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.
They should pay for prophylactic counseling? Should they pay for high quality childcare, housing and healthy food too? It’s ridiculous to suggest that they should pay for everything. That’s not in their scope.
The purpose of health insurance is to pay for medically necessary costs. Counseling for self improvement and actualization can be paid by the patient. We do have some people that do that and it’s great.
Should they pay for high quality childcare, housing and healthy food too?
Yes.
Remove the for profit “health” insurance companies and provide people with these things. It will reduce our societal costs and improve outcomes for all.
You’re changing the argument. Should someone pay for those things? Yeah. The Scandinavian countries do and they’re much better off for it.
It’s silly to suggest health insurance companies should be compelled to though.
What’s silly is for profit healthcare.
Maybe but most of the big healthcare players (hospitals and insurance providers) in my state are nonprofits and they don’t act fundamentally differently. They’re maybe very slightly better to work with.