement rates. Those who take insurance get lower reimbursement rates but instead they get a steady stream of new patients who pick them and stay with them solely based on the insurance. These practices may be newer, or have less experienced staff with only the required credentials, no extras, there maybe more turnover, or use of part timers as contractors with only hourly pay and no benefits. It's a different business model, not a bad or inferior one, just different. They accept lower per hour payment from insurance but maximize revenue by saving on staff costs. Patients who go there would not have access to services otherwise if these practices didn't take insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It's not 1 word. Assessment is a very different type of service. How is it that you're in this line of business and you don't know it?

Do - you sound like you work for an insurance company and are trying to justify putting people through the wringer.

I've been a SN mom for 2 years now, dealing with insurance, waitlists, providers, assessments and services. This is one of the first things I learned post-diagnosis, since everything needed an assessment to get the services started. And frankly, this is not rocket science. If you're as thorough as you claim you are, it shouldn't have been an issue.

NP. Yes, this is the attitude that makes professionals want to accept your insurance to save you money. Well done.

Let's not be coy here. It's not any individual attitudes that influence the decisions by providers whether to accept insurance or not. It's money - revenue optimization and reimbursement rates. Those who take insurance get lower reimbursement rates but instead they get a steady stream of new patients who pick them and stay with them solely based on the insurance. These practices may be newer, or have less experienced staff with only the required credentials, no extras, there maybe more turnover, or use of part timers as contractors with only hourly pay and no benefits. It's a different business model, not a bad or inferior one, just different. They accept lower per hour payment from insurance but maximize revenue by saving on staff costs. Patients who go there would not have access to services otherwise if these practices didn't take insurance.

Fewer experienced staff, high turnover, less credentials, focus on money. Everything you’re talking about makes it inferior. Virtually existing for people with insurance does not negate the inferiority of the services. It just means that people with insurance are more likely to get inferior services.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It's not 1 word. Assessment is a very different type of service. How is it that you're in this line of business and you don't know it?

Do - you sound like you work for an insurance company and are trying to justify putting people through the wringer.

I've been a SN mom for 2 years now, dealing with insurance, waitlists, providers, assessments and services. This is one of the first things I learned post-diagnosis, since everything needed an assessment to get the services started. And frankly, this is not rocket science. If you're as thorough as you claim you are, it shouldn't have been an issue.

NP. Yes, this is the attitude that makes professionals want to accept your insurance to save you money. Well done.

Let's not be coy here. It's not any individual attitudes that influence the decisions by providers whether to accept insurance or not. It's money - revenue optimization and reimbursement rates. Those who take insurance get lower reimbursement rates but instead they get a steady stream of new patients who pick them and stay with them solely based on the insurance. These practices may be newer, or have less experienced staff with only the required credentials, no extras, there maybe more turnover, or use of part timers as contractors with only hourly pay and no benefits. It's a different business model, not a bad or inferior one, just different. They accept lower per hour payment from insurance but maximize revenue by saving on staff costs. Patients who go there would not have access to services otherwise if these practices didn't take insurance.

Fewer experienced staff, high turnover, less credentials, focus on money. Everything you’re talking about makes it inferior. Virtually existing for people with insurance does not negate the inferiority of the services. It just means that people with insurance are more likely to get inferior services.

It's not a given, but is a possibility. But there are also underserved populations for whom access to any SLP or OT is far better than no services at all.

[Anonymous]

I'll explain simply, as a licensed therapist, how it's okay:

If I were on an insurance board, I would collect a tiny percentage of the pay I earn through the very hard work of providing therapy to high risk clients. And I mean tiny, like the amount I earned as a resident out of grad school 10 years ago. I genuinely could not make a living and support my own family.

Our system is broken. It's not the fault of the therapist.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It is terrible. People need to advocate for better insurance coverage for mental health, PT, OT, and speech. The insurance companies are the problem. There should be government involvement and oversight that holds the insuranes accountable and regulates that Americans have insurance coverage for mental health, PT, OT, and speech.

Also, the professionals need to be held accountable. If you are a mental health provider, PT, OT, or speech therapist and do not accept insurance- that is WRONG. Although the licensure says "it is ethical," everyone knows it is WRONG. You are part of the problem. I am a therapist and I have refused to work for the private, for-profit companies for over 20 years. It is also a conflict of interest because the "patient" is your payor source/customer.

People- please advocate for your insurance. Please leave negative reviews for providers who do not accept insurance.

That’s just evil.

My favorite PT is cash only. He researches, sees patients, and trains other PTs. He’ll often work 4 days in the office, fly out of state to conduct a three-day training, and then fly back for another full work week. He fixed my child’s brain swelling with gentle manual manipulation. The specific releases were discovered a few months ago. His skills are rare and his time is valuable. I’d much rather pay cash to free up his time to see more patients.

Many therapists “skills are rare” and “time is valuable”
And “services exceptional.” It’s discriminatory to only accept private pay and not allow others the opportunity to access that care through insurance.

If they accept private pay only, they can and do make clinical decisions that are influenced by your money, not necessarily what is best practice clinically or ethically. That’s the conflict of interest piece.

People should be advocating through government and insurance for better insurance coverage.

Exceptional service providers basing clinical & ethical decisions on where their money comes from. When money comes from insurance companies, certain expectations are tied to the money. When expectations tied to receipt of that money interfere with making sound clinical decisions, then ethically a provider has no choice but to stop accepting payment.

This is not discriminatory, it is ethical, and actually recognizing this is part of what makes them exceptional.

How many pro bono patients do you see a week? What are you giving back to the low income population? In the name of non discriminatory practices.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It is terrible. People need to advocate for better insurance coverage for mental health, PT, OT, and speech. The insurance companies are the problem. There should be government involvement and oversight that holds the insuranes accountable and regulates that Americans have insurance coverage for mental health, PT, OT, and speech.

Also, the professionals need to be held accountable. If you are a mental health provider, PT, OT, or speech therapist and do not accept insurance- that is WRONG. Although the licensure says "it is ethical," everyone knows it is WRONG. You are part of the problem. I am a therapist and I have refused to work for the private, for-profit companies for over 20 years. It is also a conflict of interest because the "patient" is your payor source/customer.

People- please advocate for your insurance. Please leave negative reviews for providers who do not accept insurance.

That’s just evil.

My favorite PT is cash only. He researches, sees patients, and trains other PTs. He’ll often work 4 days in the office, fly out of state to conduct a three-day training, and then fly back for another full work week. He fixed my child’s brain swelling with gentle manual manipulation. The specific releases were discovered a few months ago. His skills are rare and his time is valuable. I’d much rather pay cash to free up his time to see more patients.

Many therapists “skills are rare” and “time is valuable”
And “services exceptional.” It’s discriminatory to only accept private pay and not allow others the opportunity to access that care through insurance.

If they accept private pay only, they can and do make clinical decisions that are influenced by your money, not necessarily what is best practice clinically or ethically. That’s the conflict of interest piece.

People should be advocating through government and insurance for better insurance coverage.

Exceptional service providers basing clinical & ethical decisions on where their money comes from. When money comes from insurance companies, certain expectations are tied to the money. When expectations tied to receipt of that money interfere with making sound clinical decisions, then ethically a provider has no choice but to stop accepting payment.

This is not discriminatory, it is ethical, and actually recognizing this is part of what makes them exceptional.

How many pro bono patients do you see a week? What are you giving back to the low income population? In the name of non discriminatory practices.

I'm a DP but PP from above that wrote about being a therapist and not taking insurance.

I charge 185/session. I see 20 paying clients and 5 pro bono clients per week. I volunteer at a nonprofit in my area providing free mentoring services. I have given thousands of hours of free or very reduced therapy (some paid $5) in community clinics during my 4.5 years of internships and residency.

I understand how from the outside it seems like private practice therapists are a bunch of selfish jerks. But many of us are working within the confines of a system that will not allow us to pay off years of student loans, our own needs and our kids' needs unless we are out of network.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It is terrible. People need to advocate for better insurance coverage for mental health, PT, OT, and speech. The insurance companies are the problem. There should be government involvement and oversight that holds the insuranes accountable and regulates that Americans have insurance coverage for mental health, PT, OT, and speech.

Also, the professionals need to be held accountable. If you are a mental health provider, PT, OT, or speech therapist and do not accept insurance- that is WRONG. Although the licensure says "it is ethical," everyone knows it is WRONG. You are part of the problem. I am a therapist and I have refused to work for the private, for-profit companies for over 20 years. It is also a conflict of interest because the "patient" is your payor source/customer.

People- please advocate for your insurance. Please leave negative reviews for providers who do not accept insurance.

That’s just evil.

My favorite PT is cash only. He researches, sees patients, and trains other PTs. He’ll often work 4 days in the office, fly out of state to conduct a three-day training, and then fly back for another full work week. He fixed my child’s brain swelling with gentle manual manipulation. The specific releases were discovered a few months ago. His skills are rare and his time is valuable. I’d much rather pay cash to free up his time to see more patients.

Many therapists “skills are rare” and “time is valuable”
And “services exceptional.” It’s discriminatory to only accept private pay and not allow others the opportunity to access that care through insurance.

If they accept private pay only, they can and do make clinical decisions that are influenced by your money, not necessarily what is best practice clinically or ethically. That’s the conflict of interest piece.

People should be advocating through government and insurance for better insurance coverage.

Exceptional service providers basing clinical & ethical decisions on where their money comes from. When money comes from insurance companies, certain expectations are tied to the money. When expectations tied to receipt of that money interfere with making sound clinical decisions, then ethically a provider has no choice but to stop accepting payment.

This is not discriminatory, it is ethical, and actually recognizing this is part of what makes them exceptional.

How many pro bono patients do you see a week? What are you giving back to the low income population? In the name of non discriminatory practices.

I'm a DP but PP from above that wrote about being a therapist and not taking insurance.

I charge 185/session. I see 20 paying clients and 5 pro bono clients per week. I volunteer at a nonprofit in my area providing free mentoring services. I have given thousands of hours of free or very reduced therapy (some paid $5) in community clinics during my 4.5 years of internships and residency.

I understand how from the outside it seems like private practice therapists are a bunch of selfish jerks. But many of us are working within the confines of a system that will not allow us to pay off years of student loans, our own needs and our kids' needs unless we are out of network.

A DP who is a parent of a child that has benefited from a few out of network providers. I am so grateful for your work. I realize we are privileged to be able to access services and would absolutely be willing to pay more in premiums or taxes so more people have access. Our healthcare system is fundamentally broken, especially for therapy, and that's not your fault.

[Anonymous]

I’m a bit stunned at the number of worried well going to therapists regularly in my neighborhood.

[Anonymous]

Anonymous wrote:I’m a bit stunned at the number of worried well going to therapists regularly in my neighborhood.

How do you know your neighbors "worried well?" Did you put them all in an fMRI?

[Anonymous]

It is perfectly reasonable that some therapists don’t take insurance. I mean, we all have free choice when it comes to employment. The rest of us in this country can choose to accept the conditions of a job (in this case it would be in in network provider) or choose a job with different conditions. There is no reason that therapists shouldn’t be free to do the same.

the real problem, as most have recognized, is that insurance carriers make the job they offer so onerous that few are willing to take it. There are some that believe it is a true calling to serve the insured community, whether it be private insurance or public programs. There are some that do it because they could not make it without insurance. And there are some that decide that the amount of work required is not for them. Point is, everyone gets a choice about whom they will work for and therapists should not be held to any different standard.

As to conflict of interest when the patient and payor source are the same, well, that conflict exists no matter who pays. In order to stay in network, a provider may have to toe the line and concur on medical necessity determinations of the carrier even if they don’t agree - As a lawyer who handled such cases, I have horror stories relating to bad outcomes when providers caved. Providers may bend to the will of a parent or patient. But, ultimately, that conflict exists everywhere and it’s our codes of ethics that are designed to keep us in line. There will always be those who do not follow those codes, whether they are a therapist, a lawyer, a doctor or some other professional. But, in the end, most will.

[Anonymous]

It’s not okay. Only rich people can get help and it’s absolutely devastating. I can’t tell you how this is a constant source of stress for me and millions of other people.

[Anonymous]

Maybe insurance companies are tired of paying for endless therapy that doesn’t seem to get anywhere.