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Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy

Thursday, January 29, 2015

Is My Work “Medically Necessary”?

How insurance companies try to get around rules for mental health care.

By Darcy Lockman
Originally published January 12, 2015

Here is an excerpt:

I’ve been in private practice since 2010. Most of the people I see submit their bills to their insurance companies for reimbursement. It’s a testament to the integrity in the industry that these reimbursements often come through without a hitch. (Though only in this era of predictable corporate malfeasance could a company simply making good on its contractual obligations be praised for its integrity.) Somehow, four entire years went by during which I never once had to submit to a utilization review. But in the past year, possibly because of increased cost concerns in the wake of the Affordable Care Act, I’ve received a handful of phone calls, each caller requesting that I schedule a talk with a case manager.

The entire article is here.