Posted by mair on March 28, 2005, at 5:07:16
In reply to Re: too funny, Dinah :), posted by All Done on March 28, 2005, at 1:02:01
I know I'm jumping in late here, and I haven't read all of the posts on this thread, but I dealt with exactly the same issue with my T after i first started seeing her. She was a provider for my insurance company although she worked in a different state from the one I lived in so she had to submit claims to her state and they then passed them along to my state. The allowed amount she was permitted under her contract was less than a T would have been allowed in my state. She submitted the claims and generally didn't bill me until after she got paid, but she'd bill me for the full difference between what she got from the insurer, and her normal hourly rate. More than that, the insurer in her state was so awful about processing claims that it took months for her to get reimbursed, and I started paying her on a monthly basis what she thought I would owe. She only had a couple of patients with my company and I think she maybe thought she could bill me differently since I lived in a different state.
I figured out that what she was doing was wrong but I hadn't been seeing her that long. I have a real aversion to dealing with money matters and in particular money disputes and I really didn't want to say anything to her. I found out that it just bothered me too much, however, - not so much the money as the fact that she was just not correct in the way she was billing me. I pretty much thought that raising it with her would fracture the relationship we were just starting to build and that I'd end up losing her, but I couldn't let it go.
After I raised it, I realized that she was amazingly naive and uninformed about the way these things were supposed to work and that her billing practices were a little sloppy. She certainly wasn't gypping me deliberately. I also discovered that she was really upset to discover that she had been doing things wrong, but also that she'd be getting paid so little if she could only bill me my copay. We worked out a compromise where we split the difference. I know I was still paying more that I was supposed to, but it wasn't that much different and could certainly live with it. And I was so grateful that she handled it in a way that made me feel ok for bringing it up.
Ultimately she dropped my insurer which meant I started having to submit my own claims. That hasn't been too bad because my state's allowed amount was higher than her's anyway.
What I learned was 1) you have to bring this stuff up if it bothers you; 2) the T should be able to deal with it in a constructive way; and 3) you can't assume that the T understands his or her provider contract, or for that matter, has a clue how the financial world really operates.
Mair
poster:mair
thread:471253
URL: http://www.dr-bob.org/babble/psycho/20050315/msgs/476624.html