I regret to say that California psychologists have
turned out to be no better or worse than the medical doctors when it comes to the Managed
Health Care System. Psychologists have, by and large, become employees of the Managed
Health Care System. Their loyalties are to the owners of the hands that feed them: The
Managed Health Care System Para-professionals (clerks) who send new patients to their
offices with pre-qualified numbers of visits. When these patients arrive, the
psychologists adjust the fees charged to the insurance company down by about 25% of the
1995 level. That's the good part. The bad part is that the psychologists are required to
fill out forms revealing the most intimate details of these "managed" patients'
lives, including the intimate habits and behaviors of family members. This information,
obtained from clients solely by self-report, is not validated for accuracy before it is
returned to the clerks that made the referrals (authorized treatment). When these forms
arrive in the clerk's office, they are not only chock full of intimate and personal
information, each form is also complete with given client's name, date of birth, address,
phone number and Social Security number. No attempt is made to protect the privacy and
confidentiality of the patients. To repeat, your identity isn't even protected
by a device as simple as omitting your name and using your policyholder number .
Nothing "a managed
patient" tells a therapist can be safely considered confidential between client and
therapist. Since the clerk works for a contractor who gave the lowest
bid to an insurance carrier to "manage" psychotherapy service costs (to do the
dirty work of denying benefits), the documentation of the private lives and thoughts of
patients isn't even under the direct custody of the major insurance carriers. Who
knows what the clerk does with that information? Who knows where it will show up
next? You don't have to be paranoid to know it won't disappear.
It might surprise you to know that as a condition of getting your claim paid, you
signed a "release form" to let the managed care corporation collect all the
information they want from your therapist with no guarantee on that "release
form" what
will be done with the information. Click here to see where
the California Department of Insurance directs your complaint about your privacy being
invaded by managed care corporations (it seems the CDI has no jurisdiction
over health management corporations). You can't even be sure the therapist will tell you
the truth when asked about the information he or she is collecting for the Managed Health
Care System because some Managed Health Care System mental health contractors will drop
the therapist as a provider if he or she reveals any information about the forms the
company uses. Frankly, I don't want to be in an alliance with the managed health
care corporations against the best interests of my clients. There are a few other therapists who agree
with this position and are trying to change the laws regulating the managed health care
industry. For the present, it is a very bad system
and it makes the most useful therapy impossible.
For the latest on the "Patients Bill
of Rights," check out the following link: Patient
Bill of Rights? There is more talk than two years ago but no more
action. For now, the managed health folks
are only being regulated by the honor system. "Good luck America," a cynic
was overheard whispering under his breath.
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Herr, Ph.D.
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