[musinglizzy]

So I've been seeing my T for...well, 11 months today, actually. I see her twice a week. I go through insurance, I figure since we're paying $150 PER WEEK for our health insurance, I may as well use it. My insurance is quite good, and because of the cost we shell out for it, I have no issues using it. My session fee is $150 per therapy hour (50 minutes). I had a copay of $15 per session. I never asked, I don't believe I even hinted at having some financial hardship currently (that's one thing I won't talk to her about yet). I paid 2-300 dollars one time and like a month later received another huge bill, and my payment was never shown. I asked my T about it....who told me she has decided to lower my copay from $15 to $5. I was very thankful, but also felt horribly guilty and self conscious. She doesn't treat me as such, but I have a hard time getting a break, I don't want to be a charity case, you know? But I appreciate her understanding and care enough to make things easy on her and I reluctantly accepted. Actually, it was a huge help for me, but I felt guilty thinking she's out that money. Maybe she's not, I may not know how it works.

Anyway, I made a payment in February. In March, I received a bill (through her billing company) for $10. Seriously? I figured some payments hadn't gone through insurance yet and decided to hold off paying until the next bill. Well, here we are, April, and I get TWO bills in the mail yesterday. One for $310 and one for $105. What's confusing is that both bills (three pages each) are itemized and I can't see anything different, so why the two very different amounts due? So do I owe $310, or $105, or $415?? I find her bills confusing because they aren't in chronological order, and all of the dates are for this year, except for two dates in September. Ok.... confusing.

Anyway, I Emailed her late last night to ask about it....see if she could tell me what I owed her so I can get her a check. I was a bit taken back that I went from a $10 bill to a possibly $415. But then, on the last page, I finally found a phone number, so 10 minutes after I Emailed T asking her, I wrote her back saying sorry, I saw the number for questions, and I'll call the billing agency directly. I was going to call this morning but got called into work early last minute and didn't have a chance. So, I'm off work now, and called and left a message for them to call me back.

I got a text from my T this morning saying she has been having problems with her billing agency, and will be switching in another month to a new one. And that it would be helpful for me to call them to find out what's up with the two bills, so she can know what's been going on. I know this is not the first time they've stressed me out with their incorrect bills.

BUT....my main topic here, my T said I owe NOTHING. I don't know when she implemented this, but she told me she has waived my copay completely, and that she let the biller know this but it must not have registered. I'm touched. Very touched. Almost touched to tears, but at the same time, I feel so guilty. Money is a hugely stressful entity for me, I have to pop two Xanax just to pay bills. So this is helpful for me, but I just feel so crappy that it IS this way...and that somehow she sees it, and is doing me this huge favor of not giving me a copay at all. Has anyone else been in this boat? How did you get out of feeling so guilty about it?

I know I have been having a hard time with my T lately and have vented here about that. But she does truly care....it's sincere, I've never doubted that. I stay because I really want to make this work, even though I still am feeling the pain from our rupture. Intense pain...anger even, if I think too much about it. But she's a good T...who I think just didn't handle a decision very well. But that's MY opinion, and doesn't make it right.

Anyway, I have a session tomorrow, and would like to talk to her about it. Is it wrong to ask her why she's doing this? I've not received many breaks in life and am just curious why she'd do this. Not only that, I know I have been a hard client to have. I'm over sensitive, skeptical and cautious about everything, question motives (as I am here), and I don't talk openly very well...she really has her work cut out with me. Honestly, I can be a pain in the rear.

Anyway...has anyone else's T waived their copay? For those who pay with insurance, is it possible the T charges more per session so they end up, even without a copay, making the same amount? I believe she deserves her going rate...and I don't want to think she's reducing for my sake, which puts less money in her pocket. Ugh. I hate feeling so... unworthy... but...that's part of why I'm in therapy!

It is probably a case where the insurance hasn't paid on some claims yet and the bill is showing the balance that hasnt been paid yet, including what the insurance hasn't sent them a check for. Don't panic about it. Talk directly to the billing people to find out what is going on. I had a couple of cases where that happened. No big deal. Just took a few weeks for the insurance company payment to come through their office. Another case, they had filed and for some reason the insurance company had overlooked it. Just took a couple of phone calls to straighten out.

[Mike_J]

My therapist is currently working for a company that has huge billing department. One of the reasons she is opening her own practice.

The insurance company pays very discounted rate to what you are billed. Depending on your insurance it's either a set price for each service no matter what is billed, with other insurance it's a percentage.

You should be able to go online with your insurance company and see what is being billed and what they are paying, might be a bit of an eye opener, it was for me.

[NowhereUSA]

My T is part of a clinic so the clinic takes care of things. That being said, when I've gone in for a consult with another T, since I can't have two therapy sessions on the same day and he knew it was going to be stressful for me, he still met with me at our usual time with no charge. And he doesn't get paid unless he bills so he sat with me for an hour and did therapy with me and didn't get paid for two sessions.

[musinglizzy]

Thanks all...but how do you feel about T waiving the copay all together? For me it's one word....guilt!

[guilloche]

Oh wow, MusingLizzy, I have such mixed reactions to her waiving the copay altogether.

First, can I admit, I'm a little tiny bit jealous. My T is super-expensive, way more than other local Ts, and isn't on any insurance panels. This was clearly my fault (if I had understood my insurance better, I would have tried to find someone covered first), but it's seriously causing me stress with my budget. I feel like I'm going to go broke, it's such a huge amount of money each month, and it makes it hard to just relax and try to trust the process. It's part of why I'm ready to quit - it's just too expensive to wait and see if it's going to become helpful.

So, sorry for that rant, it's my issue... but it's true, I'm a little jealous! And, part of me thinks - wow! That's a really kind thing for your T to do! Waive your co-pays altogether, just... wow! What a great position for you to be in, to not have any financial stress over getting this help that you need.

But, I thought about it... and if my T were to reduce my fees, I'd love it, from a financial perspective, but, I'd worry a lot. I'd worry that it would be harder for me to bring issues to his attention (I'd feel really bratty, awful, and ungrateful complaining about how he handles things or if something he said was hurtful if he were giving me cheap/free therapy) - but those things can be really *useful* in understanding how/why we react to stuff in our lives! I'd worry about getting tossed out (I'd worry that I'm more trouble than I'm worth if I wasn't paying full fee! Right now, one thing that helps me worry less is that he's even said, "yes, you're a little difficult, but that's OK, I get paid enough to handle it").

And I'd worry again that I look ungrateful if I had feelings of quitting and tried to talk about them when I was getting a discount. Oh, geez, and I worry about talking about other money stuff too... what if I saved up and wanted to go on a nice vacation or replace my 11-year-old-clunker of a car? Would T be secretly thinking they should increase my fee, that I should be spending that money T and not "luxury" items?

It would give me a headache. I hope you can figure out what's best, and work it out with your T. Does it help at all to know that she's being reimbursed by your insurance, so you ARE paying for her... you're paying for her, as you said, with that $600/m that goes to the insurance company!

good luck!

[musinglizzy]

Thanks for the input. Yes, I feel really lucky...she's being very generous....but I just don't feel right about it. I'll take your 11 year old clunker! I have a 16 year old clunker with over 200,000 miles on it! Hubby's clunker is 29 years old! I also, yes, do feel guilty because I've thought about quitting myself. How could I when she's being so generous? Then I wondered if she's doing this to try to give me incentive to stay. Not to be manipulative, but because she cares and knows I need to be in therapy. I agree with her... but sometimes I think it's just too darn hard to change at my age...

I do try to make sure people realize I'm far from ungrateful...

But yeah, if she waived my copay, and I WAS able to get a new (to me) car, or go away for a weekend...I'd wonder if she was thinking "well gee, she has the money for that!" No, I don't think she would...but I know I would!!

[StressedMess]

Do you have an "out of pocket maximum" on your insurance?

I pay 100% of each bill until deductible is met. After that my copay is 20%. After I meet $2,000 out of pocket expenses, insurance pays 100%.

Just a thought, your T may not be waiving anything, your insurance may be paying the entire bill.

[stopdog]

I would ask and talk to her about it - it would seem the sort of thing a therapist should be very very clear about as it is so easy to get the money part screwed up and into other parts of therapy.

I would try not to worry about it. She is being paid something and it sounds like she wants to do this for you. If you aren't comfortable with it then definitely talk to her about it, but it wouldn't bother me.

[musinglizzy]

No....out of pocket max doesn't apply here. I should say I'm touched, I really am...very thankful... but feel like it's taking advantage. But, for now, I'll just appreciate the good thought, and just talk to her about it tomorrow. I know I didn't ask for this, or even hint towards it....in fact my financial issues are something I don't really talk about with her.

Thanks for the input...I'll just sit back, relax, and appreciate it as best I can. Dang pride, I guess.

[musinglizzy]

Any last minute thoughts? I work, then have therapy this afternoon. I'd like to even just briefly talk to her about this. Why can't I just see it as the kind, generous thing that it is, instead of wanting to ask what her motives are? I'm touched, I truly am. But I'm just curious why she would choose to do this.

All you can do is ask her since you really want to know why SHE would choose to do this. All we can do is speculate. If the help with the copay is needed, then accept it graciously and allow her to do that for you. If the help with the copay isn't needed, then you can politely thank her for the offer and decline that help.