I have a suggestion for insurance companies that would protect their interests and the interests of their members who use behavioral health services. It’s a very simple idea, It would require providers to maintain session log sheets for each client.
I had a therapist commit insurance fraud by triple billing for sessions one month. When the insurance company had to investigate it they had to go through mountains of paperwork to conclude that the therapist billed for sessions that did not occur, utilizing more time and company resources than necessary.
Had they had one simple form it could have been proven that I was or was not in therapy for the a particular date that was billed for, saving precious time and resources.
Since were talking about mental health services these log sheets would have to be kept in each clients file and every session they would have to sign in on a form that would look something like this with a column under each heading:
Date_________Printed name_________ Signature__________ .
This log would have to be sent in once a year to the insurance company and scanned into a database for the record. This would make insurance fraud much more difficult for mental health professionals, who often practice in situations where there are no “witnesses” to the “comings and goings” of clients, no diagnoses are made or tests performed for each session that would validate a client was actually there.
My insurance company never sends me notifications that my insurance has been billed. The only way I can find out is by going on line and checking the billing. This is how I caught my former therapist. He of course was shocked, and attempted denial, but eventually had to pay back the insurance company and was then dropped as a provider….(longer story available elsewhere on my blog)
I know other medical professionals use this system, and have for years. When you enter the office , you sign in.
Due to extra confidentially issues in the Mental Health Profession, again, a sheet could be kept in each clients file and signed at the start of the session, or when co-payment is paid to the therapist. If a therapist is accused of insurance fraud, the client could be sent the log sheet to verify that their signatiures are in fact their own.
After my experience, I think this practice should be made mandatory!
Filed under: Buyer Beware, Insurance Fraud, Mental Health, Therapy, Uncategorized | Tagged: anthem insurance, bad therapist, bad therapy, betrayal of trust, business, choices, department of public health, good therapy, health care fraud, HMO, insurance fraud, licensing board, medicaid, medical insurance company, medicare, mental health profession, oxford health plans, regulatory agency, State of Ct., therapist, trust, united health care, unprofessional conduct, violation, walk away from bad therapy, westport |