Psychiatrist did not verify my insurance before our appointment. They say they don't take my insurance, my insurance says they do. Now the psychiatrist is asking me to pay out of pocket

[u/trebory6]

So Psychiatrist did not verify my insurance before our appointment. They say they don't take my insurance, my insurance says they do. Now the psychiatrist is asking me to pay out of pocket while my insurance is saying they can't do anything because they can't force the provider to use insurance. What can I do?

Edit: I just got off the phone on a 3 way call between my insurance and provider assistant, and my insurance basically no bullshitted the assistant by asking for the tax number and another number and then confirmed 100% that they are in network and provided all the information, and that she'd have to put in a report if they still say they can't accept my insurance.

Assistant ended up saying they called my provider and they'll use some "old system" to bill me, and the 3rd party verifier they use was adamant they weren't in network for me.

They ended up complying and allowing me to pay my $50 copay. So either it was an obstinate assistant or just typical insurance bullshit. lol

[u/HotTakes4HotCakes]

Psychology Today

Are you saying that a magazine told you this psychiatrist accepted your insurance?

What kind of psychiatrist is this exactly?

[u/xtlou → u/HotTakes4HotCakes]

Psychology Today is a well regarded resource for people trying to find mental health care providers. Providers register & can write bios, list areas of specialty, what insurance plans they take, whether they do tele health or in office visits, if the have a sliding scale fee, and the search functionality is quite good. You can search for religious affiliations, if they’re LBGTQ friendly, and even what techniques they may use.

It sounds suspect but it helped me immensely when my insurance was an insufficient and frustrating disappointment.

[u/NiSayingKnight13 → u/xtlou]

Yes, but the website does not verify that the clinician is actually insured and all of these tecniques and what not are simple check boxes the clinican and_or office manager checks. The only thing verified through the directory is that they are licensed.

[u/xtlou → u/NiSayingKnight13]

Right. So an office manger or clinician said “this is an insurance we accept” when they submitted to psychologytoday.com, which is how OP found them. And then OP also verified the info with their insurance.

The comment made it sound like OP saw an ad next to the Personals section of an old paper magazine as if PT isn’t a legitimate resource.

[u/NiSayingKnight13 → u/xtlou]

I'm just saying PT is legitimate in the sense that the people are licensed, but everything about the person's profile is self reported and I'd recommend verifying everything, especially payment through insurance for mental health services.

[u/trebory6 → u/HotTakes4HotCakes]

Psychology Today, like the website, has a very robust mental health provider search with a lot of criteria. Both for therapy and Psychiatry that lets you filter by everything from ailment to insurance. It's usually pretty good.

[u/HotTakes4HotCakes → u/trebory6]

Oh I had no idea. I also haven't needed to change my provider in a good 15 years now but if I ever need to, good to know.

[u/Shitp0st_Supreme → u/HotTakes4HotCakes]

PsychologyToday.com has a provider directory that many clinics and private practices use. It has profiles, and potential clients can search for therapists with certain focuses and demographics in their area. It's how I found my therapist. And I also work the front desk for a therapy clinic, and many of our callers find us through PsychologyToday.com.

That being said, the therapist pages are only good when they're regularly updated. A lot of providers make a profile and don't update it for changes, so there were cases such as when I had callers requesting a specific provider to treat their BPD, as listed on her PsychologyToday page, however our internal system stated she did not specialize in BPD, so we should not schedule clients with BPD with her. I was pretty irritated and took screenshots of the page, linked that, shared a log of how many callers asked about it due to that profile, and said that she needs to update it. Thankfully, it was fixed. But I also had a situation where a therapist was listed as in-network for my insurance on her profile but then at the end of the consult she said she was cash only.

So, yes, it is up to the client to verify that they are in-network, however, in this case the insurance confirmed that the provider was in-network, meaning that to their knowledge, this provider will submit claims to them, so I'd be comfortable scheduling if my insurance said that they were in-network.

[u/[deleted] → u/Shitp0st_Supreme]

Also, as of 2022, the No Surprises Act includes that an insurer making an "affirmative statement" that a provider is in-network is binding on them, and that their provider directory can be held as an affirmative statement.

[u/snoopy369 → u/HotTakes4HotCakes]

Psychology Today is one of the major search engines for therapists and psychiatrists, and they make it fairly easy to see what insurance is accepted etc. (subject to the provider self reporting accurately of course).