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Insurance Changes Effective 8/1/2024

tree city wellness insurance update

Payment Changes as of August 1, 2024

 

 

This is a reminder that Tree City Wellness is transitioning off of all insurance panels by the end of July, 2024.

 

Beginning August 1, 2024 Tree City Wellness will not bill insurance for any appointments. As an alternative, we have partnered with a company called Mentaya that can assist you in billing an out-of-network claim for a small fee ($8). They assist their customers in receiving an average of 60% reimbursement for session fees. This service is in no way a benefit to Tree City Wellness or its therapists. It is simply a courtesy to our clients. Please ask your therapist if you would like to utilize this service for your appointments going forward. Methods of payment also include HSA/FSA accounts or any major credit cards.

 

This decision evolved after much deliberation and assessing of both the pros and cons of becoming a private pay only practice. Ultimately, this decision supports this business in remaining sustainable for its employed therapists, supporting its growth, protecting the privacy of our clients health data, the ability to expand our offerings to more modern and effective treatment options that insurance does not recognize, and advocating for change for the therapy field in general.

 

I have posted a snipped of THIS ARTICLE below which offers a detailed description of why many therapists are opting out of insurance. We are actively pushing for change for greater insurance-recognized services, increased reimbursement rates that match with economic growth, and more private coverage for it’s members for the future. We are consistently brainstorming more ways to make mental health services accessible to all both as a small community business and collectively with therapists across the country.

 

Thank you for your understanding and please reach out with any questions.

 

“Ten Reasons Why Your Mental Health Provider Stopped or Never Started Taking Your Health Insurance” by Dr. K Hixson:

 

Many people have sought out therapy for the first time as COVID and the associated psychological fallout from it continues. However, it can be difficult to connect with a mental health provider as the demand for care is far outstripping the supply of providers and available appointments. It’s not easy to lift the veil on this whole system as it can make us feel hopeless and without options. But if we become more knowledgeable about how things actually function behind the scenes, we can demand better. We can find the pathways to advocate for change in these systems that often pit clients and providers against each other. There are some suggestions at the end of the list if you are struggling to find an available in-network mental healthcare provider.

  1. If you are wondering why you never get a call back from the dozen therapists you’ve called—especially since COVID—it’s because most of us are bombarded by inquiries when we’re already full. Most insurance companies won’t accept enough people in the network for adequate coverage of their members. People looking for a provider end up scrolling through a list that is predominantly a “ghost network.” Sometimes, we can’t even apply to be in the network as much of the time they are not even accepting new providers on their in-network panel because they “already have enough providers in that service area.” Solution: Insurance companies should accept all mental health providers in good standing who want to be in the network to increase the availability of providers with openings.

  2. Each health insurance company decides to pay mental health providers whatever they individually deem acceptable. There can be up to a $100 (or more) difference in payment between two different insurance companies. Some Employee Assistance Programs pay $30/session which is less than minimum wage when factoring in taxes and the cost of doing business. There is no standard payment for mental health care. Insurance companies just subtract the amount providers ask for from their standard contracted rate. Your provider gets paid less 90% of the time to be in-network. Providers still try to accept insurance so that you have access. Then, the discount you obtain for going in-network impacts us. Insurance companies can also take weeks or months to pay us. They change billing codes without communication which forces us to re-bill and wait longer for payment, and they generally make it extremely difficult to tolerate this whole process of taking your insurance. Solution: Pay all mental health providers the same rate for the same work and give us yearly COLA’s.

  3. Health insurance companies can and do “clawback” money from us if there has been a mistake, even if it was on their part. Let’s say the company said you were covered on February 14, 2021, by their plan (confirmed by you and your provider), you obtained services, and your provider was paid. If during their audit they figure out you weren’t actually covered, insurance companies can ask for their money back from practitioners who have already provided the services. Insurance companies have clawed back thousands of dollars at a time from small businesses, often solo practitioners, causing immense stress and financial problems. Many other mistakes can cause clawbacks so providers think, why take the risk? Solution: Pass legislation in each state that limits clawbacks from insurance companies to 12 months from the date of service.

  4. The insurance companies pressure us through audit letters to see you for 45 minutes of psychotherapy (or even 30 minutes) instead of 60 minutes to save a few bucks. One well known company recently sent a letter to some providers explaining they hired a third party to audit us during the pandemic, and they want us to bill for 45-minute sessions more often or risk future audits. At times they also request phone reviews for providers to justify why we’re still seeing you for counseling and then may also request all your clinical notes. They can do this even if we’re working with them out of network—aka, aren’t in network and don’t have a contract with them. Providers have deep concerns about insurance companies dictating the type of care they provide while invading your privacy. Solution: Trust providers to provide the care they are trained to provide. Trust clients to judge the effectiveness of the care and ask them directly whether the care they are receiving is effective.

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Krysteena Wilson, LCPC, LMFT is a Licensed Therapist specializing in individual, couple, and family therapy in the Boise, ID area.

208-817-0234
krysteena@treecitywellnessid.com

410 S. Orchard Street Suite 220
Boise, ID 83705

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