How is it ok that no therapists take insurance?
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Anonymous
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Even when insurance pays decently they still create too much red tape. Here’s an example: I once put in my therapy notes that I updated x on an assessment. Thing is updating an assessment takes maybe 1-2 minutes out of 3 hours where I’m doing many other things. It’s literally cross-checking a goal and coloring in a small square on a grid to track progress. This helps keep me on point with ever changing goals and also allows me to show the parent at any time how much progress has been made since the last assessment. It’s essentially a step above “best practice” which is to update every 6 months.
Because I wrote the word “assessment” on several notes on different days they later determined they wanted reimbursement for those entire days of work, that they had already paid me for. So they punished me for doing my job “extra well” and made me pay them back for all of my time (instead of just the maybe 15 minutes total I actually spent on that assessment). I was out about 10k plus had to do more paperwork because I said 1 word they didn’t like. The lady was very rude about it too, saying I’ve never seen anyone do an assessment for that long. Like she actually thought ALL I was doing was assessing a child for 2 months? I tried to explain but clearly she’d never done my job before because she didn’t understand a word I was saying. I stopped taking insurance after that. I don’t want to do my job to the highest standards and be punished for it. |
Anonymous
| 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? |
Anonymous
Do - you sound like you work for an insurance company and are trying to justify putting people through the wringer. |
Anonymous
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. |
Anonymous
Sorry that should have said DP above. I am not the poster you were responding to. I am also a SN mom and dealing with insurance, wait-lists, providers, assessments and services and based on what that poster wrote you sound incredibly unreasonable.and unkind.to a provider who lost out on thousands due to paperwork issues. |
Anonymous
I know what an assessment is thanks, I have done them for 20+ years. I didn’t spend 60 hours doing an assessment, it was 15-maybe 30-minutes of about 60 hours across several months. Any notes that contained the word “assessment” insurance demanded I pay back. It didn’t matter to them that 59 1/2 hours were spent doing other things that were also clearly documented. So yes it did come down to just the word “assessment”. Anyone with any sense knows it’s impossible to spend 60 hours on that single assessment. Plus I’m seeing this child 25-30 hours a week and they’re a quick learner, so it’s also ridiculous to assume an assessment only needs updated once every 6 months. That’s like 700 service hours before I would be “authorized” to assess- how am I supposed to know if a child’s learning anything or create new goals if I don’t regularly evaluate progress? So I do my job and then you punish me because rate of learning exceeded the standard rate of assessment? Say what?! Also, why is there even a standard rate of assessment? Why isn’t assessment time just determined yearly and able to be billed in 15 minute increments? Why does it matter if I split 3 hours of assessment time across 6 months or do it all at once? Why choose the latter when it’s not even best practice for some children? The system shouldn’t punish someone for going above and beyond their expectation, but more importantly insurance expectations shouldn’t be so low to begin with that my standard practice is “too good” for the system. They should start by hiring people that understand the job skills when determining service hours and reviewing claims. Doing it their current way creates a system that highly qualified providers just don’t want to deal with and lowers the standards for good providers. Sorry for the rant but I hope someone from insurance is reading this because they need to understand some of these problems. |
Anonymous
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During the beginnings of the insurance mandate I spent 25 hours writing one report. They paid me for 2 hours. I was lenient because it was the first report, there was no template, there was a lot on the line, etc. The problem is expectations were so high and they wanted so many pointless details, and wanted it formatted in a way that just wasn’t conducive to the way we practice in the field that additional progress reports still took 10 hours.
I’m not spending 10 hours on a report when you’re only paying me for 2. There are report formats I can complete in 2 hours, that actually give more information in an easier to read way, why not give me leeway on that first ever report to do it in a way that makes sense? I even asked for the ability to change it before it became a “thing” to make it better, and they said no. Why? It made me very frustrated that parents had fought to get these services for their children and I’m handed a list to follow that’s so obscure I don’t think they actually thought I’d be able to accommodate what they were asking for. It felt like they wanted to make it difficult just so people wouldn’t be able to utilize it. I have no idea if they still format them that way, I never accepted another insurance client from that company after that. |
Anonymous
Another professional in the field-you’re off base here. I completely understand what that pp was saying. |
Anonymous
| I managed a pediatric center that had physical, cognitive, and mental health rehab services. If I agreed to certain insurance contracts so would be providing free care after 6-8 visits. Our patients were traditionally children who had lifelong differences so 6-8 visits was not going to work for 95-% of the caseload. We decided not to take most insurances. |
Anonymous
NP. Yes, this is the attitude that makes professionals want to accept your insurance to save you money. Well done. |
Anonymous
+1 ding ding ding |
Anonymous
What are you talking about? How is it more of a conflict of interest to have the patient paying you than the insurance company. When insurance company pays, they decide what is "medically necessary". Shouldn't you be doing that, along with the patient? What do you do when the insurance says they won't pay? Also, everyone should feel free to leave negative reviews explaining that the provider does not take insurance. It will help let people know out of the gate that they can't afford to work with a certain provider and save both them and the therapist time. it's really not the flex you think it is. But, anyway, I don't believe that you are a therapist. If you were you would already know what I just said. |
Anonymous
+1 |
Anonymous
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. |
Anonymous
You don’t make sense and understand insurance or copays. |