BrikoXHer Mental Health Treatment Was Helping. That’s Why Insurance Cut Off Her Coverage.
Encode1307I’m a mental health provider and medical necessity review irritates the hell out of me sometimes. I still think it’s absolutely necessary though. I’ve seen countless examples of therapists that want to keep working with people that are doing well. Meanwhile, someone else who really needs it can’t find a provider.
I realize that won’t be a popular opinion here but whatever.
Friend, I think you’ve drunk the Kool-aid.
The only reason the ADA can get away with recommending you brush your teeth 120 minues a month is, tooth brushes are cheep. The product don’t cost insurance companies a dime. If tooth brushes cost $150 + an hour, you’d get 6 a year, so long as you’d met your deductible.
Mental health services are not just for folks who aren’t doing well. Mental health services are prophylactic! To say that only folks not doing well need metal health services is medical model propaganda that the profit driven insurance industry wants you as a provider to buy into. They know they’re screwing you over too! Remember when they made you sign a contract to not share your payout rates with other clinicians so you can’t collectively bargain? The mental health parity act languished for ~ 16 years, and it’s still a joke.
The term “Medical necessity” is corporate speak for “lower profits”, and implies providers would be wide spread abusing the system if not for constant oversight. Meanwhile, they make billions on you, and your colleagues stolen labor.
On the other hand, it’s not like there are thousands of psychologists sitting around all day with nothing to do.
The best solution is to make it easier to become a mental health professional. More scholarships, more lower level training.
Before making it easier to become a mental health professional, we might think about retention. The APA figured a decade ago 65% of PhD (Psychology, not Psychiatry) students dropped out before program completion. The number that I’ve seen floated, but can’t find a source other than from the UK is, 89% of mental health practitioners leave the field within two years of graduation. Poor pay, and insurance industry woes are almost aways cited as top reasons why.