Posted by Solstice on April 16, 2011, at 8:20:54
In reply to Re: Paying for services not yet rendered?, posted by jane d on April 15, 2011, at 21:39:07
> I'm not sure it's a matter of ethics. The prepayment requirement sounds like they are trying to deal with the problem of a lot of no shows and cancellations that they believe are caused by people not having an economic incentive to show up.
That's what they told me.. (although they acknowledged there had been no such problem with my son).
My response was:
1) a punitive policy like that should only be imposed on those they have trouble with; and
2) their policy of not giving standard apts, and only allowing you to have four on the books, might be part of the problem. Haphazard apts prevent clients from being able to create their schedule around a fixed apt (like school schedules). I think the client population they are working with is being set up for failure-to-show because the apts are so haphazard - never the same... which makes it easier to forget.
> I do sympathize with that concern. Otherwise either the therapist eats the cost of every cancellation if they are paid per client session (many are) and pretty soon they can't buy their groceries or, if they are salaried, the practice ends up raising everyones fees to cover it.I sympathize with the concern as well - but I think there are MUCH more equitable ways to prevent themselves from taking massive hits. They can have a policy of "if you don't pay for your missed apt., then you can't schedule another apt. until you do" - - or some other thing - - but I think that particularly for anxious depressives like my son, haphazard - the anxiety of trying to keep track of inconsistent apts - the problems with the therapist sometimes being booked for two or more weeks out, where you have no choice but to wait - you can't get to your therapist on a regular basis - and you never know if you'll be able to get to him when you need him - - - I just think all of that is terribly counter-therapeutic and it just seems wrong to do it to someone who has not missed apts.
> If they are "in network" your insurance company's contract with them probably determines whether they can charge a fee like this. I'd check with them. (And complain to them.)
They are 'in network' - but although their contract prohibits them from charging anything other than the copay, the contract doesn't address other policy issues. Most providers are in many insurance networks - so it would no doubt be a nightmare if insurance companies had the power to set office policies like that.
> That said I'd personally really resent paying in advance and would probably look for someone else.I wish I'd known before he started seeing this therapist that they were going to spring this on us. There was no warning. No "here's a policy that will come into effect in three months." It was just - you go in for an apt, and when you leave, they tell you that you have to pay for the next four apts or they will cancel.
> It's never been important to me to have a fixed date and time. In fact I've sometimes suspected that the whole idea of having a specific time blocked out and treated as sacred was created for therapists' convenience and profit more than clients'.I think you might be the exception... I think most clients in therapy need the stability. I know when my world was in turmoil - there was something genuinely calming about knowing that there was this spot in the week - every single week - where I could escape the chaos around me and 'be' in a place that was stable. I knew what it would look like - I knew what it would be like - I knew the rituals. And it belonged to me. And it was 'for' me. I'm not kidding - the consistency was crucial... to my healing from trauma.
> But if it's something that matters to your son he should try to work something out with his therapist. If he can't then he may be able to get the same results by making sure that each week he's scheduling the appointment for a month from now. Or, of course, go elsewhere if he can.Problem with the scheduling is that everybody is having to do this - so there is no way to get four weeks of apts that are same day & time each week.
> I hate to say it but I suspect that if this isn't already widespread it will be soon.I hope the APA comes up with some guidance - so that therapists can be paid for their work consistently - without doing damage to crucial elements of therapy - like having a consistent day/time.
Solstice
poster:Solstice
thread:982589
URL: http://www.dr-bob.org/babble/psycho/20110324/msgs/983003.html