EveHarrington
VIP Member
Insurance should have been included as its a popular option in the USA. Results will be inaccurate because no insurance option was listed.
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That would be either the full reimbursement, or partial reimbursement.
EveHarrington
VIP Member
Wrong.
Reimbursement means you pay and get paid back. Insurance typically means you don't pay as much at the time of services.
I'm tired of arguing with an anonymous person on thread after thread after thread. Putting anon on ignore.
Friday
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Actually, I just hit the button my mistake. Mobile. You'd responded before I could notate it.
Your provider billing your insurance is a courtesy. A common one in the US & a few other places, but not required. In other countries, the reverse is true. Most people bill their own insurance, but a few providers will bill for you.
How the system actually works is the entire payment IS due at time of service. So someone is always getting reimbursed, when dealing with insurance. Either you, or your provider. Depending on who fronts the cost. Some people's insurance reimburses at 100%, others reimburse at different rates. 80% minus copay & deductible is common, but the reimbursement rate varies plan by plan.
The OP providing reimbursed @100% vs reimbursed @less than 100% keeps things both simple and valid regardless of which country we're in. And whether one is talking insurance, pension, or any other program.
Your provider billing your insurance is a courtesy. A common one in the US & a few other places, but not required. In other countries, the reverse is true. Most people bill their own insurance, but a few providers will bill for you.
How the system actually works is the entire payment IS due at time of service. So someone is always getting reimbursed, when dealing with insurance. Either you, or your provider. Depending on who fronts the cost. Some people's insurance reimburses at 100%, others reimburse at different rates. 80% minus copay & deductible is common, but the reimbursement rate varies plan by plan.
The OP providing reimbursed @100% vs reimbursed @less than 100% keeps things both simple and valid regardless of which country we're in. And whether one is talking insurance, pension, or any other program.
- If your provider bills for you, (they front the cost) then they collect your co-pay and are then reimbursed by your insurance company, banking on actually receiving payment sometime over the next few months. This is also why pre-authorization is required by some providers, or for some services; as insurance companies are fairly notorious for not reimbursing without a fight, at even the most specious reason, or randomly for no reason, they just want to make you resubmit everything. Shrug. They make zillions on interest every day they hold onto money in the bank, so the longer they can collect the interest the better.
- If they don't bill for you, then you pay then entire amount, and submit the paperwork to your insurance company yourself. Some insurance companies allow for individual reimbursement, others require "batches" of 5/10/16/25 appointments to be submitted at the same time. Then the insurance company reimburses you, minus your copay.
It's in most providers best interest to bill themselves, and take periodic losses &/or send clients to collection, because most people can't afford the cost of even basic medical care out of pocket, much less something like an ER visit (10k and upwards, easily). But it's also a huge amount of work. Hospitals have entire billing departments, clinics usually staff at least 2-3 people. At 60k or more per person per year? (And a solo practice easily has enough clients to make billing their insurance 40+ hour a week job)... That's not a service a lot of solo-providers can offer. Either they don't have the capital to pay for an employee, or they don't have an extra 40 hours to work, themselves, on top of their medical work. Which is a good thing to know, when looking for a therapist, as their not "taking" insurance? Doesn't actually mean that they're not covered by your insurance. It usually* just means one has to do the legwork one's self. There's a little bit of a learning curve, but it's actually pretty easy, once you get the hang of it.
* As long as they're able to bill insurance. An MSW, for example, cannot bill insurance. A LCSW can. Same degree, but an MSW hasn't finished their supervisory hours (3000 total, no less than 500 hours per year, no more than 1500, if they haven't changed it). Same with psychologists, doctors, etc. Insurance won't cover them until they've completed the process.
^^^
This is both from being a HUC in a few different departments in hospital, being a hospital parent (being millions in debt, as insurance refused payment, but the hospital didn't care / covered all the costs & we worked out payment -mostly medical scholarships, grants, etc. from people donating- later), as well as spending most of my marriage with individual insurance / aka nooooo one was a preferred provider nor would bill weird east coast insurance on the west coast as a courtesy, so if we wanted treatment, had to fax the forms -and check for preauthorization if we didn't want to get stuck with a whopping bill they wouldn't reimburse- ourselves. <<< But you could easily look it up. Millions of people bill their own insurance companies. And while the courtesy is common in the US, in other places, it's not.
- If they don't bill for you, then you pay then entire amount, and submit the paperwork to your insurance company yourself. Some insurance companies allow for individual reimbursement, others require "batches" of 5/10/16/25 appointments to be submitted at the same time. Then the insurance company reimburses you, minus your copay.
It's in most providers best interest to bill themselves, and take periodic losses &/or send clients to collection, because most people can't afford the cost of even basic medical care out of pocket, much less something like an ER visit (10k and upwards, easily). But it's also a huge amount of work. Hospitals have entire billing departments, clinics usually staff at least 2-3 people. At 60k or more per person per year? (And a solo practice easily has enough clients to make billing their insurance 40+ hour a week job)... That's not a service a lot of solo-providers can offer. Either they don't have the capital to pay for an employee, or they don't have an extra 40 hours to work, themselves, on top of their medical work. Which is a good thing to know, when looking for a therapist, as their not "taking" insurance? Doesn't actually mean that they're not covered by your insurance. It usually* just means one has to do the legwork one's self. There's a little bit of a learning curve, but it's actually pretty easy, once you get the hang of it.
* As long as they're able to bill insurance. An MSW, for example, cannot bill insurance. A LCSW can. Same degree, but an MSW hasn't finished their supervisory hours (3000 total, no less than 500 hours per year, no more than 1500, if they haven't changed it). Same with psychologists, doctors, etc. Insurance won't cover them until they've completed the process.
^^^
This is both from being a HUC in a few different departments in hospital, being a hospital parent (being millions in debt, as insurance refused payment, but the hospital didn't care / covered all the costs & we worked out payment -mostly medical scholarships, grants, etc. from people donating- later), as well as spending most of my marriage with individual insurance / aka nooooo one was a preferred provider nor would bill weird east coast insurance on the west coast as a courtesy, so if we wanted treatment, had to fax the forms -and check for preauthorization if we didn't want to get stuck with a whopping bill they wouldn't reimburse- ourselves. <<< But you could easily look it up. Millions of people bill their own insurance companies. And while the courtesy is common in the US, in other places, it's not.
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lostforgottensoul
VIP Member
Group insurence.
NewBeginnings
Gold Member
When I started I had full coverage from my insurance campany. After a year and a half, I went on my employers plan which was a $25 copay for T and pdoc. I go weekly.
The entire time I have been with the same therapist. I consider my situation unique and beneficial. My T has had a wealth of experiences and specializes in trauma. We had a connection early on. That said she works for an agency and has to complete paperwork on me every 12 sessions. I am a bit weirded out by the paper trail but I would not be able to make it otherwise. Then she says the billing department handles all the coding. She said she has no problem getting authorization for sessions for all her clients but that in the hospital it is more difficult. Glad to have found my T.
The entire time I have been with the same therapist. I consider my situation unique and beneficial. My T has had a wealth of experiences and specializes in trauma. We had a connection early on. That said she works for an agency and has to complete paperwork on me every 12 sessions. I am a bit weirded out by the paper trail but I would not be able to make it otherwise. Then she says the billing department handles all the coding. She said she has no problem getting authorization for sessions for all her clients but that in the hospital it is more difficult. Glad to have found my T.
D
Deleted member 8714
I've paid mine through being on SSDI. Before that we had savings and I used that. Most of the therapists I used had either a sliding scale or low cost fees. One therapist I stayed with for 14 years had a sliding scale fee and the tops I ever paid was $40 per session and that was toward the end. I saw him only twice a month at that time so it was affordable.
I found a service online, nationwide in US, where you pay a flat fee to join and then pay a sliding scale fee at $30 - $50 US dollars per 50 - 55 minute session no matter what kind of therapist they are including psychologists. I've seriously considered going back to therapy, and that would make it even more affordable than my last T's fee of $50 per 50 - 55 minute session which strained my budget.
I found a service online, nationwide in US, where you pay a flat fee to join and then pay a sliding scale fee at $30 - $50 US dollars per 50 - 55 minute session no matter what kind of therapist they are including psychologists. I've seriously considered going back to therapy, and that would make it even more affordable than my last T's fee of $50 per 50 - 55 minute session which strained my budget.
BigBirdsSister
Bronze Member
Mine is 10 euros...its with a charity. They are wonderful and work on a sliding scale :) I am going to make them some nice cushion covers for their offices too! My T said I could <3
Hopefully
Diamond Member
Mine is all through the NHS, so government funded. It has not been completely without problem but on the whole has been a great service. I am about to start again with some more EMDR.
whiteraven
Diamond Member
I'm self-pay. My T doesn't take insurance. But after I started seeing him, he reduced his fee significantly so it wasn't a burden for me. :-)
Changing4Best
VIP Member
Government pays 80% of it.
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