Boy am I torked!!!

[hart]

I have to get this off my chest and if this post does nothing else but do this, it's worth it!

I changed health insurance about 2 years ago after having one for about 20 years.

Everything was hunky dorey until I had to see a psychologist because I was lapsing into depression I wasn't able to shake.

Okay I see this gal in early October. I give her my health card, she takes a picture, I pay my co-pay, it's $35.

EACH AND EVERY VISIT, SHE TAKES PERSONAL PHONE CALLS DURING MY SESSION!!! I mean, she takes calls from her husband, she takes calls from her daughter (whose 15) and she asks me how to text...DURING MY SESSION.

Funnily enuf, I feel like she is not doing my any good....so after experiencing this three visits, I stop seeing her. Oh, by the way, I don't know if she keeps notes or whatever because as I start talking she asks me questions that she asked before then says, oh right you told me that!

Anyhow. I get this bill saying I paid $35 each time, then they list the $200/visit not paid.

This is typical, ignore the bill until the insurance co. pays it. I get a second one, it says no preauthorization I owe $820!!!

I call my insurance company. They said we always need to preauthorize things. EXCUSE me, I didn't ask for a preauthorization for my med. doctor. I didn't ask for a pre-authorization for my lab tests, why the psychologist, which is on the approved practioners with them.

I'm furious, with myself for not reading the fine print, with my insurance company for not making it clear, with her for not telling me the very first time my insurance company wasn't authorizing this.

I'm going to talk with an Attorney who practiced law in our state before becoming an administrative law judge. But what I want to do is to call that doc and rip her a new one!!! Why the F*ck didn't she tell me my insurance company wasn't paying her bills?

I am 4 days AF. I dont' want to blow it, I may just commit homicide instead!!!:damn::argh:

[Chief]

Boy am I torked!!!

Don't you dare let this blow your AF days, Hart....

They should have told you they didn't have a preauthorization before your first visit. Who is responsible for getting a pre auth?....in my plan, my medical doctor has to get all preauth's.....they even set up the appointment.

Something's not right. Call Ins. co. and tell them none of this was explained. Also, I would tell them about the doctor's behavior during your visits, that's why you left and you're not satisfied with one of their approved practitioners.

I wouldn't pay a dime until I brought this to the attention of someone who will listen.

Stay AF, hon.....

Don

[eustacia]

Boy am I torked!!!

Hart--

Don't blow your good work because of this unfortunate incident. You are not at fault. Please do not take this out on yourself!

Here are a few things that might help.

1. Call your insurance company again. Often clerks give out misleading information. Typically, one can get post-authorization for psychotherapy visits. If the first person you reach will not help you with this, ask to speak with his supervisor.

2. The psychologist should not have been taking non-emergency phone calls while she was in session with you. This was upsetting your work with her and she should have picked up on this and discussed it with you. Clearly, she was not the right therapist for you.

3. If you felt that therapy could help you before you saw this particular doctor, find another one and make it clear how unheard you felt by your previous therapist.

4. Psychotherapists occasionally ask people to repeat things because they are concentrating on a patient's big picture. This is more likely to occur early in therapy when there is a lot of biographical detail being presented for the first time. Of course, this does not leave out the possibility that your psychologist really wasn't listening, in which case you are much better off without her.

5. If paying her bill immediately would represent a financial difficulty, call or write and explain this. It is extremely UNlikely (edit) that she will pressure you for payment. Possibly she'll even forgive the bill if you tell her how unheard you felt and how much you resented her taking phone calls. She probably knows that she crossed a line with the phone calls.

Hope this helps.

:heart: E

Disclosure: Just to let you know that I'm not talking out of my hat, I'm a medical practitioner who takes no insurance whatsoever. Nonetheless, insurance companies typically cover my patients' bills.

[Cynspr]

Boy am I torked!!!

I feel your pain. I am 4 days AF too so I get it.

We had the same type thing happen to us earlier this year. I told my husband he had sleep apnea so he told his doctor. Doctor said he has to go for a sleep test (i guess me saying, he isn't breathing is not a medical diagnosis). So, finally my husband goes for the test and get this... when the bill comes it is over $8,000!!! Yes, $8,000 and no one forewarned us. Yes, shame on us but gimme a break. The freaking dentist tells you that your filling is going to cost $80 before they do any work, the least they can do is warn us.
So, of course he has sleep apnea and, he should - get this - lose 30 lbs and stop sleeping on his back. Wow - thank you geniuses.
I tried to fight it with an insurance broker that my company uses but they told us we are out of luck. You may have a case considering the phone calls, etc. during your visit but I'm not sure. They sure do know how to get us.

Stay strong... let's get way past day 4!!!

Sorry... i took up your rant time with mine but I can commisserate. Insurance sucks and so do many doctors and many doctors' offices.

[greeneyes]

Boy am I torked!!!

hart, you have a 30 day agreement to honor.

Psychology Licensing Board Contact Information & Resources I can't remember the state you are in but this link will start you out. Look at the ethics section, the boundaries section & whatever else. Call the board of examiners and ask if treatment notes are required. Your insurance should have been verified on the spot to confirm your coverage. This more than likely would have resulted in the preauth issue coming up. Be calm and in control and collect your information before you give away YOUR intent. Right? Right!

Oh duh, washington is right there. Let me look. Link took too long for me to load but the phone is (360) 236-4912. Rules and regs are in that link.
Did you have informed consent or contract agreement?
Washington State Examining Board of Psychology

[rubywillow]

Boy am I torked!!!

Yes, hold on to yourself, and be a real bitch about all of it throught the right channels. Tell her, and others, explicitly, why you are displeased with your sessions. You deserve better. If you perservere, which they hope you don't, you will probably win. It's how they play their game.

[KateH1]

Boy am I torked!!!

Hi Hart,
First of all....do not let this give you a reason to blow 4 days AF. Nothing, but nothing is worth drinking over!
Secondly, you are dealing with a couple of different issues, #1 Unprofessional behavior on the part of your psychologist and #2 Your insurance company.

I have a license to sell Health Insurance, though I do not work in the field. But, I can tell you this, it is not your Dr's resposibility to understand your insurance coverage. Nor is it the responsibility of the Dr.'s office to make sure that the insurance company pays. Many Dr's. offices offer insurance billing as a courtesy to their patients, but this is purely a courtesy.

It is up to the patient to make sure that they understand their own policy. That they make certain that any pre-authorizations for specialists, ER visits and the like are taken care of. We are also responsible to ensure that each provider is a "preferred provider". This even includes Lab companies.

I completely empathize with your situation. Many, many people fall into this type of problem all the time. It is frustrating and it can get very expensive.

Here's an idea, before you blow up at your psychologist, explain your dilema and ask her if she will accept payment at a reduced rate since your insurance is refusing to pay. Sometimes they will work with you.

I know this is not what you want to hear. But these are the facts. I hope knowing this will help you to deal with this situation. More, so, I hope that it helps you in the future.

xx Kate

[MauMcL]

Boy am I torked!!!

That's awful. Oddly enough, it sounds like you would not be so pissed off about the $ if you were not so pissed off at her lack of professionalism! They sound intertwined for you.

I agree...Do not let this take you down in terms of your AF attempts. Breathe...It was entirely inappropriate that she was accepting personal calls during your sessions. I wonder if you can go back to her and say you refuse to pay her on that basis, therefore, if she does not rescind the charges you are going to report her to whatever body regulates psychotherapists?

We have to get psychotherapy pre-approved through my husband's plan and it is an excellent one. I think it's pretty standard. I'm amazed nobody told you -- incl. the therapist! In this day and age you have to check and double check....Always write down the name, date, and time of anyone you speak to at your insurance agency.

Good luck. Keep your chin up.

[toughintexas]

Boy am I torked!!!

Hart don't blow it, I totally understand your frustration tho! Some "shrinks" need more shrinking than we do...lol....find one that helps you, she's way outta line. You already have great advice on the ins. deal, just go for it. Breathe, breathe, breathe......lol......

[Tulipe]

Boy am I torked!!!

In my opinion that are eager to milk anyone in need, most of them. Not all, but most. They have to pay the bills too, right?
The one I saw a few weeks ago has a one WEEK cancellation policy. Next time I see her I'm going to tell her either that changes or I find someone else.
Is one week normal?

[hart]

Boy am I torked!!!

Follow up

First of all (((((EVERYONE))) for your understanding. Funnily enuf I did not think of going off the wagon today and do not plan to stop for beer tonite.

Thanx for all the advice. This is what I did. I spoke to two attorneys in my office. One doesn't have a license in WA (both are Administrative Law Judges) and he recommended me see the other ALJ. I don't know her well, so was hesitant, but if you know me at all you know I'm not shy.

She suggested a few things. Contact my insurance co. again and get a written statement they reject this bill. I called them again and got a very nice woman. Mind you, one thing I will say about myself, I don't shoot the messager, I can and do speak with the poor souls who simply answer the phone with respect. This lady actually asked me when I told her I didn't want to go into details, what was the gist of it and gave me some pointers.

I have written a letter to the insurance company. I didn't want to bore those who couldn't care less, but I made it a blog on my profile. As the insurance company has 30 days to respond, I then called the B*TCH er doctor and luckily she didn't answer. I left a message asking her to wait 30 more days as I was appealing the insurance company's position, getting my treating physician's statement I suffer from panic attacks, etc.

I am not going to inform the WA board of her misconduct until after this matter is resolved. I REALLY want that 30 days extension and don't want to rock the boat.

Yes Kate, I know it's my responsiblity to read the fine print. But as (((MauMcL))) correctly pointed out, I am mostly mad that this so and so doc didn't TELL me my insurance was not covering her bill and a few other items I mention in my blog. I've had other docs tell me this and we made out payment plans or I didn't see them. I find it unconscionable this doctor did not do so! And boy am I gonna try and get her sanctioned after this.

Again, thanx for the ears and advice :l

[greeneyes]

Boy am I torked!!!

Sounds like a plan, hart.

Tulipe, anyone can make whatever CA policy they want. Enforcing it is another thing. They can't MAKE you pay for missed or short notice CAs, but they can no longer see you and then you have to start all over. Wonder why they have a one week policy? Usually you hear of 24 (or 48 for something that requires a lengthy duration). I'd ask just out of curiosity.

[rubywillow]

Boy am I torked!!!

This is happening to me similarly with my pain specialist now. I called to schedule my next appt, mostly for refills, and was told my meds wouldn't be filled and I wouldn't be seen till I paid my outstanding balance, which is due b/c THEY screwed up the filing. I was days away from being out of the antidepressants, muscle relaxers, pain meds, etc., I've been taking for 10 years, and they were going to cut me off. The triage nurse who is German and I call Nurse Ratchett, 'Ve are NOT a free clinic!' after all these years of never having a balance. So I made an appointment, after I called her a heartless f*cking b*tch, threatened to call the med boards and report them to local news, then went in a made a scene in their waiting room when they started the crap again. As I pointed out, stopping my meds without care could kill me, and I made sure my family would hold them completely responsible. Finally, I got to talk to my doc, who's a junior partner, and he was appalled, told me he's trying to leave the practice, and to call him at home if there were further problems. I'm working through my ins now, then I'm going to expose them for what they are. If I didn't love my doc, I'd never darken their door again. God bless the poor people who just get trampled.

[greeneyes]

Boy am I torked!!!

It has been my experience, that if a patient's care is to be terminated a written notice is in order and gives the patient 2 weeks for emergency visits only in which time they can make other arrangements. Dont' know if it's written in stone though. Experience as the letter writer, not the patient......:H

[Cinders]

Boy am I torked!!!

Wow.