How is it ok that no therapists take insurance?

[Anonymous]

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

They could increase the pay rate but cap the number of sessions. I would rather get 10 sessions with a quality therapist than get nothing because I can’t afford to pay out of pocket.

[Anonymous]

It is outrageous. Do consider a deep dive into what 'reasonable and customary' charges are for both you and your spouse's insurances. I thought I had good insurance until I realized that my plan only paid about $40 for a $200 session (and only counted $40 each time toward the 2000-dollar deductible!) GEHA standard (a Fed plan) is supposed to be better, as it considers up to $220 reasonable for out of network... but with the UHC hack, we haven't gotten any reimbursements yet, so we'll see!

[Anonymous]

Anonymous wrote:It is outrageous. Do consider a deep dive into what 'reasonable and customary' charges are for both you and your spouse's insurances. I thought I had good insurance until I realized that my plan only paid about $40 for a $200 session (and only counted $40 each time toward the 2000-dollar deductible!) GEHA standard (a Fed plan) is supposed to be better, as it considers up to $220 reasonable for out of network... but with the UHC hack, we haven't gotten any reimbursements yet, so we'll see!

+1

This speaks to the lack of consumer protections in health insurance. They will never tell you ahead of time what the insurance will reimburse for specific services. You have to sign up for the plan, pay for the out of network service up front, submit a claim, and THEN they will tell you how much they will reimburse for that specific service. I've tried calling and giving them codes and they say nope, can't tell you. It's clear that they could tell you, but do not want to and know they do not have to. And it's specific to your employer/plan. I see people listing what they get back from their plan on DCUM, we have the same carrier and we get a different amount for similar services. There should be a law requiring that they publish schedules listing their allowable benefits/reasonable and customary charges for out of network benefits.

[Anonymous]

Anonymous wrote:

Anonymous wrote:It is outrageous. Do consider a deep dive into what 'reasonable and customary' charges are for both you and your spouse's insurances. I thought I had good insurance until I realized that my plan only paid about $40 for a $200 session (and only counted $40 each time toward the 2000-dollar deductible!) GEHA standard (a Fed plan) is supposed to be better, as it considers up to $220 reasonable for out of network... but with the UHC hack, we haven't gotten any reimbursements yet, so we'll see!

+1

This speaks to the lack of consumer protections in health insurance. They will never tell you ahead of time what the insurance will reimburse for specific services. You have to sign up for the plan, pay for the out of network service up front, submit a claim, and THEN they will tell you how much they will reimburse for that specific service. I've tried calling and giving them codes and they say nope, can't tell you. It's clear that they could tell you, but do not want to and know they do not have to. And it's specific to your employer/plan. I see people listing what they get back from their plan on DCUM, we have the same carrier and we get a different amount for similar services. There should be a law requiring that they publish schedules listing their allowable benefits/reasonable and customary charges for out of network benefits.

Providers have this problem with insurance companies too. You have to sign up with a company, which can be months of paperwork and phone calls, before they’ll tell you anything about payment. So you’re expected to sign up, do an intake assessment, bill insurance, and then be stuck with whatever incredibly low reimbursement rates they deem appropriate. Problem is reimbursement can take a month or more, and assessment rates are probably much higher than you’ll get for regular services. So now you’ve spent a couple months working with a client before you realize you’re extremely underpaid. You’re placed in an ethical dilemma of do I drop this client because the pay is too low? It’s too much hassle for small providers and another reason many don’t accept insurance.

[Anonymous]

Anonymous wrote: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.

Then organize and vote. Pressure your elected representatives on this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It is outrageous. Do consider a deep dive into what 'reasonable and customary' charges are for both you and your spouse's insurances. I thought I had good insurance until I realized that my plan only paid about $40 for a $200 session (and only counted $40 each time toward the 2000-dollar deductible!) GEHA standard (a Fed plan) is supposed to be better, as it considers up to $220 reasonable for out of network... but with the UHC hack, we haven't gotten any reimbursements yet, so we'll see!

+1

This speaks to the lack of consumer protections in health insurance. They will never tell you ahead of time what the insurance will reimburse for specific services. You have to sign up for the plan, pay for the out of network service up front, submit a claim, and THEN they will tell you how much they will reimburse for that specific service. I've tried calling and giving them codes and they say nope, can't tell you. It's clear that they could tell you, but do not want to and know they do not have to. And it's specific to your employer/plan. I see people listing what they get back from their plan on DCUM, we have the same carrier and we get a different amount for similar services. There should be a law requiring that they publish schedules listing their allowable benefits/reasonable and customary charges for out of network benefits.

Providers have this problem with insurance companies too. You have to sign up with a company, which can be months of paperwork and phone calls, before they’ll tell you anything about payment. So you’re expected to sign up, do an intake assessment, bill insurance, and then be stuck with whatever incredibly low reimbursement rates they deem appropriate. Problem is reimbursement can take a month or more, and assessment rates are probably much higher than you’ll get for regular services. So now you’ve spent a couple months working with a client before you realize you’re extremely underpaid. You’re placed in an ethical dilemma of do I drop this client because the pay is too low? It’s too much hassle for small providers and another reason many don’t accept insurance.

I totally hear you. A good friend of mine is a physician and she has said the insurance companies do the same things to them. Their reimbursement rates for physicians make it worth it, but they have to hire people to deal with the massive bureaucratic hassle of getting claims paid out.