Mental Health Care Is Making Me Insane

It’s hilarious, really. I mean it must be some kind of cosmic joke. Something on the order of irony, or a social statement on the need for serious consideration of mental health care. Only one of these things could explain the absolutely epic billing shenanigans going on here.

Right, so I told you about shrinkapy. The therapy sessions are required, in this health system, in order to allow for better living through pharmaceuticals, also known as a tiny little dose of Lexapro per diem, which keeps my endocrine system from squirting panic chemicals through me for reasons passing understanding at any occasion. My therapist, an LCSW I call Ali Velshi, is very cool, and we are simpatico, so that makes things much easier. We laugh, I cry… it’s better than Cats.

I laughed and cried when I got the billing statements, too.

See, thanks to my stupid union, I get medical care through no fewer than five insurance providers: one for vision, one for dental (oh, cleanings only), one for major medical, one for prescriptions, and one for mental/behavioral.  That one’s called ValueOptions. I think of it as Acme-Brand mental health care. ValueOptions is merely the insurance provider. The front money comes from my union’s health plan, which also does the billing.

It recently came to my attention that my union’s health care plan had not received the authorization had received from ValueOptions in order to have ten visits. Beyond that, my shrinkapist had to submit a form explaining the need for further treatment, which would then be approved or denied, all or in part, somewhat arbitrarily, by ValueOptions, and record thereof forwarded on to my union health plan, so they knew what to pay and what not to pay.

What could possibly go wrong?

So I got a bill in December from the hospital system with which the shrinkapist is associated. The bill was for nearly $1,300. It lists one date for service. That date was in October. This is the first bill I’ve gotten, and treatment began in June.

So I called the hospital, asking for an itemized bill, which I have yet to receive. I called ValueOptions, who told me to call my union health plan, who told me they had no record of certification from ValueOptions or communication from the hospital system. But I have right in front of me the paperwork from ValueOptions, certifying 2 initial visits with the psychiatrist and 10 therapy sessions with Ali Velshi, plus 5 joint appointments. And Ali Velshi told me that he talked to billing and they told him that they had record of at least 20 communications with the insurer.

I flipped back through all my medical records from the union. I found a couple of statements dating from July through September, which I had apparently previously completely blocked out of my head, because they list the charges for each therapy session at somewhere around $700.


People, I like Ali Velshi. But he is not worth $700 per hour. I don’t even think the most expensive lawyer in the state charges that. He’s an LSCW. He’s not even a doctor. And he is not the ghost of Sigmund fucking Freud. And these were the visits that I have record would be covered. Fo’ sho’.

So who’s crazy now, bitches?

I’ve said it before, and I’ll say it again: insurance companies, doctors and hospitals basically take turns making it so incredibly difficult, confusing and bankrupting to seek and receive proper medical care that it is no wonder that we have massive health crises of the physical and mental varieties in the United States. Absolutely no wonder at all. The billing alone is enough to make someone with a relatively minor mental health issue go stark raving mad.

Or maybe this is all just a decimal point mishap. That could be it, right? I really only owe $6.83 per visit. That must be it.



4 thoughts on “Mental Health Care Is Making Me Insane

  1. Not a chance you’ve got it wrong.
    BUT what happens with the bill and payment is what’s interesting. The doctor just chalks up the visit as having occurred, and then the medical practice he works for (that is, the elves in the coding office) check off a bunch of boxes and add them all up to as big a whopping bill as possible. Because they know that the insurance company will only pay half. Or a third. So they’re just trying to make ends meet and get a little extra, don’t you see? AND, because the hospitals and medical practice corporations are charging so much, the insurance company feels perfectly justified in raising its rates – after all, medical charges have gone up. Isn’t that obvious? So it’s a grand, upward spiral, and a way to make everyone go broke except the insurance companies, the medical practice organizations (and some/most doctors, depending on what you consider “broke”).
    Of course, the system’s broke (or broken, should I say for the grammarians out there), and it will be until we get universal health care. But that is unlikely, because a lot of people with influence are making a lot of money in this shell game. Welcome to lala land. We all live here – sane or not. Just try not to get REALLY sick!

  2. I’m ashamed to admit I’m an insurance agent. On behalf of the entire industry, I’m so sorry you’re getting this runaround. It’s like they WANT to make people need therapy!

    But there’s no way the LCSW’s bill is $700 per session and if that’s what he submitted, then that’s probably a large part of the problem with getting this processed. Have you checked with HIS office on what they sent in?

    • Thank you, you have said exactly how I feel. In fact, I did check with his people. He works for a hospital system, and according to the billing folk, the state has approved their charges for ambulatory psychiatry services, which vary between $550 and $750 depending on THE DAY. Insurance has paid for some, but not all. I have to get it fixed retroactively. Failing that, I plan on telling the hospital system to bite me, since it was apparently their responsibility to confirm coverage, as I do not have access to the magical portal that portends these things.

      • That is just crazy. No WONDER health insurance costs so much. Providers will charge whatever the payer approves. There’s no way they would get away with charging that much in a private PPO network.

        I was just cozying up with the Affordable Care Act this morning. Since the president was re-elected everyone is scrambling to understand and implement all the provisions they were praying would be overturned. Things are not going to get any better in the next few years, I promise.

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