Monday, March 23, 2009

Dilemma

While doing my taxes, I noticed that I hadn't received any reimbursement for my psychiatrist visits, even though I remembered submitting the receipts. I called today (among other things, I'm still being billed for the time I was hit by a car) and learned that there's no out-of-network coverage for behavioral health. Maybe for all health, I'm not sure.

So I'm in a bind. Do I stop seeing a psychiatrist I've been seeing for more than 5 years, who knows me well and has managed me up to this point? I'm too stunned to think. Gd knows how I'll get through the rest of the day. Hope my clients feel like talking, because I want to curl into a ball and go to sleep. In fact, I slept most of the weekend. But I can't do that all week. I'm just stunned. I don't know what to do.

At least I don't feel like eating. For once.
Copyright (c) "Ayelet Survivor"

7 comments:

  1. If you can afford to pay out of network by all means continue seeing this doctor. Don't risk finding another provider.
    Do the bills add up enough to be tax deductible? Can you fight the insurance company on this, given the long history w/this provider? Can Roda give you a break on his fees if you are not covered?

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  2. You may be able to challenge their exclusion of the treatment from coverage. Go over your policy with a fine tooth comb and look up on the internet and see if anyone else has managed to get this insurance company to pay for mental health. If your'e a really squeaky wheel, you may get the grease.

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  3. Also remember if you have a flex plan at work you can use the flex to pay that which the insurance won't. Also see if there is more than one plan offered and if one has out of network coverage and if you can switch midyear. (Generally you can't but with the recession lots of carriers are allowing it).

    This is my field, email me if I can help you with this more. MES

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  4. Flex plan is a good idea, MES. I'm eligible for that after I've been with the company for a year. I don't think we have any other plans -- it's a small agency. I'm going to talk to my supervisor on Wednesday to see what she thinks.

    I just feel like I'm sleepwalking. I can barely think straight. I'm numb. It's just one damn thing after another. I'm so tired of it. (I know you know how I feel.)

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  5. Definitely worth speaking with Dr Roda about a discount -- and it's also worth speaking with him about whether he'd consider joining their network. Clearly, if there are major reasons he isn't in it, then you might not change his mind, but maybe it isn't a big deal for him to join...?

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  6. You definitely should discuss it with Dr. Roda. I have no idea how the American medical insurance system works. But I know that there are always back door entrances after the initial "no". My brother recently received a "no" from his medical insurance here regarding the surgeon he was going to, so the surgeon got involved himself to help them and they were able to get at least a partial "yes". See if Dr. Roda can help.

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  7. honey I am right there with you in regards to the being tired of it all. hugs! MES

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