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Wysteria · Jul 15, 2014, 04:43 PM

Okay...I'll use "real" numbers... (RANT ALERT)

My insurance company only pays T's the "market rate" of like $45-65/hour. The real rate that almost every T I know of is more like $110-$145. And SW, LC's etc think that they should be paid same rate as T's with PhD's....

So, if my T took insurance, he would have to be "processed" and fill out all kinds of paperwork for ALL the different insurance companies. He would have to deal with "filing" paperwork every time a patient came in. He would have to answer endless calls and questions about how he practices and whether there is a real "need" for me to see him. He would have to rebill and keep track of all the monies paid and not paid and the mistakes by the insurance companies and bs...

He still has other patients to deal with and his daytime hours are filled with taking care of patients and some groups at night. Thus he would have to fit in in all this paperwork on his own time or between clients or use billable time to deal with my insurance company and their "processes".

In the end...he would get like $45 from insurance and I would still have to pay the $30 copay. Thus he nets $75 and a HUGE waste of his time.

He still has to pay for the office, insurance, general admin costs...and eventually would probably have to pay for an office administrator to deal with the paperwork...and thus payroll taxes and a bunch of other crap.

ON the other hand, and as 90% of other Therapists have ended up doing...they just charge cash and deal with some special clients with a sliding scale for those that really need help. If at all.

He still has student loans to pay off, the mortgage, business expenses, transportation and all the other lovely things that take money in this world.

So if you, on a sliding scale pay him $65 dollars, he is still short the other $60 he could make dealing with cash clients. And would be short the $10 that he would have made if he had filed insurance and finally gotten paid sometime down the road and wasted hours on paperwork.

Meanwhile...you also have to meet your annual deductibles for individual or family (typically @ $1000 to $5000) and thus your first say 20 + visits you would have to pay the full $75...or until your deductible has been met.

In the past, there has been a "special" deductible just for Psych stuff...so you actually had to meet two...one medical and one psychological. (oh and by the way...you are only allowed 10 T visits a year and 2 pdoc visits by your insurance unless you have a special rider ($$$) for extre psych care...!!!

)

Or you can pay cash all year and take a big deduction on your income taxes at the end of the year...if you file long form. It has actually helped me quite a bit, but cannot make up for the amount I spend on psych visits, T visits and medication copays.

If you were a Therapist....which would you choose to do?
There are NO easy answers, but most T's have given up on the system and only work with paying clients...and my T also answers emails, phone calls and talks with my other psych providers to help me get good care. All that time also comes out of his "billable hours" or budget and his personal time with family or friends....and should be considered when looking at the $125 he charges me per hour "in the chair"...

I hate this system!!!!! But I have had to go into debt to try and make ends meet and get the help I need. Hopefully the Obamacare mental health parity rules will help all of us get the care we really need....not just 10 visits a year even if you are sui and have major psych illnesses...

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