Re: Aetna Insurance - more info

June 20, 2012

I would like to assure everyone, based on my experience with insurance companies

as both an LCAT and an LCSW, that the LCAT license is not being picked on, as

Kat worries: " we are still not recognized as qualified mental health care. " This

is not about art therapy, this is about insurance as a for-profit business.

Insurance companies have no incentive to add providers to their networks. More

providers = more claims = more money paid out. I have been called many times by

people desperate for a sliding scale because all the providers in their zip code

and in-network on their plan are no longer accepting new patients.

Several insurances only accept LCSW-R and Phd providers in-network. This means,

no LCAT, no LPC, no LMFT, no LP, no nothing else! As private for-profit

companies, they have the right to dictate who they enroll as a provider. This

means that LCATs are not the only professionals shut out of the plans. The

requirements to join many networks is becoming increasingly stringent. As an

example, LCSW-Rs must have a minimum of six (6) years post graduate supervision

and approximately 4500 hours of direct client contact hours. And many plans are

now requiring that practitioners show proof of additional professional training

in their declared area of expertise, i.e. trauma treatment, CBT, ABA, etc.

As another post noted, most New York insurance plans are closed to all mental

health providers at this time, unless you are located in a severely under-served

geographic area (like far upstate NY). And with the health care laws in flux,

there is no telling where all of this will land.

As Natasha pointed out, out-of-network coverage is often a better reimbursement

rate. But, in our practice we are seeing fewer people who even have

out-of-network plans.

Insurance is a moving target. We do the best we can with this crazy system.

Drena Fagen LCAT, LCSW, ATR-BC

nycreativetherapists.com

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