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MoxieDoxie
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Default May 19, 2019 at 01:00 PM
  #1
Where is the leadership in Mass. compensation debate? | New England Psychologist

This is just not happening in Massachusetts it is happening where I live as well and I am seeing it first hand with my therapist. Once he got a foot hold in the area, as he started his practice last year, he raised his rates to $200 and stopped taking insurance. This leaves people who can not afford an extra $800 a month for therapy out. Trying to find a good therapist taking insurance is getting harder. I pay a $30 copay and then he gets $75 from the health insurance. Try getting a good massage for less than that. I charge $120 for a massage and places like Red Door charge over $200. Therapist go through a ton of education, internship and the supervision but do not get paid what they are worth. So when we are looking to get between session contact through phone calls or emails I always do think about the cost of his time he gives up for me.

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Default May 19, 2019 at 08:17 PM
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I don't think they are doing too bad, but I also think many people are underpaid.

They can earn about the same as physical therapists or pharmacists.

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Default May 19, 2019 at 08:54 PM
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I noticed just today that my psychologist has gone from a handful of accepted insurances to just one. He dumped my insurance and another one several months ago, although I guess since I'm an existing client he made an exception and still bills my insurance for me. He probably still had 5 or 6 left that he was accepting.

I had feelings noticing that today. I wonder if he wishes I would just pay out of pocket, which would probably be anywhere from 30 - 60 dollars more per session, or go away entirely.
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Default May 19, 2019 at 09:03 PM
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I don't feel sorry for therapists. I think they are paid well enough.
There are a lot of professions I think are paid worse than therapists that I think should make more money before I would worry about a therapist

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LonesomeTonight
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Default May 20, 2019 at 06:21 AM
  #5
It can be difficult to find good T's who don't take insurance. My T is out of network and doesn't take insurance, like many T's are near me, so he gets paid his full fee by me, then insurance reimburses me part of it. His full fee is $175, and until this year, insurance was reimbursing me 60% of that. Then they decided to only reimburse 60% of $127 or some weird number like that--it's the most they allow for T's who are in network. T was kind enough to reduce his fee to $150, so it would work out to be about the same for me out of pocket per session. And I see him twice a week--when I eventually go back to once a week, I'll just pay his full fee (I offered to switch to that in a set time frame, so I wasn't taking advantage of him with the lower rate, but he said he's concerned about the effect it could have on my mental health, so stay twice a week at lower rate as long as I want/need).

I know part of why he doesn't take insurance is that they can dictate treatment plans, but I'm sure another part is the cost. This is a very expensive area for rent and office space, so I imagine it would be difficult for him to afford it if he took insurance--he'd probably need to have a heavier caseload than he currently does, which could also possibly lead to burnout.

To your last comment, my T does charge for emails that take him longer than 15 minutes and for all phone calls (unless just scheduling) at his hourly rate (broken down into 15-minute segments). And he doesn't allow nonscheduling texts. So he does get compensated for time above a certain amount. Usually, my emails have stayed in the free zone, though I've requested longer responses maybe 6 times (and he wrote really long replies in those cases).
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Default May 20, 2019 at 07:19 AM
  #6
Around here, what is hard to find at times is a good pdoc that contracts with insurance. I get it; they don't want to be bound by the rules of insurance, but it seems rather arrogant and a bit elitist to say "I'm so good that people will come to me and pay out of pocket" and I'm above having to deal with clients who really need to use their insurance for services. The one really good pdoc (and he really is excellent in ability) in town is that way. We ended up traveling into the city for our pdocs (who were also excellent, just inconvenient). Finding a therapist in town that takes insurance isn't really a big problem; there are a fair number. But many don't, and since they aren't, technically, medical providers, I sort of understand their choice not to do so more than a pdoc who IS a medical provider.
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Default May 20, 2019 at 10:09 AM
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For me im very lucky to get my therapy covered by the provincal health care, and if I ever need to see a pdoc that it is covered to. If i ever had to get therapy else where it's $200.00 easy if insurance doesn't cover and it's very limited on most insurance plans how many sessions are covered.
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Default May 20, 2019 at 10:16 AM
  #8
I have discussed insurance/ income with both Ts along with coworkers. The consensus is that therapists who work within a facility or whatever make a lot less than those in private practice.

Some insurances pay horribly. I have cigna which is one of the lower paying insurance so a significant number of people will not take it. There is one company that pays even less. T stopped accepting new clients with it. By the time she paid her rent, billing person, etc she made very little. She would never have stopped seeing an existing client because of the money though.

I suspect on top of all paperwork and hoop jumping from insurance company there is also a wait to get paid. It takes about 6 weeks to receive payment. Due to insurance changes I talked to Emdr T. There is about a 6 week delay between billing and her receiving payment. She sees it as the cost of doing business. I imagine though some providers dont want the wait.

My area has very few Ts who don't accept insurance probably because it is a poor community

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Default May 20, 2019 at 12:38 PM
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My former T didn't take any insurance, but did have a sliding scale so the fee was pretty reasonable. Current T takes my insurance. So that's good. HUGS Kit

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Default May 20, 2019 at 09:51 PM
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My T doesn't take insurance. Unlike medical care, therapy is not a necessity for me, so it's not a big deal.

I hope those who truly need it can get insurance covered services through their teaching hospitals or academic counseling centers. Many in private practice offer services primarily to those who don't consider therapy to be a necessity, and there is enough demand to only take cash payers.

Back when I did need it for one of my children, their "discounted rate" was $80 an hour on a sliding scale. This was at a nonprofit 20+ years ago. As a high school drop out and single, teen mother, that was one third of my entire income.

In my opinion, most don't care if they truly help people. Child care workers who made $5 an hour cared more and did more for my child than any of those savage therapists would. They get no sympathy from me.

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