For those of you, like me, who choose not to work directly with insurance companies, you are considered to be an out-of-network provider. A mental health provider I will call “John” wrote in asking for clarification about his out-of-network responsibilities . . . .
A new client whose health insurance policy is from out-of-state just sent me a Treatment Request Form from Magellan, and he told me that I am
supposed to fill it out and submit it to them.
Is this true? If I don’t accept insurance, I thought that meant I would not have to fill out any insurance-related paperwork?
Please help to clarify if you can.”
One of the perks of being a mental health provider in private practice is that you get to determine what each of your office policies is including those that address if and how you decide to work with insurance and managed care. Because “John” is an out-of-network provider, he may choose (or choose not)
- to complete insurance claims for his clients;
- to then file those claims for clients;
- to contact insurance companies on behalf of his clients’ claims (after obtaining permission to do so); and,
- to accept payments directly from insurance companies.
Each one of these choices can be made independent of the other choices listed above. (I no longer choose to work directly with managed care. Here’s a post I wrote explaining why.)
As a mental health provider you are not obligated to complete any form or document from an insurance company unless you have agreed you will do so (typically in the form of a contract).
[my own emphasis] I really enjoy working with clients on relationship and communication issues. Feel free to give her my phone # below.”
individuals with a masters degree is the
Recent Comments