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...is she dead?
March 24, 2014 12:24 PM   Subscribe

How to handle insurance when your doctor/therapist goes AWOL?

I'd been seeing a therapist for several months last year. It wasn't not not going anywhere (but nothing has ever gone anywhere), but it was OK enough that I didn't feel like going through the hassle of seeing 15 different people in an attempt to find someone who I didn't have to explain the basic principles of my job and my situation to and didn't seem like they'd have bullied me if we went to high school together and actually took my insurance, you know the drill. There was one major problem, which was insurance: there was apparently an issue with my current plan (insurance company said they covered the sessions, she said they had turned it down, god I hate insurance companies they always do this shit.) I went on Obamacare/Medicaid at the beginning of 2014 and didn't know whether she took it, so after the holidays I called her to see if she took it and to get a referral if not.

Or so I thought. It took several calls and messages over the course of several weeks to get in touch with her, which was in mid-January while I was moving, and she apologized and said she'd been sick and to get back in touch to talk scheduling / insurance stuff when my move was over. It's now the end of March, and I've done that, rather tried to do that, by which I mean I've been calling about once a week leaving messages trying to get in touch, and I sent an email, and I haven't heard anything. It is like leaving messages into the void. It is like she's dead or something. And I still may or may not be on the hook for several months' worth of bills.

What is the appropriate etiquette/boundaries in this situation? On the one hand I don't want to come off like some kind of creepy stalker, and if this were literally any other context I probably would. On the other hand, this is several months' worth of medical bills that are up in the air, and if I know anything about medical bills it's that they don't just disappear. Maybe this is some sort of analogue to when you get ghosted on while dating, a "polite" way of saying "fuck you, I don't want to deal with your shit anymore," but generally when therapists have told me that they've actually told me that, in person, and more to the point, you also don't have several months' worth of Schroedinger's medical bills while dating.

(If anyone asks I didn't get any signs -- ever, none, at no point -- that she was flaky or disreputable. She's licensed, she's listed in all the websites/databases she should be, she's been in practice a long time, the office wasn't sketchy in the slightest. Nor did it seem like she had, as morbid as this sounds, serious health problems. All of this is completely out of character.)

(Also, given the situation, if anyone has any recommendations they would be helpful, preferably people with experience in career counseling.)
posted by dekathelon to Health & Fitness (8 answers total)
 
Assuming your visits are at an office that is a neutral third place and not your therapist's home, what about just stopping in?

When I was in therapy a few years ago, when my therapist and I were done, we were done, and there was a formal exit process. I don't think it's likely that they just dropped you like a hot rock or whatever you're feeling. Therapists aren't like shitty hookups who never text you back.

I don't think you'd be unwelcome if you dropped by, if even to just reassure yourself that they are still in practice, alive, seeing patients, etc. I'm not sure if there's a receptionist in your therapy setup, but if so, that person could probably shed some light even if you can't see your therapist specifically.
posted by Sara C. at 12:29 PM on March 24 [3 favorites]


Was she part of a larger practice, or was she running her own practice? I'm assuming the latter, since you're contacting her directly. Does your old insurance company have any EOBs explaining their processing of the claims from the dates you saw her? If she submitted the bills to them and they denied them, they should still be able to provide you with EOBs. If she never submitted the bills, she can't hold you responsible for the balance, since she had your insurance info on file.
posted by ThePinkSuperhero at 12:31 PM on March 24


I'd write a letter and have it sent Certified mail to her office address.

Dear Therapist;

Due to insurance changes and the ACA, I am receiving information from my insurance companies regarding your billing submissions. I want to insure that you are fully compensated based upon what my insurance will cover.

I have tried on numerous occasions to contact you regarding this and my calls have gone unanswered. I would like to clear this up quickly as I am concered about coverage due to my change in insurers.

Please contact me prior to (date two weeks out) I can be reached by phone, email and/or carrier pigeon at this address.

If I don't hear from you by that date, I will assume that all payments have been received by you, and that my account is at a zero balance.

Thank you for your time,

dekathelon

Send Certified Mail, and if your therapist has email, send it to her that way, return, reciept, so you have evidence that she's received it.


Save EVERYTHING in a file, including your delivery receipts and put it some place safe.

At some point, a professional has to be professional. If she can't be bothered, you can't.
posted by Ruthless Bunny at 12:35 PM on March 24 [13 favorites]


I had a health care provider who submitted some bills to a commercial insurance company and the company and the company kept rejecting the paperwork again and again for minor problems until it reached 180 days after the date of service or something like that, then declared that they didn't have to pay at all because claims had to be submitted within that time frame as mandated in their contract with the provider. In my case, I believe the provider simply gave up and settled for getting the amount the copay would have been from me but I believe they could have tried to get the whole amount from me if they weren't sick of it all by then.

Ruthless Bunny's suggested certified letter seems like a good idea to me, perhaps with a sentence added about how you're aware there may be time limits on processing the claims and you do not expect to be liable for any of the portion of the bill that should be covered by insurance, if time limits are exceeded.
posted by XMLicious at 12:49 PM on March 24 [1 favorite]


It's definitely not a larger practice - sessions were held in a rather expensive-seeming condominium building. I don't know whether she lives there or was renting it as an office (it's mixed-use, it could be either maybe, it's too above my price range for me to know firsthand), but it doesn't really seem like the kind of place I could just stop by.
posted by dekathelon at 12:51 PM on March 24


but it doesn't really seem like the kind of place I could just stop by.

Sure it is. You go there during business hours and knock on the door. If there's a desk person acting gatekeeper, you say to them, "I'm here to see so-and-so" and they either wave you through or call up for confirmation or say "actually, so-and-so is no longer at this location." In any case, you'll have more information than you do now.

I think Ruthless Bunny's suggestion to send the formal letter and email are the best routes, but if it's logistically easy for you to make a trip in person, it is doable.

This is at least the second nonresponsive therapist askme in the past week. What is it with people, jesus.
posted by phunniemee at 1:02 PM on March 24 [2 favorites]


You can at least stop by and check to see if she's still on the directory for the building, or like phunniemee said, check with the doorperson or whoever. If this is where you're mailing your correspondence, it's prudent to make sure she's even still there before you shell out for certified mail.
posted by yasaman at 1:05 PM on March 24 [2 favorites]


FWIW, I have never had a therapist (shared office or no) that had office staff or any ability to handle drop-by patients. No, wait, I take that back: one office in theory had an office staff, but the office was always unstaffed any time I was there. This may be a regional thing, but let's call it 6 out of 7 different therapists would have been totally unable to accommodate me if I had dropped by at a non-appointment-time to ask about billing. So use your judgment of the situation rather than other people's advice.
posted by instamatic at 4:54 PM on March 24 [2 favorites]


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