They studied, honed their skills and opened practices, joining health insurance networks that put them within reach of people who couldn’t afford to pay for sessions out of pocket.
But one after another, they confronted a system set up to squeeze them out.
Although federal law requires insurers to provide the same access to mental and physical health care, these companies have been caught, time and again, shortchanging customers with mental illness — restricting coverage and delaying or denying treatment.
Although the patient was covered by UnitedHealthcare, America’s largest insurer, Todd was unable to find anyone who had openings. Her patient had to pay hundreds of dollars for out-of-network psychiatry sessions.
Then, six months into treatment, UnitedHealthcare began to question whether therapy was even necessary.
Anneliese Hanson, a former Cigna manager, told ProPublica that the poor customer service can be traced, in part, to a decision several years ago to outsource these calls to the Philippines. A therapist who was hired as a manager at Cigna, Hanson worked in the behavioral health department during that transition. She said overseas employees lack access to the full claims system and often are unfamiliar with complex medical terminology in English.
This issue exists in managed care plans including MA, EGH, Obamacare, etc. It is not limited to one carrier or patient demographic.
But one after another, they confronted a system set up to squeeze them out.
Although federal law requires insurers to provide the same access to mental and physical health care, these companies have been caught, time and again, shortchanging customers with mental illness — restricting coverage and delaying or denying treatment.
Although the patient was covered by UnitedHealthcare, America’s largest insurer, Todd was unable to find anyone who had openings. Her patient had to pay hundreds of dollars for out-of-network psychiatry sessions.
Then, six months into treatment, UnitedHealthcare began to question whether therapy was even necessary.
Anneliese Hanson, a former Cigna manager, told ProPublica that the poor customer service can be traced, in part, to a decision several years ago to outsource these calls to the Philippines. A therapist who was hired as a manager at Cigna, Hanson worked in the behavioral health department during that transition. She said overseas employees lack access to the full claims system and often are unfamiliar with complex medical terminology in English.
This issue exists in managed care plans including MA, EGH, Obamacare, etc. It is not limited to one carrier or patient demographic.
