Why We Choose to Continue Billing Insurance

Why We Choose To Continue Billing Insurance

Written by Kelsie Goller, MA, LPC-S, RPT, and Sarah Kranz, PhD

Kranz Psychological Services

This week, we received a notification from an insurance company responding to a claim we submitted. “Great news! The following claim has been paid!” the insurance company claims. The amount billed for this service, which was for an hour of face to face time with a client (with someone with an advanced degree and years of experience), in addition to the time that it took the provider to write the insurance-compliant notes for the client’s chart was $160. The amount the insurance paid on this claim? 40 CENTS.

It’s not surprising at all that many mental health professionals choose not to take insurance. Getting credentialed on insurance boards and submitting all the claims is a significant time commitment, so it is difficult for the mental health professional out on their own to give up precious hours that could be spent doing what we love (providing counseling or psychological evaluations) to do what we are not generally trained for (billing, credentialing, refuting denied claims). In our office, we have a billing department whom we are extremely grateful for, who navigate those murky waters for us, but this also means that compensation from the insurance company should contribute to their salaries, as well. Why do the staff at Kranz Psychological Services (KPS) commit to the frequently frustrating, often disappointing work of credentialing providers, accepting insurance, and billing insurance?

Because we believe that everyone (regardless of socioeconomic status, geographical location, or age) should have access to high quality mental health services AND that our professional staff with years of training and experience should be paid commensurately. That is hard to achieve with private pay. Private pay rates may range from $90 to $120 (or more), and clients may meet weekly or biweekly with a counselor. For the majority of clients, that financial commitment is not possible. Additionally, most children in foster care and many who have been adopted receive Medicaid, and this is a population that we are passionate about providing accessible services to. When we bill insurances, including Medicaid, we allow mental health treatment to be accessible to many who should rightly have access to counseling or psychological evaluations, as insurance companies fill in the gap. At least, that is the ideal. Unfortunately, it is sometimes the second part of the equation (paying our professional staff with years of training and experience commensurately) that sometimes suffers when an insurance company chooses to add 40 cents to the member’s (low) copay for an hour’s worth of time.

Many insurance companies are making up the difference between what is affordable for clients and what is expected from clinicians, but even in those times when an insurance company pays an amount that wouldn’t even cover the cost of a stamp, we are still committed to making services accessible for as many people as possible by continuing to advocate for what both clients and counselors need. Thankfully, the entire staff (both practitioners and support staff) here at KPS is like-minded, and we will continue to serve our people well, without favoring higher paying insurances over lower paying insurances, without compromising our belief that every person, no matter their status, is equally worthy of our time and equally worthy of high quality mental health care.