I am a licensed mental health counselor
  1. I specialize with children and adolescents
  2. I specialize with adoption, foster care, abandonment, trauma...
  3. I could be making 40-70 percent more if I was not seeing clients with state insurance
  4. Yet I have found, some of my most motivated, and consistent clients, have state insurance.
  5. Back in 2011, as a new provider, newly licensed, I took on many people who had state insurance, even though the pay is very little.
  6. And even though many of my colleagues, would not take state insurance, because they needed the full pay
  7. Long story long, I was with one company, for over five years. They were a local company. I had 25 clients through them.
  8. Again, not trying to sound conceited or elite, but there are not many people who work with kids and teens, with defiance, attachment, trauma, etc.
  9. I could easily fill my practice with full paying clients
  10. But, I refuse to do that, if the clients who are already established with me, still need and want my care
  11. So, this community-based agency, who was taking care of Medicaid clients, got bought out, by fortune 500 company.
  12. That new company allowed me to submit and they automatically approved, all 17 of my active clients, as the other dozen clients, were on breaks, and since I was told by this new insurance company, I would be approved within a week, there was no need to pre-authorize everyone
  13. Fast forward to February. I receive phone calls and letters welcoming me to the new insurance company.
  14. I have not gotten any notification or packets, saying I was a provider
  15. So I followed up
  16. Then, it was like they realized they had lost me in the shuffle
  17. They decided I would not be a provider
  18. They sent me a letter on March 8, that was a certified letter needing a signature, and I must've been in session when they delivered it, so they sent it to the post office, and I could not get it until March 14
  19. The letter said that I was not approved as a provider, in contract with them
  20. I Promptly question if not being a provider for them meant I could not take on new clients? Or did it mean the preauthorizations considering of my 17 clients that were now under their care, (had all been with me, from six months to five years, under a different company), were also not allowed to see me?
  21. I did not receive notice. I didn't know what was going on, as I was simultaneously receiving calls and letters from people in the company welcoming me as A provider
  22. I of course informed all my clients, of the situation
  23. Most of them called in. All who called in, or told the prior authorizations to see me through 2016 would be a upheld.
  24. Meanwhile I am being told, I cannot see any clients, but I'm still not being told, if that means the clients transferred from the other management company
  25. Finally, I sent all the people I had been in touch with, and email CCing all of them, and pointing out the four different answers that I and the clients had been given
  26. At that point, I finally got a call from one of the lead credentialing people, saying that no, I was not allowed to see any of them, as of March 2.
  27. Funny thing. The committee met on March 2. To decide if I would be a provider. I had asked the credentialing specialist, to please email me or call me and let me know the decision
  28. I followed up with that request when I did not hear from her
  29. I followed up a week later. Still no answer
  30. I finally retrieved the certified letter, on March 14. But I did not get clarification, if their denial of me being a provider, meant new clients, and or the clients that had been transferred to them.
  31. I then received notification on March 22, that as of March 2, I would not be reimbursed for any sessions.
  32. If you are still reading this, you probably have an investment in how mental health is being cared for in our country
  33. I am actively fighting this situation
  34. I guess I'm just venting right now.
  35. Oh yeah, but they're also 17 to 25 people, with active rapport and therapy with me, who would like to see me, and we're allowed to see me, and now are abruptly told they need to transfer to a new provider
  36. Mental health doesn't work that way people
  37. Mental health care can only be as good as the people running it
  38. And right now, I am being treated as a problem with the company who just took over clients that I've had from six months to five years
  39. Did I mention that these are all children and teenagers? These are all minors.
  40. This situation, is absolutely ridiculous.