From The Therapist, magazine of the California Association
of Marriage and Family Therapists (Nov/Dec. 2008)
by Patrick Healy, MFT, Former Board President
Barbara Griswold is credited for perhaps the greatest paradigm shift of my career as a licensed marriage and family therapist. What has changed is my perspective toward managed care. It has undergone an about face. Once I’d sit among a group of MFTs who one after the other adamantly proclaimed their refusal to bother with insurance companies. They dealt strictly with cash pay clients. Mostly I listened, not because I thought them errant in their thinking but because in truth, private practice made up the smaller portion of my work as a mental health professional. The bulk of it still is done in a school setting and insurance there isn’t a factor. As for private practice, I was always on some insurance panels, but most of my clients are cash pay. That is changing.
The altered viewpoint came last spring at the CAMFT Annual Conference in Los Angeles. The staff asked me to introduce Barbara at her workshop, appropriately titled, “What Every Therapist Should Know About Insurance – Even If you Want Nothing To Do with It.” I was happy, even honored, to make the introduction. I had an appreciation for Barbara Griswold and felt gratitude for the contributions she has made over the years to the association. She was and still is, a member of the CAMFT Ethics Committee, and we served together on a prior conference planning committee. Still, her workshop title seemed to say it all, I didn’t want much to do with it. And then Barbara started speaking, and all of it sounded from the heart, and what she said seemed to make sense; a lot of sense. Admitting to be wrong isn’t an obstacle for me. It’s just that I’m not comfortable being naive. And it was becoming clear I had been both.
Pretty much she convinced me out of the gate, and this time it was she who was adamant. Clients, directly or indirectly, pay for health benefits, and when health benefits include psychotherapy, they should be able to take advantage of those benefits if the criteria are met. It doesn’t speak well for the profession or the professional when a client is refused treatment with the therapist to whom they’ve been referred; especially if it’s because the provider doesn’t want to take insurance. It doesn’t feel good. It’s not just. There’s more to my conversion and not everything Barbara had to say was easy to hear. Really, she spoke to everything I knew and didn’t want to hear and wanted nothing to do with. Except now, it’s no longer reasonable to keep on as I had been keeping on.
The process is proving to be a rich education, which is to say it has been slow and laborious. There are the applications, the denials, the appeals, instructions, claim forms and more. My wife is good with details. She helps where it’s appropriate. In the office next door I have a mentor; a person who helped put MFTs on the map in California. His direction and coaching is beneficial. And Barbara Griswold is available as a consultant, she’s a resource. Her book, Navigating the Insurance Maze is a must-have, in my opinion. Her newsletter is filled with practical advice.
Like many parts of life, you find what you’re looking for; the good if you want to find it, the bad if you go looking. As I navigate the insurance maze I am developing greater discipline. I require myself to be more organized, there is increased accountability. The times have changed. There will be other issues where I must consider whether I am in error. As for insurance matters, at the least, I’m a bit less naive.
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