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If
you have a health insurance policy, it will usually provide some coverage for
mental health treatment. I will
fill out forms and provide you with whatever assistance I can in helping you
receive the benefits to which you are entitled; however, you (not your
insurance company) are responsible for full payment of my fees.
It is very important that you find out exactly what mental health
services your insurance policy covers.
You
should carefully read the section in your insurance coverage booklet that
describes mental health services. If
you have questions about the coverage, call your plan administrator. Of course,
I will provide you with whatever information I can based on my experience and
will be happy to help you in understanding the information you receive from your
insurance company.
Due
to the rising costs of health care, insurance benefits have increasingly become
more complex. It is sometimes difficult to determine exactly how much mental
health coverage is available. “Managed
Health Care” plans such as HMOs and PPOs often require pre-authorization
before they provide reimbursement for mental health services.
These plans are often limited to short-term treatment approaches designed
to work out specific problems that interfere with a person’s usual level of
functioning. It may be necessary to
seek approval for more therapy after a certain number of sessions. While much
can be accomplished in short-term therapy, some patients feel that they need
more services after insurance benefits end. [Some managed-care plans will not
allow me to provide services to you once your benefits end. If this is the case,
I will do my best to find another provider who will help you continue your
psychotherapy.]
You
should also be aware that your contract with your health insurance company
requires that I provide it with information relevant to the services that I
provide to you. I am required to
provide a clinical diagnosis. Sometimes
I am required to provide additional clinical information such as treatment plans
or summaries, or copies of your entire Clinical Record.
In such situations, I will make every effort to release only the minimum
information about you that is necessary for the purpose requested.
This information will become part of the insurance company files and will
probably be stored in a computer. Though
all insurance companies claim to keep such information confidential, I have no
control over what they do with it once it is in their hands.
In some cases, they may share the information with a national medical
information databank.
Once we have all of the information about your insurance coverage, we will discuss what we can expect to accomplish with the benefits that are available and what will happen if they run out before you feel ready to end your sessions. It is important to remember that you always have the right to pay for my services yourself to avoid the problems described above.
Copyright© 2003-2013 Dr. Jeffrey Bryer