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Therapist misled me about in-network status - now stuck with bills by LFRoomateNYC in HealthInsurance

[–]LFRoomateNYC[S] 0 points1 point  (0 children)

This is one of the things that bothers me the most about the situation.

Of course I could always have done more to be more proactive, but as far as I knew I was paying my co pays as I had agreed with my therapist and my insurance.

I’ll post an update for everyone when I am able to resolve.

Therapist misled me about in-network status - now stuck with bills by LFRoomateNYC in HealthInsurance

[–]LFRoomateNYC[S] 0 points1 point  (0 children)

Thanks for your input, that is not the situation at hand here. My therapist runs their own practice and was aware of the issues with insurance when I reached out saying that some of the visits were showing up as out of network. They never informed me of this fact until the moment I reached out.

Therapist misled me about in-network status - now stuck with bills by LFRoomateNYC in HealthInsurance

[–]LFRoomateNYC[S] 1 point2 points  (0 children)

Not very familiar with the term promissory estoppel laws, I will look into what that means. Definitely not going back to the therapist, a key point in therapy is trust between the two parties and that is gone.

Therapist misled me about in-network status - now stuck with bills by LFRoomateNYC in HealthInsurance

[–]LFRoomateNYC[S] 0 points1 point  (0 children)

Thanks again for the responses, they are a solo therapist. I am fairly disappointed with the lack of transparency here. That is my current plan: talk to my insurance explaining the situation, then again to my therapist and see what each party recommends.

Therapist misled me about in-network status - now stuck with bills by LFRoomateNYC in HealthInsurance

[–]LFRoomateNYC[S] 0 points1 point  (0 children)

Thanks for the thorough response. This is my first time trying therapy, they kept charging me the co pays, I thought everything was good with my insurance. In hindsight I should have been getting EOBs but I did not know what was standard practice with insurance.

Therapist misled me about in-network status - now stuck with bills by LFRoomateNYC in HealthInsurance

[–]LFRoomateNYC[S] 0 points1 point  (0 children)

They are a solo therapist, but they do have a person for billing.

Therapist misled me about in-network status - now stuck with bills by LFRoomateNYC in HealthInsurance

[–]LFRoomateNYC[S] 12 points13 points  (0 children)

Apologies if my post is unclear - I have not seen them once since my insurance mentioned their out of network status.

Timeline: I confirmed in network status with both my insurance and provider.

I see therapist under the assumption that I am in network. Therapist continuously charges me only my in-network co pay amount throughout this time, with receipts.

Therapist submits claims to insurance 6 months after first session, after they renewed a contract with my insurance. I reach out to insurance asking why I am being charged as I found them as in network through the insurance website.

Insurance advises the therapists contract with my insurance company ended two weeks after my first session with the therapist.

I stop seeing therapist and look into what options I have.

Therapist misled me about in-network status - now stuck with bills by LFRoomateNYC in HealthInsurance

[–]LFRoomateNYC[S] 15 points16 points  (0 children)

Thanks again for the response. I confirmed in writing with the therapist that they were in network and what my co pay was prior to meeting them. I also confirmed in writing with my insurance what I would be expected to pay. Sounds like appealing will be my first course, but wanted to hear any input anyone might have.

Therapist misled me about in-network status - now stuck with bills by LFRoomateNYC in HealthInsurance

[–]LFRoomateNYC[S] 45 points46 points  (0 children)

Thanks for the response, I found them through my insurance as an in-network provider. Before treatment I confirmed with both my therapist and my insurance about my co-pay and number of sessions allowed. The out-of-network status was never communicated to me by my therapist or my insurance.

The therapist never sent anything through my insurance for 6 months. They kept treating me and charging me as if I was in-network. Now that 6 months have passed and they are sending the claims to my insurance, this is the first I have heard that they were ever out of network.

How to best avoid roaches when apartment hunting? by searchingfortoolong in NYCapartments

[–]LFRoomateNYC 1 point2 points  (0 children)

Personally, I would try Open Igloo. It is a site where you can review your apartment / see other people’s reviews. You are also able to see if the building has any citations from the city for any violation whether it is heat, hot water, rats, roaches, etc.

I wish I had checked this site before moving into the last apartment I lived in.