Managed Care: A Personal Balancing Act

I find that managed care has only created a way for us as consumers, as well as our deserving practitioners, to feel exploited. I'm sure many of you may agree with me.

I have encountered many clients in great need of counseling who feel they must take the managed care route to pay for their therapy. I fully support this, especially when people pay a virtual second mortgage quarterly to be covered for a myriad of possible medical emergencies that may arise. Provided that the insurance companies do what they are supposed to do (file properly and justly and compensate the practitioner and/or patient as well when out-of-network benefits are utilized), everyone ends up happy, patients are well taken care of, and practitioners feel pride for a job well-done and well-appreciated for their expertise.

From personal experience and hearsay from colleagues as well as clients, sadly, this does not always happen. Many of the insurance companies, who seem to have acquired wells full of our money, beat around the proverbial bush, stall their payments, come up with reasons not to approve a patient who truly needs help, and sometimes never pay the practitioner at all.

This leaves patients without appropriate care, upset, and out of money. This also leaves practitioners devoid of their important clientele, bitter, and out of money.

My solution for this is to find a balance with my patients. I am not on any insurance company panels for the reasons I listed above. The heartache and turmoil it causes for all involved is, I believe, easily handled. I offer 2 very feasible options.

I am an out-of network provider. This means that if you have out-of-network benefits, then you can be reimbursed for a portion of my fees. I offer a detailed receipt including all codes and diagnoses potentially needed to approve your treatment. You may send in a copy of the receipt to the insurance company and receive their prompt reimbursement. I have seen this a very successful and more profitable way, for the patient, to deal with managed care.

One other thing I offer is a sliding scale fee schedule for patients with specific financial needs. Sliding scale fee schedule means that the fee is negotiated so as to get the patient the help they need, cut out the middle man, and help all parties feel appreciated and respected.

Just ask me. I'll get you the help you need.