Confidentiality Hot Seat


The headline “Insurers In Kansas Asking Mental-Health Providers For Notes ” hit me like a punch in the face. I am not sure why as 1) I strongly believe every therapist should have the confidentiality, payment, and boundary talk with patients at their initial appointment and throughout the treatment of care. 2) I also do not believe in life long therapy. I make it clear with my clients the max amount of sessions available. Once these sessions are met they are entitled to two paid crisis management sessions, at which time I can refer them to another provider.

I have to say I agree with the insurance company’s statement “Audits only apply to a small number of high-cost providers and they’re used to determine whether the services rendered fit what was billed.” This makes me wonder what the going rate is and the practice of the provider. In the article Tom Bartlett, a clinical psychologist in Topeka, said, “It seems like unless his patients are suicidal; BCBS Kansas doesn’t want him to see them more than once a week. Which might be enough to help them survive, but not enough to help them thrive.” I believe one cannot continue to hold one’s hand throughout a life time and as a clinician one should not be the superhero trying to solely manage a patient care. I wonder why Bartlett isn’t splitting this patient care between himself (he is able to prescribe medication) and a clinical social worker who can provide this client with weekly therapy session in addition to his. Why hasn’t Bartlett delved into this individual’s support system to see if there is a viable member who can help his patient on this journey to wellness or referred this patient to various support groups or clinical research trials? As a clinical research therapist, working for a major University, I know there are often positive options and outcomes for support.

BCBS Kansas spokeswoman Mary Beth Chambers goes on to say, “We realize that claims analysis does not paint a complete picture, which is why we seek documentation to better understand the diagnostic complexity and why the provider believes a specific patient requires a significantly higher number of visits than the norm.” To this I would say, “Don’t put us providers in the confidentiality hot seat. Why not request providers submit a summary that would include history of diagnosis and a medication treatment plan of what is going on with the patient and how the individual has progressed over time.”

I also would challenge insurers and patients to think outside of the therapist’s office. I applaud the mom who enrolled her child in a wilderness camp. I was, however, pissed that insurer denied this service. I will say if insurers continue this path I have no choice to echo Bartlett “You’re probably going to find a lot more adult children with mental illness living in their parents’ houses.”

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2 Responses to Confidentiality Hot Seat

  1. Gee Jen says:

    Thanks for sharing. May I ask what your maximum number of sessions is?

    Liked by 1 person

    • msw blog says:

      You are welcome. I find it a topic many of us need to think about. I offer twelve, 55 minute individual sessions, ten, 85 minutes family/marriage/couple sessions, and four 45 minute crisis sessions.

      Liked by 1 person

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