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Postdoctoral Reimbursement

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PsySeeker

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    Hello all,

    I’ve run into some challenges in crafting my postdoctoral experience. Specifically, I’ve got a solid option, but it’s predicated on my ability to bill under my supervisors license. I’ve seen the blanket statements on here that this isn’t possible, but I know that it sometimes is. The problem, in my case, is I really need to be able to bill Highmark BCBS in the Western PA region (though knowledge of any of the areas insurers could help), and it seems that no one at the company can give me (nor my prospective superviser) a solid answer.

    Thus, my question. Does anyone know anything about private pay reimbursement for postdoctoral residents under supervision from any of the major private pay insurers in Western PA?

    For the record, when we call, the agents seem to not really understand the question...

    Thanks!
     

    singasongofjoy

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    IF you would be doing mostly therapy, perhaps you could get licensed at the master's level and bill as such while still getting supervision towards your doctoral hours. (IME, diagnostic evaluations require a doctoral level, so you might be stuck doing mostly therapy for billing purposes, but I'm not in PA). Unless your supervisor was willing to be present for the minimum required F2F time and then supervise you remotely for diagnostics and that way they would be listed as the billing provider. That wouldn't work if the deal is they want you to basically cover the cost of your own salary though because you would not be the billing provider. It does not sound like an ideal situation. Good luck.
     

    AcronymAllergy

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    I'd issue the caveat of checking with your state board before billing for services at the master's level. I'm sure folks have done this without issue, but I also think I can recall hearing that some boards might disqualify supervised hours if they're earned while using a master's-level credential.
     
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    SpacePsych

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    I'd issue the caveat of checking with your state board before billing for services at the master's level. I'm sure folks have done this without issue, but I also think I can recall hearing that some boards might disqualify supervised hours if they're earned while using a master's-level credential.

    My cursory review of PA’s website a few weeks back has this to be the case. It forbids combining supervised hours with hours under a license. So this idea is probably not going to work of OP wants to be licensed in PA (at least in the next five years).
     
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    temppsych123

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    No clue about the state board part of the question, but several years ago I saw a postdoc (in a different state) where I paid for sessions out of pocket and then got reimbursed by my insurance (Aetna). The fact that it was billed under the supervisor's license number, but the postdoctoral clinician's name, was a HUGE PITA, and basically every one of my reimbursement forms got bounced for some stupid reason before I had to resubmit them to eventually get covered. So, no surprise that the folks you're getting on the phone aren't super clear about what you're asking.

    Is there a way that you (or someone else on postdoc) could do a session under the supervisor's license, try to bill to Highmark, and then waive the fee for the client if Highmark doesn't reimburse? Perhaps with a client who your supervisor would be willing to see sliding scale/low fee anyway, or for someone coming in for a single assessment or assessment+feedback set of sessions, without the expectation of long-term therapy with the postdoc. I know it seems ridiculous that you'd have to do that to figure out the answer, but it might be the easiest option...
     

    WisNeuro

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    Is there a way that you (or someone else on postdoc) could do a session under the supervisor's license, try to bill to Highmark, and then waive the fee for the client if Highmark doesn't reimburse? Perhaps with a client who your supervisor would be willing to see sliding scale/low fee anyway, or for someone coming in for a single assessment or assessment+feedback set of sessions, without the expectation of long-term therapy with the postdoc. I know it seems ridiculous that you'd have to do that to figure out the answer, but it might be the easiest option...

    It gets murky depending on your jurisdiction. But, you're getting into the grey area of insurance/billing fraud here. Also, good luck getting a PP provider to agree to supervise someone who is only seeing sliding scale or no-fee patients. Huge loss of income for the supervising provider there.
     

    PsySeeker

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    I'd issue the caveat of checking with your state board before billing for services at the master's level. I'm sure folks have done this without issue, but I also think I can recall hearing that some boards might disqualify supervised hours if they're earned while using a master's-level credential.
    This is true in PA. It’s also not possible to get licensed here as a masters level without jumping through a million hoops, and taking a bunch of additional classes, and then hundreds of master’s level supervised hours...
     

    PsySeeker

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    No clue about the state board part of the question, but several years ago I saw a postdoc (in a different state) where I paid for sessions out of pocket and then got reimbursed by my insurance (Aetna). The fact that it was billed under the supervisor's license number, but the postdoctoral clinician's name, was a HUGE PITA, and basically every one of my reimbursement forms got bounced for some stupid reason before I had to resubmit them to eventually get covered. So, no surprise that the folks you're getting on the phone aren't super clear about what you're asking.

    Is there a way that you (or someone else on postdoc) could do a session under the supervisor's license, try to bill to Highmark, and then waive the fee for the client if Highmark doesn't reimburse? Perhaps with a client who your supervisor would be willing to see sliding scale/low fee anyway, or for someone coming in for a single assessment or assessment+feedback set of sessions, without the expectation of long-term therapy with the postdoc. I know it seems ridiculous that you'd have to do that to figure out the answer, but it might be the easiest option...

    That’s an idea, albeit murky. I know others have successfully worked under supervisor’s licenses, even doing primarily evals in PA (a perspective supervisor of mine did just that). The thing is, it was a decade ago, and now it’s unclear how or if it’s still possible.

    It’s a real conundrum, because I need to know I’ll get the hours I need for licensure, but it doesn’t seem like we will know until I’m already committed and/or out of options for this year...

    What a mess this all is... I’m in a major metro and there are maybe 4 formal postdocs, 1 is VA, 1 is pediatric neuro, 1 is medical, and the other is college counseling with a 26k salary (seriously?)... I have multiple supervisors willing to work with me, but nobody can figure out how to pay me... if anyone’s got any any other ideas on this, I appreciate it. Just as I appreciate the thought so far....
     

    Ollie123

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    This is going to be very jurisdiction dependent. I billed under my supervisor's license. At least here, it is possible with private insurers (not medicare/medicaid). We are part of a large hospital system. I am credentialed through the hospital system, which is a part of it. If you are looking at small group practices or something like that, this is going to be sticky. Hospitals will likely have a whole department dedicated to it and you may be better off looking in that sort of setting. Even if not a "formal" post-doc, there are tons of settings where people take folks on to supervise. The clinical portion of mine was certainly informal (I was brought in as a researcher and they "found someone to supervise me" since the department wants me to get licensed) - this is a fairly common scenario
     
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