Perhaps you should use your health insurance for counseling? Isn’t very that what it is for?
Yet using health insurance for mental wellness services is a little different than other medical issues. Sometimes mental health issues aren’t covered by your health insurance. Once you occurs health insurance for mental health, you will have a mental health diagnosis on document – a mental health disorder/mental health illness must be on the insurance policy claim in order for insurance to pay for treatment. This will be in your permanent medical record.
Of course you want to consider using your health insurance policy for counseling, but there are some good reasons for you to consider why you may not wish to use your insurance for counseling services.
The reason why doesn’t my counselor accept the health insurance?
Many counselors choose not to accept health insurance for very good reasons. They want to focus 100% of their time in treating you. If they accept health insurance, there is a lot of extra work involved in taking insurance, in addition to agreeing to work for a discounted fee. The counselor may spend hours on the phone obtaining benefit information, authorizations, or following up on claims payments. The counselor has to wait a month for transaction from the insurance company. The counselor has to file progress reports with the insurance company. The counselor is required to submit treatment reports and other details about your health background with the insurance company.
It’s not that counselors don’t like insurance companies, or don’t wish you to use your insurance (we have got health insurance too! ), but many advisors prefer to focus 100% of their time plus energy in helping clients, rather than doing paperwork for insurance companies.
But this isn’t the only reason counselors may not be within network with your health insurance company.
The other reasons are more compelling, and you need to consider them BEFORE you decide to use your health insurance.
Many counselors prefer not to operate network with health insurance companies so that they can better protect your confidentiality. Details (claims, reports, or treatment plans) filed with health insurance leaves the particular protection of their office and their own locked files and your personal, private, emotional information is outside of your counselor’s office. In order for any insurance provider to reimburse or pay for counseling (both in network and away from network), you must be considered “ill”. You should be diagnosed with a mental health illness or disorder. If you are not sick enough to warrant a diagnosis, after that insurance will not pay for counseling services. If you qualify for a mental health analysis, your illness will be listed in your permanent medical record. Many advisors don’t like this “medical model” associated with declaring someone ill, so they select not to accept insurance because they wish to focus on their client’s strengths, but not label them as mentally sick.
Do you want to be considered mentally ill? For those who have a mental health diagnosis currently, because you have been to counseling or psychiatric appointments in the past, find out what your own diagnosis on file is. If you already have a mental health medical diagnosis, this may not be a concern to you, but if not, you may not want this in your medical record.
Counselors also do not like releasing information to others to protect your own confidentiality. Once a claim is posted to the insurance company, who knows how many individuals take a look at it and rubber stamp it while it travels through the system? If insurance pays for any counseling classes (in network or out of network), then the insurance company has the right to review your complete file.
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They can request copies of counseling notes, assessments, and other personal emotional information to find out if you really are “sick enough” in order to warrant their payment. They can deny services to you if they think you are not sick enough or if they think your counseling is not “medically necessary”.
Additionally , there are many counseling issues that are not even covered by insurance at all. Tension management and anger management are usually not covered. Marriage counseling is usually not protected. Certain medical conditions/mental health conditions might be excluded (such as attention deficit disorder or adjustment disorder). Even if your illness or disorder is covered by your insurance plan, they may limit the number of visits they will cover (sometimes only 20 per year), and they’ll set a maximum amount they will pay per calendar year or within your lifetime.
Additionally , counselors prefer to not have someone in the insurance company telling them how to treat their customers. Insurance companies can decide what type of counseling is covered, what diagnoses are usually allowed, and how many times the client needs to come before they are cured. Many counselors prefer to work directly along with clients to serve their needs, without interference from an insurance company.
Using your health insurance for counseling services may also affect your security clearance, insurance coverage rate, employment, or future health insurance plan.
For the above reasons, I recommend that you be informed about using health insurance to get counseling. You may choose to file anyway, but be an informed consumer.
Be an informed consumer.
Know your mental health diagnosis.
Talk to your counselor regarding the diagnosis.
Ask your counselor about your treatment reports.
Decide if you might have, or want to have, a psychiatric sickness.
If you have clinical, severe depression, anxiety, or other issues, then you possibly already have a diagnosis.
But if you are stressed, having relationship problems, or trying to puzzle out your purpose in life, your signs and symptoms may be minor, and you may not want to have a mental health diagnosis in your records.
Once an insurance claim is submitted to your health insurance company, your own diagnosis becomes part of your permanent medical record, and can affect upcoming life insurance, preexisting conditions, or the cost of private health insurance.
Jama Thurman is really a Licensed Professional Counselor in Manassas, VA. She helps teens plus adults who are stressed and stressed find peace and purpose.
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She offers practical recommendations and answers questions most consumers have about counseling services. You’ll discover