The underbelly of mental Health: why clients lose their therapists or can't find one

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If you are reading this, perhaps you have experienced frustration trying to find a therapist or learned your therapist is no longer taking your insurance. Clients, like yourself, have been caught in the crossfire of an unseen battle waging between therapists and insurers. The battle has so brutally ravished therapists' ability to sustain their practices that they may often surrender and quit the insurance networks, ultimately causing unintended collateral damage to their clients. 

"I went into this profession to help people, but because of the bad faith practices by insurance companies, thousands of my colleagues and I are fleeing the insurance networks," said Licensed Marriage Family Therapist Marsinah Ramirez Buchan. "The last thing I wanted to do was leave my clients, but the insurance companies have made it so difficult to keep my practice afloat, that I was forced to quit."

The linked article, a deep investigative journalistic report by ProPublica that interviewed scores of therapists nationwide, illuminates pervasive and unethical insurers' tactics that have debilitated small, independent private practices, exacerbating the mental health crisis in America. Like many of the therapists noted in this article, Buchan has quit some insurance panels and is on the brink of quitting Halcyon (and its payors like Advantek) because of its unethical, if not illegal, payment delays.  

With open enrollment soon coming for clients to select an insurance carrier, Buchan's hope is consumers will consider the following facts to make an informed decision before enrolling in a network. 

1) Determine if your insurer has an in-network provider that fits with your particular need/condition; You may want to call first to see if you can find a provider before electing to enroll in a plan; There are some insurers who tout a large network of providers on their panel, but when you try to make an appointment, there is a good chance you will find it difficult to get an appointment because therapists have quit their network. Congress has even tried to regulate these ghost panels, as reported here. It is common for insurers to advertise more therapists than they actually have. For example, Buchan resigned from the Magellan Network (associated with Blue Shield) in January 2023, but almost a year later, Blue Shield/Magellan were still informing their members that Buchan was still in the network. 

2) Assess if there is a long wait time to get an appointment in-network, and if you need help now, consider options below: 

3) If your copayment is low, but you can't find a provider, consider seeking an out-of-network provider for faster access (as many therapists reserve space for out of network clients). Determine if your insurer will pay for an out-of-network provider. However, always check with your insurance and get it in writing what, if any percentage, they will pay for an out-of-network provider. 

4) Consider talking to your therapist about a cash sliding scale, if you can't find a provider in your network. Many therapists set aside a few slots for cash paying clients, and may offer them discounted rates. 

If you are having difficulty finding a provider or if a therapist dropped your insurance, please keep in mind therapists are in the business to help, but may be prevented from working with certain insurers due to adverse associated business practices designed to frustrate and virtually bankrupt therapists. When therapists become so frustrated in trying to get paid or work tirelessly to ensure clients' treatments are not denied by the insurers, they may end up quitting the network. The insurance companies subsequently win because when a therapist gives up, insurers  don't have to pay your claim to the therapist, but have yet collected from you any applicable premium fees. 

Consider exploring whether or not another insurance can better suit you and your family needs. You may be getting a competitive rate from your current insurer, but if you can't find a provider in the network, there is a reason for that. And what is the point of having health insurance, if you can't get help. 
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