Her Mental Health Treatment Was Helping. That’s Why Insurance Cut Off Her Coverage.
Her Mental Health Treatment Was Helping. That’s Why Insurance Cut Off Her Coverage.
Providers, patients and even some federal judges say progress-based insurance denials harm patients at key moments of mental health treatment.
Honestly, I have to wonder if the cruelty is the point here. Even in the cold light of pure financial terms, it's bad for insurers to behave this like:
Unable to pay the $350-a-day out-of-pocket cost for additional intensive outpatient treatment, Moore left her program within a week of BCBS Texas’ denial. The insurer would only cover outpatient talk therapy.
During her final day at the program, records show, Moore’s suicidal thoughts and intent to carry them out had escalated from a 7 to a 10 on a 1-to-10 scale. She was barely eating or sleeping.
A few hours after the session, Moore drove herself to a hospital and was admitted to the emergency room, accelerating a downward spiral that would eventually cost the insurer tens of thousands of dollars, more than the cost of the treatment she initially requested.
Likely some internal incentive program that rewards certain minimum rejection rates. Costs following that are counted elsewhere.
I can definitely believe that. The whole "not my specific budget, not my problem" thing.
Boot licker.
Same thing that most people say about antibiotics. I don't need to finish this, I'm getting better now, and then they relapse and the antibiotics don't work the second time around. Stopping the treatment of a disease when the patient just begins recovery rather than allowing the patient to fully recover is always bad and sometimes means the second try will be that much more difficult as they are traumatized by the poor result of the previous try. "Fine" is not recovered. I was "fine" for 40+ years with undiagnosed ASD and ADHD, because I learned to mask so I appeared "fine". But really I just had to end treatment every time before prior to finding the root causes.
Source?
Absolutely not. You can't just stop mental health treatment. It's like they stopped cancer treatment because the tumors started reacting to treatment. They aren't gone, the patient isn't in remission, they're going to die if they don't get more treatment.
Guess they need a visit from our hero Luigi.
Assuming Luigi is guilty is stripping his rights.
Friend, I think you've drunk the Kool-aid.
The only reason the ADA can get away with recommending you brush your teeth 120 minues a month is, tooth brushes are cheep. The product don't cost insurance companies a dime. If tooth brushes cost $150 + an hour, you'd get 6 a year, so long as you'd met your deductible.
Mental health services are not just for folks who aren't doing well. Mental health services are prophylactic! To say that only folks not doing well need metal health services is medical model propaganda that the profit driven insurance industry wants you as a provider to buy into. They know they're screwing you over too! Remember when they made you sign a contract to not share your payout rates with other clinicians so you can't collectively bargain? The mental health parity act languished for ~ 16 years, and it's still a joke.
The term "Medical necessity" is corporate speak for "lower profits", and implies providers would be wide spread abusing the system if not for constant oversight. Meanwhile, they make billions on you, and your colleagues stolen labor.
The point of the article was about how the patients in question were only doing better(ish) due to intensive help from the therapists and still needed time.
From a lay persons view “better” does not equal doesn’t need continued therapy by a long shot and I’d rather have people use more therapy than they need than the other way around due to the outsize harms of getting that decision wrong.
You think people go to therapy for fun or what?
Somebody who'll sit and listen to them talk about themselves for an hour? Oh, hell yeah!