Boy am I torked!!!

[brittzak]

Boy am I torked!!!

Hart,
KateH1 is right. I was cringing reading your post. Pre-authorization is the patients responsibility. It kills me because only someone in billing knows this. Physicians do not know nor do they care. Their resposibility is for treatment of their pt.. NOW, she was slack in her care. That is a separate issue. Most physicians hire staff to do all their billing and have no idea the ins and outs. All they know is what they make at the end of the month based on monthly reports. The break down for them is not pt by pt. You can report her, but as far as the bill.....I'd see if she would work something out.

[YoungAtHeart]

Boy am I torked!!!

Getting pre-authorization is a patient's responsibility, but if the therapist participates with the insurance company, s/he will not be paid by the insurance company for any unauthorized visits. If they are a participating provider, they are NOT entitled to charge the patient if there is no authorization. Of course, it is a completely different situation if the therapist is out-of-network.

I am a psychotherapist, and I check on a patient's insurance during the initial phone call. I advise them to find out whether they need pre-authorization from their company if I don't know myself. If I know they need preauthorization, I tell them how to get it. With those companies I participate in, I am not allowed to charge the patient because there is no authorization. Usually insurance companies will work with the patient and the therapist--at least that has been my experience.

I have, on occasion, taken phone calls during a session when it is unavoidable. If that occurs, I give the patient that much extra time. They are not paying me to take phone calls. Your description of your therapist's behavior sounds over-the-top and very unprofessional. Every patient deserves their therapist's full attention.

Unfortunately, the rules for mental health treatment are often different than for other types of medical coverage.

I do think that you should try and work something out with the therapist if the insurance company refuses to pay. Good luck, hart!

[myra]

Boy am I torked!!!

Shame, shame on her. Psychotherapists have a pretty strict code of ethics, which sounds like this person has seriously violated. Not all are like that. Very unprofessional.

[hart]

Boy am I torked!!!

Update

Well as I said, I wrote the insurance company to appeal their decision. Then, late yesterday afternoon I got a call from the doctor's billing office that she had agreed to cut my bill in half! On the one hand, I'm still mad at her and I had already appealed the decision and might not have to pay anything. But $400+ is a H*ll of a lot less than $800+ and do you think this indicates a guilty conscience on her part.

So I told the bookkeeper as Dr. X had said she didn't mind waiting a month I would wait to get insurance company's decision and if negative, pay her half.

Should I have taken the offer and said good enuf. Now I hesitate to report her to the board, which she had no knowledge I was going to do, because of her willingness to cut bill?

Advice? Comments? :thanks:

[greeneyes]

Boy am I torked!!!

Give it some time hart. You're still pretty wrapped up in the emotion part. She waited so long, you can too.

[hart]

Boy am I torked!!!

Thanx Greenie that's my inclination. Funny how one can be so furious at one time, ready to do battle then with time and some overtures from that "dastardly doc" , I feel maybe I over-reacted. Can you tell I don't do grudges? LOL