Therapist dropped my insurance plan (Part 2)

So...met with her today.

She said she isn't willing to offer a discounted rate because I take up too much time outside of session, and my insurance has been grossly under paying her (currently $87.50 instead of $120, and for a portion of this year, the rate was $75.)

She was rather hostile today...angry. She's also mad at my insurance for terminating her and doesn't know if shes willing to do a special contract with them for me. I still want to see her (I don't know why...)

But a serious issue here is that I can be very vindictive. I know that about myself. If she really does this, I'll probably fight against that bad part of me for awhile, but ultimately I'll end up filing some sort of report against her with intent to have her suspended or license revoked. And I think I have enough "proof" that I could really destroy her career, and I know if I did it I would hate myself for it..but I'd still do it.

I want to talk to her about it, but I can't bc it will come out sounding like a threat and she will be even less likely to want to see me if she knows I keep thinking about it.

that's some dirty *** bs. she should keep on seeing even at 75$. boy wat a greese ball. see its all about the benjamins. theres the society that gets good treatment then theres us the poor population that get the dumb docs.

It sounded like it was all about money in your part 1 of this. Did you throw in her face the comment she made the previous appointment about you not making it without her & what a stupid comment for her to make then turn around & do this to you.

She is really an unprofessional who is only in being a T for the money she can get out of it, not for the people she can help.....

It really shows her true colors (greed greed greed).....definitely NOT the kind of T you would really want to have. Maybe it's good that she showed her true colors now rather than later IMO.

I wouldn't waste my time on her regarding any of this....I would drop her & NEVER bother to communicate with her ever again......even if you would end up with insurance she would accept, I would never go back to someone like that.

No, I didn't mention it. Maybe shes right. She is right- I am needy and I do take up an awful lot of time outside session.

One has to pay for one's time, whatever the rate the therapist charges. If your insurance dropped her and/or she dropped them, etc. because they don't pay well, that happens. But if you use a lot of time outside the therapy hour, that has to be paid for too. Do you have a co-pay (in addition to what your insurance pays)? Insurance paperwork is a big pain/additional time factor for therapists, lots of therapists don't take any insurance anymore because of it costing them so much time they don't get reimbursed for.

why doesn't she not just bill you the difference?

Dear InRealLife, I feel bad for you and wish I could give you a hug to help your hurt feelings.

I hope you can avoid giving into your vindictive impulse. Self-hatred ... it's a terrible soul-killing state of mind. When push comes to shove, this isn't about your T's bad behavior, it's about you and your feelings and actions. This whole thing is a big disappointment. My feeling would be hurt if I were in your shoes. I'd probably feel rejected and abandoned, even if I knew I'd been so needy that maybe I'd brought some of it down on my own head. I'd still have hurt feelings.

But no hurt feelings would ever be worth doing something I know would fill me with self-hatred.

I happen to belong to an ethnic group well-known for it's love of revenge and honor and all of that ****. Self-hate is just not worth it. I'm not going to kill my soul for anyone. Please keep talking about this here. Get it out, tear it apart, analyze it, turn it around and look at it from all sides so you can figure out how to avoid hating yourself for going Godzilla on your T ... just for hurt feelings. Not worth it.

I hope I am not going to offend you on this. I really do feel for you, the predicament you are in. However, there is a reality here. Yes, in our dreamy world, we like to think we are "special" and our therapists really care about us. But in truth, bottom line, it is a business they are running. They, like many of us in other professions, have paid alot of money for education plus have either rent or mortgage to pay for their office, utility bills and much more of the like. Just like you and me. Yes, they are in the business of helping people, but that in no way means they should suffer any less than another person in other professions that have to make difficult decissions for financial gain. That is why we work. To get paid. We go to them because they are [I]professionals. Think of it this way.....say you are a designer and have had several clients come to you for your services......and you only have time in your schedule for one of them........who would you choose? The lowest paying one? I think not. Designers go into their profession because they have a love for it. Do you think they wrong for making the decission that sounds most sensible?
I know this may sound harsh and I am sorry for that. I just don't know how to word this delicatly. I feel therapists deserve the same professional respect and the right to bill how they choose. It is unfortunate for alot of us that really need this help, but it is just the cold hard truth. They are trying to earn a living just like you and me. Most therapists are in it because they felt compelled in some way to help others....but the reality is, there is a business side to it.
Insurance companies have made this field a nightmare for both patients and clinicians. They have caused this. I can't even find a pdoc within 30 miles of my home that takes ANY insurance. It's horrible. I stress big time if I will be able to afford my next appointment or not. But I do not blame the Dr. I blame the insurance companies for not paying them fairly.
In your case though, it sounds like you have other issues with your therapist that are not just financial and that is what you should focus on. Does this therapist deserve the rate they are demanding? Just like the designer I talked about---I wouldn't choose one that did not care about the outcome and wouldn't work with me in the way I needed for the best results.
That is what I hope you will dig deeper into.
It's so hard to find the right T for ourself, let alone one we can afford.
I hope this did not offend you. I just felt so strongly about this, I had to respond. I'm not good at writing so I did the best I could here. Sorry it's so long.
I wish you well with this. I really feel for you and your situation.
You deserve good care. That is the most important bottom line.

I have medicare, she can't bill me the difference, it would constitute medicare fraud.

government insurance......

that explains it.

BullSH*T to "she's running a business" - she could work on a sliding scale, or work out payments with you if she really wanted to. My advice is to turn around and walk away from your very unprofessional and uncaring now-former therapist. Walk away and never look back. Find a therapist who is more on the ball than the loser you've been seeing. I am serious.

I've offered before to pay per e-mail, bc they are NOT part of the therapy hour, but shes always refused setting up a payment plan for that. I do not have any copay, what they pay her ($87.50) is just what they pay her.

This was our conversation:

T: So, I'm hearing you say that you can't afford the session fee of $120 and if that's the case then this is our wrap up session.
M: Why can't you keep it at $75, like my insurance was paying?
T: That isn't what I was getting-they did for a little while, but then they gave me more, but, um, the fact that they were underpaying me by half doesn't mean I should charge all my clients such fees.
M: I'm not saying you should charge all your clients those fees, I'm not all your clients.
T: Yeah....you AREN'T. And you know what? My other clients- they get the time face to face that they pay for, with the session fee that I offer them. You on the other hand get time from me almost every single day. You cross boundaries. You crossed the boundary with the texting. I can't trust that you would...you would keep boundaries. I'm not willing to offer a lower fee. You and I had contact every single day from last...Saturday (the day she emailed to tell me my insurance wouldn't pay anymore). Saturday, Sunday, Monday, Tuesday. And you want to pay me $75 for this?

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She also said it would be best to find a new therapist bc I shouldn't have to struggle to pay her fee, bc it would cause more stress for me, but that if I can pay her session fee shes happy to continue seeing me and she would hope I can figure out a way to make use of the time regardless who is paying and how much.

Then I asked if the ability to pay wasn't an issue, if she was still able to get her rate of $87.50 a session, (not $120) would she still be willing to see me, or would she prefer to give that spot to a cash client able to pay her full $120 fee.
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After all this I told her my insurance would still pay, my insurance called her and said the clinical director approved still paying her, and she said she has to think about it, if she wants to engage in a weird contract with my insurance (if it's worth it.) My regular session is on Monday and she hasn't called me back yet to say yes she'll use the insurance or no, we've had our final session.

i can not say i completely blame her (the therapist).

if she is getting all the clients she needs at "X" dollars, why should she accept less from some clients?

I do not tell my employer to pay me less on Fridays (cuz I do not work as hard on Friday). We all want the most we can get.

I was up front about my diagnosis (borderline) from the first session. She chose to take me on despite that- several other therapists declined. I know that therapists hate working with borderlines bc we are more work, so there was full disclosure so she could make an informed decision, and she knew how much they were offering in compensation.

I wish she had refused me back then, day one, instead of waiting two years after it will hurt.

From what you say, she does sound like, as you suspected, that she has seen you as a difficult patient, and she knows she can't work with you. (Do you possibly have borderline personality disorder? We tend to be very demanding.)

I suggest taking it as a blessing that the insurance issue came up. You need a therapist who can set boundaries when she needs to and not get mad about things. I think you need to talk to your new therapist at first about your problems with the former one. Don't hold on to the former one. Therapy needs to be a good match.

I guess I'm holding on bc we used to have a really great relationship. It just...got all messed up. And I cant bring myself to walk away. It's been two years...

I guess I thought that my T couldn't just walk away from me, either. But it turns out that she could. Would. Without a second thought.

Do you see where your borderline, gets in the way, right here, with this particular statement? If she contacted you, out of session, for several days in a row, after notifying you, then technically speaking, it wasn't without 'second thought'.

It does stink to be in your predicament. You are specifying a need and desire for therapy, and though this thread, you've had difficulty finding a treatment provider. That's not fair, to someone who is willing to seek treatment.

Just wanted to point out, where your illness, is getting in the way of this particular struggle.

Is she able to refer you to anyone, at all, who will take your insurance coverage? As a courtesy to you?

I disagree.

Saturday:
I responded to the email she sent me saying I had to pay for future sessions saying I couldn't afford that fee. then a 1 minute phone call to say I'd be there Monday.

Sunday:
1 voicemail left to say that I wouldn't be at my Monday session after all (due to hospitalization, but I didnt tell her why).

Monday:
1 text to ask if my Wed session was still available, and if so to please hold it for me, as I expected to be out on Tuesday.

All of the contact was regarding scheduling/payment, and I don't think it has anything to do with my being borderline. It all was regarding scheduling and payment.

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I say without second thought bc her stance never changed from the saturday e-mail= pay me full fee or goodbye.

How is that anything but "without second thought?"

Additionally, my insurance has told her no less than three times that they will continue to cover my sessions as of june 1, and they are working on pulling up a new contract, but that they'll definitely pay for the sessions- she says shes not going to see me until a contract is signed bc she doesn't believe them, so if I want to come in the meantime I still need to pay full fee.

I'm trying not to let my inner borderline out, bc I will do something really mean. Trying not to bc I know its a borderline reaction, but my whole body is screaming at me to do it. But I don't want to be that person.

As time goes on, I believe we will see fewer and fewer providers accepting Medicare. In addition to lower rates, there are reams of paperwork for Medicare.

I do see what you are saying. The borderline aspect, is in the thought process, as my intention. It's the all or nothing, emotions ruling the reaction thinking, the sense of abandonment and rejection, is where I am looking at your mentioned diagnosis.

If she makes an exception for you, does she not have to make an exception for any others?

Overcoming the hurt, and recognition of it not being personal, but business angled, is about overcoming that fight response, does it not?

You've written, if she has a signed contract, she'd continue to treat you?

According to Marsha Linehans CBT for Borderline Personality Disorder, she mentioned that vindictiveness is not part of the illness. I can quote the page, given time to breeze through it..

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