ACA Blog

Robbin Miller
Dec 07, 2010

Mental Health’s Big White Elephant

Bravo to the physicians for speaking against the upcoming cuts in Medicare reimbursements and the threat of refusal of accepting more patients in their medical practices. How come mental health professionals can’t follow this same pursuit? Our profession has a big white elephant in our presence for refusing to speak out against cuts in payments for providing mental health services to our clients. I will give you an example on what I am talking about.

Two years, one big powerful health insurance company in Central Massachusetts cut reimbursements from $ 55.00 to $ 50.00 for providing mental health services to their clients. There are two things wrong:
1) Why on earth are mental health professionals taking their clients for low pay?
2) Where is the threat from the profession to stop taking their clients when the rate dropped to $ 50.00?

I have more pet peeves with this provider. Last Spring, they implemented a new conversion of billing claims with their contracted provider to pay mental health professionals. It has been a nightmare in getting paid on time. From June to November, I called the contact in provider relations to complain that I was not being paid for my services. Due to my constant telephone calling on a weekly basis, I was paid for one claim in October after I saw the client in April. In November, I was paid for two claims (after being overpaid twice) after I saw the client in June. As I write this blogpost, I am still have not been paid for ten claims since September to October due to their billing company losing the claims and my bookkeeper having to fax the claims to their supervisor.

Isn’t this ridiculous and doesn't it add insult to injury for fellow counselors?

Regarding low reimbursement rates, this health insurance company does not value the work that we do in our state. I am very disappointed with the leadership from both the mental health counselor and social work association for not speaking out on these two issues.

Regarding this horrible billing system, many complaints have been noted on their annual feedback form that the health insurance emailed to use to fill out this year.

You may ask why we continue to take their clients? There are two reasons:
1) In my area, many companies have switched from Blue Cross to this provider who have cheaper rates.
2) Getting private pay clients is not happening. In fact, many working families are now on the state medicaid system due to not being able to purchase an affordable health insurance commercial program.

What can we do about these issues?
1) The state social work and mental health counselor association need to speak out against this insulting low reimbursement rates.
2) They also need to meet with this provider to negotiate a high reimbursement rate to accept their clients.
3) If the above two tactics don’t work, then I advocate that the two associations call for a statewide boycott of accepting more clients from this provider.

I don’t know if the velvet glove approach will work. I welcome your comments.

Robbin Miller is a counselor who specializes in mindfulness meditation; Positive Psychology; and Cognitive-Behavioral Therapies; and is also a volunteer cable access producer and co-host of her show, "Miller Chat" in Massachusetts.

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