This is insurance fraud as well, Mr. Therapist!

I hope to be writing a more interesting blog tomorrow on my journeys in finding and working with a “helpful” therapist. For now though, it’s time to relax and unwind after spending several hours today putting together a file to send to the Ct. Dept. of Insurance to reclaim the money my former therapist took from me outside of my insurance coverage. Essentially, he told me that I owed him for sessions because the insurance company didn’t pay the claims he made. I later found out that this wasn’t the case and he never had filed the claims at all, and I had “unlimited coverage” available. It would appear that he didn’t care to file the necessary OTR’s and paperwork, and thought he’d lie to me instead.
I had been hoping the CT DPH would have been able to help in this regard but they claim insurance issues with a provider don’t fall under their area of responsibility

update 11/11/10: I didn’t realize this until yesterday but it is insurance fraud as well!!!!
***billing a patient more than the co-pay amount for services that were prepaid or paid in full by the benefit plan under the terms of a managed care contract. ( from Cigna’s Website)

And…. HEY! I want my $800 bucks back !

So the file is ready to go!
Redacted Psych notes,calendars, payment records,emails and other items to “prove” that I had sessions with this therapist since the insurance company claims they can’t do anything since he never filed claims for the sessions, therefore it isn’t their issue. What the Department of Insurance plans to do is chase the insurance company to pay as the therapist was under contract with the insurance company at the time, and his contract read that he could not bill a client under a managed care plan when coverage was available!
The insurance company can then go after the therapsit to get their money back.
My best advice to anyone going through something similiar, Licensing Board Complaints, Insurance Claims, etc. is to send everything you have even if it doesn’t seem necessary. Public Agencies generally will not ask you for specific information. Since were all not born to be “Clara the Psychic” and mind read with ease…. …send everything you have. The 7 cents a copy at the Copy store is well worth it!

Only one question remaining for tonight…do I set my coffee maker back an hour, or be realistic that I am going to wake up at the same phase of the morning anyway and want my coffee then?

All be well!


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