Used priv insurance, saw in-net therapist employed by a FQHC health center a few times. Never met in person, only did over phone because covid. First time we talked, we spoke for –12 min– talking about my goals & expectations & scheduled my 1st official therapy visit at the end. Didn’t realize it at the time but he charged $99 for the phone call. Used hcpcs code t 10 1 6. I thought it was free since it was so short & he never said he was going to bill me for it. When I looked this code up it says for 15 min. I checked my record and call was only 12 min. It’s possible the therapist wrote stuff down after the visit making it “15 min” which I’m not sure is allowed.
My insurance got the therapist claim and they are denying it because it’s not med care, it’s admin care. I’m now on the hook for entire phone call/appointment and they are charging me the full amount my normal therapy visits cost (different code, these normal therapy visits CPT codes not HCPCS).
I didn’t record the phone call but I know they did (they aren’t releasing it to me tho saying they “don’t record calls”). I want them to rescind the insurance claim or waive the fee but Idk how. In AZ not much billing protection for health care patients. Additionally I think they might not want to voluntarily rescind the insurance claim bcuz the optics look bad for them bcuz it looks like fraud.
How can I get them to rescind this claim or waive all of it?
More salient facts:
-the original phone call was scheduled as an “appointment.” however, before i spoke to this therapist, i spoke many times with the health center’s mental health case manager, all my calls with her were also scheduled as “appointments.” in my calls/”appointments” with the case manager (who didn’t have any medical licenses), i never was billed for my long phone “appointments”/calls with her.
-the mental health dept of this health center is mostly separate from the main part/medical part of the health center. its very a small dept & they mostly handle their own things including scheduling.
-Fqhc=serves underserved areas (ex, low income person with no insurance) but they also take priv insurance. altho they are fqhc, they been proven very stubborn with me on my past medical non mental health bills as a priv insurance client, refusing to give me any kind of discount or payment plan.
-the person who oversees the entire mental health dept is also my psych. from this incident, i now know this med center mental health dept charges anytime a patient speaks with a licensed med professional about anything. while i want to escalate this to her, I’m scared about getting another surprise bill for talking to a med professional.
Last, i’m gonna to end ties with these people so don’t tell me i need to find a new therapist. I will but i can’t afford this bill and need this charge removed.
submitted by /u/Common-Stranger613
[link] [comments]
Used priv insurance, saw in-net therapist employed by a FQHC health center a few times. Never met in person, only did over phone because covid. First time we talked, we spoke for –12 min– talking about my goals & expectations & scheduled my 1st official therapy visit at the end. Didn’t realize it at the time but he charged $99 for the phone call. Used hcpcs code t 10 1 6. I thought it was free since it was so short & he never said he was going to bill me for it. When I looked this code up it says for 15 min. I checked my record and call was only 12 min. It’s possible the therapist wrote stuff down after the visit making it “15 min” which I’m not sure is allowed. My insurance got the therapist claim and they are denying it because it’s not med care, it’s admin care. I’m now on the hook for entire phone call/appointment and they are charging me the full amount my normal therapy visits cost (different code, these normal therapy visits CPT codes not HCPCS). I didn’t record the phone call but I know they did (they aren’t releasing it to me tho saying they “don’t record calls”). I want them to rescind the insurance claim or waive the fee but Idk how. In AZ not much billing protection for health care patients. Additionally I think they might not want to voluntarily rescind the insurance claim bcuz the optics look bad for them bcuz it looks like fraud. How can I get them to rescind this claim or waive all of it? More salient facts: -the original phone call was scheduled as an “appointment.” however, before i spoke to this therapist, i spoke many times with the health center’s mental health case manager, all my calls with her were also scheduled as “appointments.” in my calls/”appointments” with the case manager (who didn’t have any medical licenses), i never was billed for my long phone “appointments”/calls with her. -the mental health dept of this health center is mostly separate from the main part/medical part of the health center. its very a small dept & they mostly handle their own things including scheduling. -Fqhc=serves underserved areas (ex, low income person with no insurance) but they also take priv insurance. altho they are fqhc, they been proven very stubborn with me on my past medical non mental health bills as a priv insurance client, refusing to give me any kind of discount or payment plan. -the person who oversees the entire mental health dept is also my psych. from this incident, i now know this med center mental health dept charges anytime a patient speaks with a licensed med professional about anything. while i want to escalate this to her, I’m scared about getting another surprise bill for talking to a med professional. Last, i’m gonna to end ties with these people so don’t tell me i need to find a new therapist. I will but i can’t afford this bill and need this charge removed.
submitted by /u/Common-Stranger613 [link] [comments]Read Morer/HealthInsurance