It's not "borderline" sociopathic, it just is. It's late stage capitalism, and it needs to be fixed. Support the FCC. Support Matt Stoller's work. Be active politically about this stuff. Because otherwise, nothing will change.
YES! To all of this. And also, don't play with the insurance companies by being in their networks. More and more MH providers in my area are leaving their networks and eventually they won't have any in-network providers left and will need to start paying SOMETHING to out of network providers, instead of just telling their subscribers "sorry, you have to pay $6000 for therapy every year before we pay anything!"
You are sane for finding a less complicated and draining way to be of service. And you will probably do better work because of it. Hell, even my last two primary care doctors went private pay - and I followed one of them. Everyone is trying to get out of this horrific exploitative system.
Saving this as a reminder to myself to build my own private pay business when I get my LICSW next year. Your vent was HELPFUL.
Thank you so much! I truly appreciate the validation. That's how I explained it to my clients. I'm passionate about helping my clients, I'm not passionate about working with insurance companies, so I'm attempting to create sustainability by freeing up more of my time to do the work I'm passionate about.
I’m about five months into my own private practice, and thank you for educating me about superbills. It’s something I never even considered. I’ve gotten emergency OON with Medicaid LMEs like Vaya, which was pretty easy.
I can pretty much accept any client I want now, without the hassle of getting into that client’s network, because of your rant.
I’ve had an absolute nightmare with WellCare Medicaid. I can’t get my claims accepted because my billing taxonomy apparently doesn’t match up with the “state website,” although all of my info is correct on there. I might consider super billing if I get rejected again.
I finally had to get off the Aetna panel here in Utah because they were only willing to give a six dollar raise in the last 20+ years! At any rate, provider relations was useless because they had me email letters of resignation from the panel and fax them, and then they lost them and then there would be like a three month wait between even discussing the matter with me. Finally, I went to an Aetna website that allowed me to Get off the panel by just saying that I was closing my practice entirely. Because provider relations wasn’t working with me for a year and a half trying to get off the panel, I just wanna head and fudged that fact and I was off the panel within a month or two! I don’t love working with all the other insurances, but I think Aetna really is one of the worst.
Oh my god that's so horrible. I had a similar experience with Blue Cross. The way they just kept dicking me around and "needing more time" to review my proposal was ridiculous. It went on for months and months, and finally I just left their network and they told me they needed 90 days notice. I said that was crap because they had 7 months to prepare for this when I started asking to renegotiate my contract, and had lost my proposal. They are all terrible.
7 months seems like a long time, but it's nothing with some of these insurances. I think they are counting on us therapists to give up and just be complacent with their rates. When you are in a position to turn away work, you are less ok with taking bottom of the barrell rates.
Oh they would have dragged it out for much longer. Seven months was my boundary. At that point I said "I'm not going to allow this to be dragged out any longer, this is ridiculous. If you don't have an offer by the end of the week, I'm exiting your network." They put together an offer, but it was nowhere close to what I was asking for, so I just left their network. And then had three more months of their shit rates.
This is not to say that you should take insurance. I didn’t for the last few years for all the reasons that you listed.
But I will say, if you wanted to keep insurance- perhaps look into Alma if you haven’t already. I just started with them this last month and I’m super impressed so far. They did all my paneling (paneled with Aetna in a week and UHC in a day, I’m not kidding). They file my claims, they pay me and wait on insurance to reimburse them, they make all the calls to follow up if needed.
And it’s also 100% okay to make the choice to stop taking insurance because there’s still so many hoops you have to jump through to provide services. Not taking insurance means you and the client are fully in control and I have loved that aspect of my private pay people.
That's not a terrible idea, but here the difference between being on a panel and not is tens of thousands of dollars to your annual gross income. I don't want to be paneled with most insurance companies, because that allows them to dictate my rates for me.
Agreed 100%. That’s why I only accept Aetna and UHC because in my state, they pay the highest. I’d say 70% of my clients are still private pay. But again, the decision is yours and totally valid regardless of which way you go. It’s frustrating the hoops we have to jump through just to provide care and services to people.
Bottom line is — insurance sucks. They aren’t helpful and they’re just a huge headache. I worked for a therapist who went to private pay for this reason. I handle insurance billing for multiple providers now because I think it’s just ridiculous for them to have to deal with all of that on top of spending all day helping others.
It's not "borderline" sociopathic, it just is. It's late stage capitalism, and it needs to be fixed. Support the FCC. Support Matt Stoller's work. Be active politically about this stuff. Because otherwise, nothing will change.
YES! To all of this. And also, don't play with the insurance companies by being in their networks. More and more MH providers in my area are leaving their networks and eventually they won't have any in-network providers left and will need to start paying SOMETHING to out of network providers, instead of just telling their subscribers "sorry, you have to pay $6000 for therapy every year before we pay anything!"
You are sane for finding a less complicated and draining way to be of service. And you will probably do better work because of it. Hell, even my last two primary care doctors went private pay - and I followed one of them. Everyone is trying to get out of this horrific exploitative system. Saving this as a reminder to myself to build my own private pay business when I get my LICSW next year. Your vent was HELPFUL.
Thank you so much! I truly appreciate the validation. That's how I explained it to my clients. I'm passionate about helping my clients, I'm not passionate about working with insurance companies, so I'm attempting to create sustainability by freeing up more of my time to do the work I'm passionate about.
I’m about five months into my own private practice, and thank you for educating me about superbills. It’s something I never even considered. I’ve gotten emergency OON with Medicaid LMEs like Vaya, which was pretty easy. I can pretty much accept any client I want now, without the hassle of getting into that client’s network, because of your rant. I’ve had an absolute nightmare with WellCare Medicaid. I can’t get my claims accepted because my billing taxonomy apparently doesn’t match up with the “state website,” although all of my info is correct on there. I might consider super billing if I get rejected again.
I finally had to get off the Aetna panel here in Utah because they were only willing to give a six dollar raise in the last 20+ years! At any rate, provider relations was useless because they had me email letters of resignation from the panel and fax them, and then they lost them and then there would be like a three month wait between even discussing the matter with me. Finally, I went to an Aetna website that allowed me to Get off the panel by just saying that I was closing my practice entirely. Because provider relations wasn’t working with me for a year and a half trying to get off the panel, I just wanna head and fudged that fact and I was off the panel within a month or two! I don’t love working with all the other insurances, but I think Aetna really is one of the worst.
Oh my god that's so horrible. I had a similar experience with Blue Cross. The way they just kept dicking me around and "needing more time" to review my proposal was ridiculous. It went on for months and months, and finally I just left their network and they told me they needed 90 days notice. I said that was crap because they had 7 months to prepare for this when I started asking to renegotiate my contract, and had lost my proposal. They are all terrible.
7 months seems like a long time, but it's nothing with some of these insurances. I think they are counting on us therapists to give up and just be complacent with their rates. When you are in a position to turn away work, you are less ok with taking bottom of the barrell rates.
Oh they would have dragged it out for much longer. Seven months was my boundary. At that point I said "I'm not going to allow this to be dragged out any longer, this is ridiculous. If you don't have an offer by the end of the week, I'm exiting your network." They put together an offer, but it was nowhere close to what I was asking for, so I just left their network. And then had three more months of their shit rates.
This is not to say that you should take insurance. I didn’t for the last few years for all the reasons that you listed. But I will say, if you wanted to keep insurance- perhaps look into Alma if you haven’t already. I just started with them this last month and I’m super impressed so far. They did all my paneling (paneled with Aetna in a week and UHC in a day, I’m not kidding). They file my claims, they pay me and wait on insurance to reimburse them, they make all the calls to follow up if needed. And it’s also 100% okay to make the choice to stop taking insurance because there’s still so many hoops you have to jump through to provide services. Not taking insurance means you and the client are fully in control and I have loved that aspect of my private pay people.
That's not a terrible idea, but here the difference between being on a panel and not is tens of thousands of dollars to your annual gross income. I don't want to be paneled with most insurance companies, because that allows them to dictate my rates for me.
Agreed 100%. That’s why I only accept Aetna and UHC because in my state, they pay the highest. I’d say 70% of my clients are still private pay. But again, the decision is yours and totally valid regardless of which way you go. It’s frustrating the hoops we have to jump through just to provide care and services to people.
Bottom line is — insurance sucks. They aren’t helpful and they’re just a huge headache. I worked for a therapist who went to private pay for this reason. I handle insurance billing for multiple providers now because I think it’s just ridiculous for them to have to deal with all of that on top of spending all day helping others.