We will also make an issue of managed care, and try to show that it is
neither "managed" nor "care." As the consumer, patient, client, the
decision to use your insurance through managed care is up to you. We just
want you to be aware of the possible pitfalls and difficulties that might
arise in the future, should you choose to use this option.
Even though the example we use may apply to the medical end of the spectrum, we will concentrate most of my comments on the mental health aspect of managed care.
In the past, you would visit your doctor, who examined you, took blood samples, and sent you for lab tests if he or she felt something was wrong. You sent your bill to the insurance company, who usually paid. Now, it is necessary to ask permission for these tests or procedures. Not only that, but a huge layer of people now stands between you and the services you need. Guess who pays for them, and for the multi-million dollar C.E.O.s who run these companies.
YOU DO!!!
The same procedures are followed on the mental health end of the spectrum. Except, every 10 or so visits, the therapist (or you) have to request permission to continue treatment. This means explaining why treatment is still necessary.
THIS MEANS DETAILS OF YOUR PROGRESS AND THE REASON YOU ARE THERE IN THE FIRST PLACE.
And, do you believe that this information is going to a mental health professional to decide?...Guess again! In many cases, it goes to a clerk who usually does not know much about treatment issues. YOU HAVE NO PRIVACY!!
And you though that Roe v. Wade reasserted your right to privacy.
The greatest obstacle is that you, as the purchaser of psychotherapy services, own the right of confidentiality - not the therapist. So if you sign on the dotted line to allow the insurance company and managed care provider the right to pry and probe, the therapist can do little, except to caution you about the consequences.
If you have a history of psychotherapy, even for something like anxiety after a divorce, or for stress on the job, you could have difficulty getting certain jobs, or be denied life insurance, or even have a "snitch" at the insurance company spread the word if you run for public office. In the next section, there is a WORD FOR WORD copy from a release that a client was asked to sign. Look at it carefully, and consider how your life would be different if ANY one of the people mentioned was notified of your therapy.
The following is quoted directly from a release from an insurance company.
"TO: All hospitals and other medical care institutions, physicians and
other medical professionals, insurance institutions, employers, group
policyholders, contractholders, benefit plan administrators, independent
claim administrators, and insurance support organizations.
"I authorize you to furnish New York Life Insurance Company, its agents,
affiliates and subsidiaries, or benefit plan administrators, independent
claim administrators, and insurance support organizations with copies of
records you may have concerning examinations, treatment, including drug,
alcohol or psychiatric treatments, if any, history, diagnoses, prescriptions,
other medical information, information relating to medical expenses and any
personal or employment related information which may relate to this claim.
"I understand that such information and records will be used by New York Life
for the purpose of evaluating and administering claims for benefits. New
York Life may release it for those purposes, or for the purpose of coordinating
benefit payments under any Non-Duplication of Benefit Provision, to any of
its affiliates and subsidiaries, to its representatives performing business
or legal functions, to insurance support organizations, to benefit plan
administrators, to independent claim administrators, to my employer, group
policyholder or contractholder and their representatives, and to all other
insurance institutions.
"This authorization shall be valid for the duration of this claim.
"I know that I have the right to ask for and receive a copy of this authorization.
I agree that a reproduced copy of this authorization will be as valid as the original."
Think carefully about using your insurance. Even without the managed care side of the issue, there is less and less privacy between you and the world. You risk much.
As a last comment, I have found that those who pay for their own treatment actually have a tendency to improve faster. They have made an investment in their own lives and seem to work harder than if treatment is paid for by a third party.
Please e-mail us if you have comments or questions.
There are other sources of on-line information about managed care. Please check them out; this issue is very important for you as consumers of mental health care.
BACK TO, OR FORWARD TO:
This page maintained by Straight Eagle Productions...Master of the Web