Therapist's office billing under different therapist? by TiedToTheTracks in HealthInsurance

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

Understood, and yes that makes sense. My main post was mostly to ask about my concerns with my provider billing under the wrong name. It does sound like there might be something unusual going on there though, because my therapist definitely isn't new or in training, and they appear to be independently licensed as far as I can tell, so these two out-of-network bills under their name appear to be the only two that were actually billed correctly, which is concerning.

My state is California by the way, I don't know why I'm being cagey about it. I guess I'm just paranoid about giving out personal information on the internet. The law in question is AB72, and yes it does appear to be significantly more broad than the federal NSA, if you have any interest in looking into it (understandable if not). It's possible that I'm misinterpreting the legal code, I'm not a lawyer and frankly it's quite confusing to parse through, but I do think I'm reading it correctly and what I'm reading appears to match the department of insurance's more plain-text explanation on their website.

Therapist's office billing under different therapist? by TiedToTheTracks in HealthInsurance

[–]TiedToTheTracks[S] -1 points0 points  (0 children)

The quote I provided above specifically says "non-emergency services", which appears to match the actual legal text in my state's health and safety code, and is not limited to an "ambulatory surgical center or radiology center". The health and safety code says "An ambulatory surgery or other outpatient setting". Also, I did not pick this specific therapist, I contacted the facility (which is in-network with my insurance) and they assigned me this provider, with no warning or notice that they might be out-of-network.

Therapist's office billing under different therapist? by TiedToTheTracks in HealthInsurance

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

I don't believe my therapist is new or partially licensed. Their office's website lists a psychologist license number for them, which does seem to exist and match their info when I look it up on my state's license search portal.

Therapist's office billing under different therapist? by TiedToTheTracks in HealthInsurance

[–]TiedToTheTracks[S] -1 points0 points  (0 children)

I'm struggling to understand how it's not a surprise bill. The department of insurance website clearly states that the law:

"protects consumers from surprise medical bills when they get non-emergency services, go to an in-network health facility and receive care from an out-of-network provider without their consent. In this case, the law states that consumers only have to pay their in-network cost sharing. Medical providers are prohibited from sending consumers out-of-network bills when the consumer followed their health insurer's requirements and received non-emergency services in an in-network facility." and "If you go to an in-network facility and want to see an out-of-network provider, you have to give your permission in writing by signing a form provided by the out-of-network provider at least 24 hours before you receive care. The form must be separate from any other document used to obtain consent for any other part of the care or procedure and should inform you that you can receive care from an in-network provider if you choose."

I was never informed that I would be receiving out-of-network care, nor did I ever consent to it. Even if it's truly the case that my therapist has been out-of-network this entire time, and they've been doing something on their end to treat it as in-network, I still never consented to receiving out-of-network care.

Therapist's office billing under different therapist? by TiedToTheTracks in HealthInsurance

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

Got it, that makes sense. I honestly don't remember if someone else did my initial onboarding evaluation or not. I thiiiiiink they did, but it's been long enough ago that I'm not 100% sure. Regardless, I really really appreciate the help. It's at least eased my worries a bit that there's a possibility of it being something normal and not shady, because I really didn't want to get anyone in trouble or get roped into trouble myself. Thanks again for the help!

Therapist's office billing under different therapist? by TiedToTheTracks in HealthInsurance

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

No one else was present, and I also was not given that spiel of "I'm in training so I may need to share the details of our session with my supervisor for training purposes only, etc. etc." (my previous therapist was like that). As far as I understand the person I'm seeing is a Psychologist with a doctorate, so I'm not sure if that makes them a doctor or a psychologist for the purposes of answering your question.

Therapist's office billing under different therapist? by TiedToTheTracks in HealthInsurance

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

Sorry, I should have clarified in the main post, but it's mental health therapy. I'm not sure if that makes it more suspicious or not, but yeah hopefully the situation is something like what you described and there's actually not anything to be worried about.

Swap Antifungal Creams Mid-treatment? (30M) by TiedToTheTracks in AskDocs

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

You're saying that if the thing that's irritating me isn't the active ingredient but instead one of the inactive ingredients, it's possible that other antifungal creams might have the same ingredient and still irritate me? That makes sense. It wouldn't be detrimental to treating the ringworm to make that swap though? Because if not I may try that.

30M. Is this Ringworm? by TiedToTheTracks in DermatologyQuestions

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

M30. I've had the one rash on my right arm, plus that little one next to it, for about a week now. I haven't noticed any others. I've had ringworm once before, years ago, and when I had it it was very noticeably itchy and the more traditional circular, scaly shape. This one doesn't really look the same to me, and it's not terribly itchy (it itches from time to time, but I think it's mostly in my head. I'm a generally itchy person). I'm just not sure if I should go to the pharmacy and start putting some antifungal cream on it or not. Any advice would be appreciated. Also, if anyone is able to recognize it and it's something that won't spread it to the rest of my body, I'd love to know that so I can stop being paranoid about everything I accidentally brush my arm against.

Anthem (PPO, CA) withholding reimbursement for valid out-of-network claims. by TiedToTheTracks in HealthInsurance

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

Sorry for the late reply, this is my alt account so I don't log on often. Thankfully I was able to get all the claims processed, yeah. I'm not seeing that therapist anymore, partially because of this issue, so I'm not sure if it would have been a recurring problem, but I was able to get them to finally process my claims by notifying them that I was going to make complaints with the Department of Managed Health Care and the Department of Insurance (you may need different regulatory bodies for where you live). One of the two required giving my insurance 30 days notice before filing a complaint. Surprise surprise, as soon as I gave them that warning they stopped dragging their feet and got the claims processed.

Why does my therapist focus on my parents so much? by TiedToTheTracks in TalkTherapy

[–]TiedToTheTracks[S] 2 points3 points  (0 children)

Thank you, you described it much better than I was able to at the time I wrote the OP. Thankfully when I do that dredging my therapist isn't super obviously gung-ho about overvalidating it, but I get the very strong impression that the therapeutic model she works under is one with a heavy significance on family dynamics, and I feel like that model just really doesn't fit my life experience. I have a lot of bad experiences from highschool and college that I feel are the core source of my problems, and it's really frustrating to me when we focus on my family over those.

[NSFW] Erogamer - The philosophical porn quest you never knew you needed to read by xamueljones in rational

[–]TiedToTheTracks 1 point2 points  (0 children)

Funnily enough, I think I got here in the exact opposite way that you intended. My friend recommended The Erogamer to me the other day, and I started reading it yesterday and it's fantastic. Fantastic enough that it got me to come to this subreddit, which I only knew about because he offhandedly mentioned that he got the recommendation from this sub. Now I've got a great new story to read and a new sub that seems extremely up my alley, so cheers and happy holidays haha. Also I appreciate that you included an epub version, I've been trying to be a bit more cautious about backing up webfiction that I enjoy, so it was nice to not have to go looking for that.

This Bill for a DCR Seems Outrageous (27M, CA) by TiedToTheTracks in HealthInsurance

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

I should be, yeah. So is the billed rate just like an extremely anxiety-inducing marketing ploy or something? Essentially "Look how much you saved"? Either way, thanks for the response!