I have always believed and followed that while I can not change entire systems in my life time, I can make small changes towards the positive in my lifetime. I still feel this away about the infamous overwhelming multifaceted alien system that is Insurance Coverage;)
I strongly believe if one has insurance, I want to try my hardest to utilize this for their services. They are paying for it and it is theirs to be utilized! Ironic moment, I currently can only afford an insurance plan that DOES NOT cover mental health services LOL. Have that chuckle for a moment.
I worked on that side of the game for a few years because I wanted to understand their system and perception of services so I could utilize that knowledge strategically in private practice.
The only large plan I am not contracted with is FL Blue/BCBS and trust me, even after everyone in my field told me to run far far away and never look back, my at times ridiculous belief I can fix this kicked in overdrive. I had a moment where they had a good enrollment year and I had regulars who had changed to that plan.
7 months later, I asked them to remove my application after it sat in credentialing for that long, while I had individuals who had needs and I realized this truly is just business as usual for BCBS. I was a sweet but terrier type with them, trying to move the application forward. I had bit into this process and I am not letting go until I am done. If I am contracted with everyone else, what could you possibly be researching on me LOL. The last answer I received was they were backed up. Every other insurance plan I contracted with took at maximum 60 days. So, in the end my ethics one out, I asked them to remove me from the process and realized, yes all my colleagues were correct.
It broke my heart as FL Blue is very prevalent on the health exchange and many individuals coming out of substance use treatment have this plan.
My close colleague wrote a very interesting and honest blog about insurance, and while I do not yet follow her business practice yet, I truly understand her information to be correct from experience.
With all this being said, I will continue to try my best to continue to be able to serve individuals with insurance plans.
If you have questions about coverage, deductibles and such, I am also quite knowledgeable in that arena.
The biggest difficulty will always be TIME. I have found over the years most individuals prefer 90 minutes and even 2 hrs. at times particularly if we are working through a trauma or very involved situation. I understand the importance of this but insurance does not. They will audit me at times as I can not bill either of those lengths.
They truly want you to see me for 40 mins, let me document visit for 10 mins and that is it unless I am documenting it is "medically necessary". The timeframe has always been interesting to me, we all know that is not enough time and by not provided needed service utilization, they may save money but will then spend it in other areas of utilization on the health side as of course mental health affects physical health. But that is too sane of a thought;)
Back to medically necessary, I will do this when appropriate but lord have mercy it is not a simple task. My clients are my number 1 priority and I will always fight for you. Just know when we have insurance bumps, I will be there to offer every possible solution I can think of after I have had a few cups of coffee;) and probably asked Headway, an amazing billing platform I use that also will play middle man for you and I if there is an insurance blip.
We got this! And sometimes we just have to maneuver our way through a system, instead of possibly becoming anxious, fearful or angry with it. I remind myself often LOL.
"Be awesome is the best revenge"
Just some of my thoughts and experiences throughout my journey that may resonant with others or encourage individuals to look at their own journey from a different perspective. I believe we are all in this together. Open, safe and non-judgemental communication is one of the best healers I have come to know in my life.