Therapist didn't inform no longer taking insurance

[Anonymous]

I saw a therapist in the fall for a few months and stopped, and they let me know I could come back at any point for a follow up appointment on an as needed basis.

I made two appointments for this week as many things have been happening.

After the second appointment, they told me they're no longer taking insurance and explained how we could proceed in the future, although I'd only planned on these two appointments for now. Not taking insurance means paying out of my deductible at four times the cost of my co pay.

I was shocked that they clearly knew this and yet waited til the end of my second appt to tell me. Therapist said we could find some middle ground and mentioned a figure which was about three times my co pay cost for this visit and the earlier visit this week- for which I had already paid the co pay and thought we were in the clear.

What do you make of this situation? What am I responsible for? Am I right in being upset that therapist did not tell me before the visit, as they clearly knew bc they said it at the end? I am very frustrated.

[Anonymous]

it's your job to make sure your insurance is accepted. find middle ground and find another therapist.

[Anonymous]

You should not be charged full price for the sessions you had if they did not inform you of the insurance change. That sounds shady.

I would be fine with them telling you after the 2 sessions if you just went back for a 2 session tune up because you are not in dire straits and you now have warning that the next time you need a booster, it will cost much more. I think it would be obnoxious to tell someone in crisis, your next session will cost you 3x as much. There should be a warning of IMO a few weeks in advance so you have time to call around and find someone else you can afford without having to stop treatment.

[Anonymous]

Anonymous wrote:it's your job to make sure your insurance is accepted. find middle ground and find another therapist.

This. You need to check, especially after the start of a new year.

[Anonymous]

You should not be charged full price for the sessions you had if they did not inform you of the insurance change. That sounds shady.

I would be fine with them telling you after the 2 sessions if you just went back for a 2 session tune up because you are not in dire straits and you now have warning that the next time you need a booster, it will cost much more. I think it would be obnoxious to tell someone in crisis, your next session will cost you 3x as much. There should be a warning of IMO a few weeks in advance so you have time to call around and find someone else you can afford without having to stop treatment.

+1

[Anonymous]

Just posted, but may not have made myself clear. They should only charge you the co-pay if they were not upfront about costs BEFORE the sessions.

[Anonymous]

Anonymous wrote: Just posted, but may not have made myself clear. They should only charge you the co-pay if they were not upfront about costs BEFORE the sessions.

+1

[Anonymous]

I think the therapist should swallow the whole fee (minus the old copy amount) for these two sessions. They accepted your insurance a few months ago, so it's reasonable to assume they still do if you didn't change your insurance plan in December. If they change their billing practices, it's their responsibility to inform you ahead of time.

[Anonymous]

Do you have a behavioral health benefits through your employer? I am not talking about the behavioral/mental health part of your health insurance. A lot of employers extend a few sessions (5 or so) to certain therapists at no charge to the employee. I'm drawing a blank on the "name" of the benefit/program.

At my employer, anyone in my family is covered under it. Not just who is on my policy. When I was getting a counselor for my son, they offered to set the date the "effective date" for any visits we had prior to my request.

Good luck.

[Anonymous]

Anonymous wrote:I think the therapist should swallow the whole fee (minus the old copy amount) for these two sessions. They accepted your insurance a few months ago, so it's reasonable to assume they still do if you didn't change your insurance plan in December. If they change their billing practices, it's their responsibility to inform you ahead of time.

+1 (and I'm a therapist)

[Anonymous]

If they accepted the co-pay after the first visit, then this was their mistake. They didn't know they no longer took your insurance either until the 2nd appointment at which point they figured it out and then tried to pass the buck.

By accepting the co-pay, it implied that they took your insurance. They run that office. They know good and well what insurance companies they accept and when you went to pay the FIRST time was when they should have discovered that your insurance is no longer one they accept.

[Anonymous]

What is the person's licensure in? Social work? Counseling? Psychology? Every organization has a code of ethics and fees are included. Here is a link to the APA's code.http://www.apa.org/ethics/code/. I think your situation falls under "misrepresentation of fees." I would call and explain to your therapist that you would not have come if they had informed you in advance of the new fees. I would then ask them to honor the old agreement of just co-pay for the sessions you had. If they don't comply, I'd call the APA and find out what your rights are as a patient. If it violates the ethical code maybe a rep could call and explain the expectations and potential consequences of charging a new fee without prior notice.

[Anonymous]

OP here. It gets better! Therapist just emailed me and said that they will stop accepting it next month. So they had been trying to find this "middle ground" today and charge me more when they were still accepting it. They apologized. I will be finding a new therapist for the future.

Thanks all!

[Anonymous]

Glad it worked out well for you, OP.

[Anonymous]

Anonymous wrote:Glad it worked out well for you, OP.

This.