As a healthcare provider of mental health services, I have decided to no longer accept insurance. Even though billing is easy with online methods, I found that payment was often delayed. With PPO’s, the rate reimbursed often changed month by month making more paperwork and extra billing for me. I was unable to charge a stable co-payment. I had to often re-bill clients for what was missing or what changed. I had to spend time explaining to the client that their insurance could randomly change the amount they pay, and that the client or I do not say. This random changing happens a lot. As well, clients had a hard time understanding that even though the insurance plan said that they cover, for example, 50% of cost that did not mean 50% of what I billed. It was 50% of what they deem reasonable. What most HMO’s and PPO’s find reasonable is 60% less than my fee. It is the same rate they deemed reasonable in 1990. That means that mental health providers should not have gotten a raise in 18 years. With PPO, I naturally can collect the rest of the outstanding bill from the client. But the client often has to be responsible for 75% of the cost. If I were to be on any HMO’s I would have to accept the fact that my work is so devalued, I would not be granted a raise ever. The best thing I have ever done for myself professionally was to decide not to take insurances. Now, I just give people a receipt and they can deal with the insurance company. Sure, I have fewer clients but I now get what I ask for in reimbursement and feel better about myself. I no longer feel devalued and abused by the system.
Sincerely,
ESC