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Using insurance for mental health treatment: know the risks

Whether you're considering billing your insurance or seeing a therapist who accepts your plan, it's important to consider the risks of using insurance for mental health services very carefully.  Insurance companies will not process claims without a valid diagnosis code.  Therefore, your therapist would be expected to give you a hasty diagnosis on the first visit, even if you're just seeking reimbursement for marriage counseling.  Additionally, since many plans will only approve treatment they deem "medically necessary," there is pressure to give a diagnosis that reflects this, and your records would also need to justify such a diagnosis.  Once a bill is submitted, this code remains part of your personal health information forever, regardless of it's validity, accuracy, if you switch insurance companies at a later date, and MAY impact future rates and coverage, and select career fields, including: transportation, law enforcement, and military service. 

Your medical records no longer private

If your right to privacy is important to you, it's important to understand that changes are currently being implemented within government and health care systems.  According to the “Federal Health IT Strategic Plan 2015-2020” (archieved pdf), your health records will be shared with 38 government agencies (that are currently disclosed), with personal consequences for the average citizen yet unknown.

 

Note the stated mission is "Collect, Share, Use" YOUR formerly private health information.

The 38 government agencies slated to share your health records are listed below:

  • Administration for Children & Families (ACF)

  • Administration for Community Living (ACL)

  • Agency for Healthcare Research and Quality (AHRQ)

  • Centers for Disease Control and Prevention (CDC)

  • Centers for Medicare & Medicaid Services (CMS)

  • Department of Agriculture (USDA)

  • Department of Defense (DOD)

  • Department of Education (DOE)

  • Department of Justice (DOJ)

  • Bureau of Prisons (BOP)

  • Department of Labor (DOL)

  • Department of Veterans Affairs (VA)

  • Federal Communications Commission (FCC)

  • Federal Health Architecture (FHA)

  • Federal Trade Commission (FTC)

  • Food and Drug Administration (FDA)

  • Health Resources and Services Administration (HRSA)

  • HHS Assistant Secretary for Financial Resources (ASFR)

  • HHS Assistant Secretary for Health (OASH)

  • HHS Assistant Secretary for Legislation (ASL)

  • HHS Assistant Secretary for Planning and Evaluation (ASPE)

  • HHS Assistant Secretary for Preparedness and Response (ASPR)

  • HHS Office of the National Coordinator for Health Information Technology (ONC)

  • HHS Office for Civil Rights (OCR)

  • HHS Office of the Chief Information Officer (OCIO)

  • HHS Office of the Chief Technology Officer (CTO)

  • HHS Office of the General Counsel (OGC)

  • HHS Office of Minority Health (OMH)

  • HHS Office of the Secretary (OS)

  • Indian Health Service (IHS)

  • National Aeronautics and Space Administration (NASA)

  • National Institutes of Health (NIH)

  • National Institute of Standards and Technology (NIST)

  • National Science Foundation (NSF)

  • Networking and Information Technology Research and Development (NITRD)

  • Office of Personnel Management (OPM)

  • Social Security Administration (SSA)

  • Substance Abuse and Mental Health Services Administration (SAMHSA)

 

Bob Parkins, MS, LMFT
Licensed Marriage and Family Therapist

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