A few months back, I shared an article, and my comments on Finding a therapist who takes your insurance can be nearly impossible. Here’s why
That article talked a lot about the difficulty many therapists have with making a living wage when insurance claims get rejected and they have to spend as much time going back and forth to get paid, etc. That’s why so many mental healthcare providers either don’t take insurance or are very selective about which ones they will.
Yesterday, I came across a post by Dr. Amy Marschall about insurance clawback.
I work in the legal sector, so I am familiar with clawbacks in legal cases. The basic idea is that you discover that information that the other side in a case shouldn’t have access to was inadvertently sent to them, and you can claw it back – they have to return it and can’t use it in court.
With health insurance, this is not what is happening.
Sometimes, an insurance company will approve a treatment, the provider completes that treatment, the insurance company pays for that treatment, and later they change their minds and take it back. Laws vary by jurisdiction, but I have seen cases where insurance has taken back money that was paid up to five years in the past.
If you worked for someone who paid your salary and then came back a year or two later and said you had to give it back, you wouldn’t work for them any longer. That’s what is happening with these insurance clawbacks. Given everything we know about how difficult insurance companies make it for therapists just to get paid, is it any wonder it’s so difficult to find one in network with your insurance?
The fault here isn’t with the therapists, as Dr. Amy writes:
What can you do about insurance clawbacks? Call your representatives and demand that they hold insurance companies accountable. Pressure them to pass laws prohibiting clawbacks and reversing decisions for services already rendered. Part of making healthcare accessible is ensuring that providers can pay our bills and requiring that the insurance you pay for actually covers the services you need.
It’s almost Election Day in the US. Think carefully about who wants to help make mental healthcare more accessible to everyone in this country and who wants to ensure insurance companies maintain their profits above all else.