Tips / Tricks / Experiences Dealing w. Beh Health v. Med Plan Insurance Games

[Therapist4Chnge]

Part inquiry, part venting.

I am only paneled on the medical side of a handful of insurance companies (to provide neuropsych evals), but I still seem to get dragged into Beh. Health insurance BS more and more. I see people in my home state, as well as a number of surrounding states and also nationally. I keep running into issues with insurance companies (typically outside of my home state) who try and push through neuropsych evals through Beh Health (and requiring pre-auth, intake eval before granting testing hours, etc) instead of going through medical…which is why I'm seeing them. Eventually Beh. Health rejects it and says it is medical. I always provide medical codes and tell them that it is medical, but they say, "Well…we handle ALL testing through Beh Health". It seems like the same type of run around, but across different providers. BCBS did it to me a few months ago, now Aetna is doing it again, etc. It's happened w. plans in NJ, NY, TX, and PA just in the past yr.

Any ideas, forms/canned language, tactics that people have found useful? Most of the time I just say No and decline the referral bc it just isn't worth the hassle. For the ones that get through I generally book out 1-3ish months ahead of time, so there is plenty of time to go back and forth w. the insurance companies, but I don't want to waste my staff's time w. this kind of stuff.

Any insight, information, etc. would be greatly appreciated.

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[deleted343839]

I run into this same situation often because, like you, I am only paneled for medical payers. My naive hope that using H&B codes would help has not really panned out. I have yet to find a good solution though I'm curious to hear how others handle this.