releasing counseling record to insurance? any bad impact?
December 12, 2013 3:53 AM   Subscribe

In order to get reimburstment, I was requested by my insurance to provide medical record from my doctor. I'm wondering is there any bad impact in the future to release these confidentical (psychiatric)counselling histrory to insurance company? They do not always request this. This is the first time. I do not know why they are requesting it this time. I guess maybe because I submitted the claim for several visits all together which is a large bill that they are not willing to pay? Any my doctor is kind of tight on this saying that he had never done this before and unless I sign a release and come to pick up myself he would not do it. His emphasis on "comfidencial" made me think about is there any bad impact if I release this to insurance company? Will it be in my public record? will I be quoted higher premium in the future? Will these be recorded as pre-existing conditions? Does it worth it to give up reimburstment to keep record from insurance? Thanks.
posted by pack2themoon to Health & Fitness (8 answers total) 2 users marked this as a favorite
It is common practice for any insurance company asked to provide coverage to request a copy of the records of the treatment. You cannot expect that level of confidentiality if you want your treatment covered. There are Federal laws that require that the company asking for those records keep them confidential, but those same Federal laws allow for sharing those records with defined persons/companies.

If you must keep the records confidential, you must pay for the treatment yourself.
posted by megatherium at 4:37 AM on December 12, 2013

I would check to make sure exactly what it is that they are asking for. Surely they are not asking for the counseling notes of the doctor or therapist? Please double check with them that they are not just asking for record of office visits with dates, etc.
posted by tamitang at 4:39 AM on December 12, 2013 [2 favorites]

I frequently receive requests from Insurance Companies documenting treatment, this will typically include the initial assessment, diagnosis, and progress notes. Often this request comes with a release signed by the client authorizing me to release the records, if it doesn't include a release, I inform the client and let them know the records won't be sent without a release.

As megatherium stated, if you do not want to release treatment information to your insurance company you will need to pay for the treatment out of pocket.

If you're in the US, preexisting conditions no longer carry the stigma they used to in terms of denial of coverage. Also, I'm not aware of a psychiatric/psychological diagnosis in the past being considered a pre-existing condition resulting in denial of coverage in the future.

I am not an attorney, I do not work for an insurance company, this information is from my experience only, this information might be different for you depending on where you live and who your insurance provider is.
posted by HuronBob at 4:47 AM on December 12, 2013 [1 favorite]

I'd start with having the doctor's billing office send a breakdown sheet of visits - date, times, pricing. I deal with daycare reimbursement under similar circumstances, and each time we change management companies, they change what they consider "enough" documentation. At this time, they accept a signed note from me and provider (I fill out a form online) with Tax ID information, and a "dates of service + amount" breakdown as proof. Apples and Oranges but it can't hurt to start with that.
posted by tilde at 4:47 AM on December 12, 2013

I had therapists that SPECIFICALLY did not take notes in session so they would have nothing to pass on to insurance companies when asked.


If your psychiatrist ever noted risky behavior or suicidal thoughts in your file , I could see that being a problem.

If his notes are limited to, "Patient reports nausea on increased dose," or "Switching to med X at Y dose to curb anxiety," then that might be OK.

Talk to your psychiatrist. This will not be a new concern for them.
posted by jbenben at 4:51 AM on December 12, 2013

I had therapists that SPECIFICALLY did not take notes in session so they would have nothing to pass on to insurance companies when asked.

This is a horrible practice from a risk management standpoint, and unethical to boot.

As HuronBob details above, this is a pretty standard request. Many therapists/doctors object to it, and if they are being reimbursed directly by the insurance company they may find a way to send something like a treatment summary instead. The offer to do so is not always accepted by the insurance company, however. You may have less leverage to offer this since it sounds like you already paid for the services.

This is the deal you make with insurance: they pay, but you agree that they can set limits on that payment. In order to do that they have a right to determine if the treatment was medically necessary.
posted by OmieWise at 5:17 AM on December 12, 2013 [1 favorite]

I've had lots of mental health treatment. First off the good news: in the US there is no such thing as pre-existing conditions anymore! YAY!

A Medical Record can mean many things. Usually, they don't want the ENTIRE thing, as that is way cumbersome (especially if you've seen a doctor for years) and no one wants to read the thing. I think getting clarification on what they want is important. There is an art to notes (I'm a social worker) about what details you put into notes, and what is needed for billing. I'd suggest not giving them anything that you feel uncomfortable with.

There are some things you do have to give the insurance, and a diagnosis is one of those things. Usually an Assessment is another. You are not going to get around that unless you self pay. Generally there are some confidentiality standards ask your insurance company what they are. It may be called their privacy policy.
posted by AlexiaSky at 6:47 AM on December 12, 2013

The statements I had to provide my insurance/healthcare savings account administrator with in order to be reimbursed for my visits included my therapist's name, contact information, and license number; my name and contact information; the date of the visit and the amount charged for the visit; and the DSM code for my diagnosis.

That was all they required for reimbursement. I would have felt very uneasy if they had asked for more.
posted by Lexica at 9:21 PM on December 12, 2013

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