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Twilightyoga
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Exclamation Mar 23, 2013 at 12:27 PM
  #1
I am really curious to find out if anyone else's therapist is double billing them with the new insurance code changes that took effect January 1, 2013?

My therapist is a Nurse Practitioner but she only does therapy for me because I have a psychiatrist who is my prescribing doctor.

According to her, she is required to bill me for both an office visit (therapy) and now also medical services for every single visit, even though she does nothing more than make a note from time to time about my current med dosage. This resulted in me paying her over $400 in January on top of what my insurance company paid her, all for 5 visits of 45 minutes.

My husband and I are stunned and really taken aback by this new development.

She says she says she has to do this because she is a nurse practitioner. Does anyone else have a therapist who is doing this????
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Default Mar 23, 2013 at 11:54 PM
  #2
I've always had multiple billings because I see my nurse practitioner at a university clinic. What got me is, I don't think my copay got recorded or applied cuz I got a bill that didn't indicate I had paid anything yet, when I'm pretty sure I had. I just see her for meds, but we do a 45 minute therapy session.
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Default Mar 24, 2013 at 12:58 AM
  #3
How much is your deductible?

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Default Mar 24, 2013 at 08:02 AM
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Yes, your deductible probably has not been used yet; $80 a session for therapy or a medical visit does not sound too bad to me and getting both for that price would be acceptible to me. But if you are being double billed and don't like it, I'd change your type of therapist to one who is not also medical-related, a social worker or something.

Here's a good definition (Oregon's) of what a NP does; the "counselling" in this list is medical counselling, how your meds are affecting you, for example, your side effects, so that is not therapy, psychotherapy is not the same kind of counselling. If you have medical conditions so that taking meds is a mine field (high blood pressure meds, heart problems, diabetes, etc.) I'd stay with the nurse practitioner as you can more quickly get help than just through a psychiatrist; I'd see it as a boon that you were seeing someone with both medical and therapy knowledge.

http://www.medscape.com/viewarticle/422935_5

Or, you could see if your nurse practitioner could write your psych scripts if you are "stable" and just doing maintenance, and then you would not have to pay a psychiatrist, too.

No one "has" to do this, they are allowed to and they (clinics/practices) need the money so they are. Talk it over with your NP and decide if you want to come to some other arrangement so they aren't getting 3 payments, only two (and/or you could have your regular medical doctor prescribe your meds if you know what works and s/he's okay with it).

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Thanks for this!
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Default Apr 23, 2013 at 09:49 AM
  #5
Quote:
Originally Posted by Twilightyoga View Post
I am really curious to find out if anyone else's therapist is double billing them with the new insurance code changes that took effect January 1, 2013?

My therapist is a Nurse Practitioner but she only does therapy for me because I have a psychiatrist who is my prescribing doctor.

According to her, she is required to bill me for both an office visit (therapy) and now also medical services for every single visit, even though she does nothing more than make a note from time to time about my current med dosage. This resulted in me paying her over $400 in January on top of what my insurance company paid her, all for 5 visits of 45 minutes.

My husband and I are stunned and really taken aback by this new development.

She says she says she has to do this because she is a nurse practitioner. Does anyone else have a therapist who is doing this????
just now running into this type of thing. More later
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anneo59
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Default Apr 23, 2013 at 09:52 AM
  #6
Quote:
Originally Posted by Perna View Post
Yes, your deductible probably has not been used yet; $80 a session for therapy or a medical visit does not sound too bad to me and getting both for that price would be acceptible to me. But if you are being double billed and don't like it, I'd change your type of therapist to one who is not also medical-related, a social worker or something.

Here's a good definition (Oregon's) of what a NP does; the "counselling" in this list is medical counselling, how your meds are affecting you, for example, your side effects, so that is not therapy, psychotherapy is not the same kind of counselling. If you have medical conditions so that taking meds is a mine field (high blood pressure meds, heart problems, diabetes, etc.) I'd stay with the nurse practitioner as you can more quickly get help than just through a psychiatrist; I'd see it as a boon that you were seeing someone with both medical and therapy knowledge.

http://www.medscape.com/viewarticle/422935_5

Or, you could see if your nurse practitioner could write your psych scripts if you are "stable" and just doing maintenance, and then you would not have to pay a psychiatrist, too.

No one "has" to do this, they are allowed to and they (clinics/practices) need the money so they are. Talk it over with your NP and decide if you want to come to some other arrangement so they aren't getting 3 payments, only two (and/or you could have your regular medical doctor prescribe your meds if you know what works and s/he's okay with it).
excellent points here, Perna
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