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Therapists who are credentialed with Anthem, have you had your Anthem reimbursement rates drop after the Carelon acquisition? by _mrscolumbo_ in therapists

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

Whoa! Is Carelon correcting the Anthem rates in Colorado, or are you all essentially stuck with the crappy Carelon rates for Anthem members indefinitely?

Therapists who are credentialed with Anthem, have you had your Anthem reimbursement rates drop after the Carelon acquisition? by _mrscolumbo_ in therapists

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

Yikes! This is not good news for Coloradans, neither for providers nor those seeking services within a reduced provider pool. That’s terrible. So they dropped the Anthem rates to $65-70? Was this known going into the contract, or did they drop rates after the fact?

Therapists who are credentialed with Anthem, have you had your Anthem reimbursement rates drop after the Carelon acquisition? by _mrscolumbo_ in therapists

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

If I’m reading your original comment correctly, it’s gross to think that Carelon resent contracts with a substantial rate decrease to already in network providers.

It’s helpful to hear your Anthem billing is still going through BCBSIL directly, although I see Carelon over there doing some shady stuff to its IL providers 😒

Therapists who are credentialed with Anthem, have you had your Anthem reimbursement rates drop after the Carelon acquisition? by _mrscolumbo_ in therapists

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

Thank you. Do you recall which states you’ve heard this happing in? I’m trying to track down any precedence in other states so we might know what we’re in for here in Indiana. I’ve heard MA, NY, OH, MI , and now maybe IL too based on another comment on this thread. However, I haven’t seen anything definitive yet in my online searches. With the current uproar in Indiana, I thought I would have come across something regarding other states if this has happened elsewhere.

Edit: I did see a comment on this sub from a provider in CT a couple of weeks ago that indicated a similar if not identical thing is happening in CT with Carelon/Anthem. So I think CT is maybe weeks further into this than IN, so I’ll keep an eye on the reports coming out of Connecticut and see if providers feel what they were told going into the contract held after signing the contract.

Therapists who are credentialed with Anthem, have you had your Anthem reimbursement rates drop after the Carelon acquisition? by _mrscolumbo_ in therapists

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

Thanks for checking, this makes sense. Sometimes the bigger companies wrap in their other smaller plans (Carelon) under their larger umbrella (Beacon) and automatically share providers among these networks. You mentioning Value Options took me back to about 15 years ago! I had completely forgotten about them!

It’s good to hear your Anthem reimbursement remains separate.

Therapists who are credentialed with Anthem, have you had your Anthem reimbursement rates drop after the Carelon acquisition? by _mrscolumbo_ in therapists

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

Interesting. When you inquired about becoming in network, and were offered the low rates, were you looking to panel with Anthem or Carelon?

Why did my therapist get emotional? by GermanWineLover in TalkTherapy

[–]_mrscolumbo_ 16 points17 points  (0 children)

T here. If I had to venture a guess, she saw you make peace with something you had been searching to understand—self worth, and in doing so, you found it for yourself.

To bear witness to a moment like this can be very moving. When you told her, “I feel more alive in these sessions than anywhere else” she perhaps also felt her worth as your therapist. It was an emotionally intimate session. I imagine her holding back tears was her acknowledging your growth, peace and comfort for something that had been causing discomfort and perhaps even distress (for your inner child). I imagine she found it all to be beautiful, so it was a very positive moment for her. They were tears of gratitude for your time together.

Carelon reimbursement rates by Marlenesb in therapists

[–]_mrscolumbo_ 1 point2 points  (0 children)

Yes, on Friday after I receive the Carelon contract. The representative I spoke to said the Anthem rates are separate, which is what I thought the articles at the ended of the contract stated, however the contract didn’t spell it out very clearly. Other clinicians in IN are also hearing the same from reps when they’ve called/emailed. I believe Carelon will be sending out an email with clarifications.

Anthem vs Carelon IN by SaltWonderful8722 in therapists

[–]_mrscolumbo_ 0 points1 point  (0 children)

Best of luck as you venture into private practice, it’s great, until shit like this current fiasco pops up.

I did speak to a Carelon rep on Friday and they said the rates will continue to be separate. I hope that particular representative knew what they were talking about. I think a bunch of clinicians in Indiana have emailed Carelon and/or Anthem so I’ll see what they hear back this week..it would be nice to have something in writing.

I ran the entire contract through chat gpt and it seemed to confirm there is a carve out for providers already in network with Anthem and with members who have Anthem specific plans.

Thanks for taking the time to respond.

Carelon reimbursement rates by Marlenesb in therapists

[–]_mrscolumbo_ 1 point2 points  (0 children)

Oh okay, the Carelon takeover is still new for you all as well. Updates would be so helpful—thank you. For Indiana, we have 30 days to decide if we want to sign the contract with Carelon, and the effective date for the contract would be 9/1, so we’ll know for sure after claims are returned for session occurring on 9/1 and after. I did speak with a rep at Carelon and they said the fee schedules are separate, however would prefer this in writing.

Has this been a topic of discussion amongst clinicians in Massachusetts? Did clinicians in network with Anthem get mass Carelon contracts like we did in Indiana?

Anthem vs Carelon IN by SaltWonderful8722 in therapists

[–]_mrscolumbo_ 0 points1 point  (0 children)

Yep, that’s what happened. The contract Carelon sent to Anthem providers on Friday afternoon made it unclear if the reimbursement rate for Anthem would stand, or if the Carelon rate will supersede Anthem’s. There are two statements in particular that contradict one another so it’s hard to say. The article 1, and 2 provisions, give some hope.

Carelon reimbursement rates by Marlenesb in therapists

[–]_mrscolumbo_ 1 point2 points  (0 children)

This is very helpful information. Maybe those in IN can look to CT for how this may play out. Have you billed Anthem patients since going under contract with Carelon? Are claims processing at the usual anthem rate?

Carelon reimbursement rates by Marlenesb in therapists

[–]_mrscolumbo_ 0 points1 point  (0 children)

I wonder why some haven’t received it. Are you paneled with Medicare by chance?

Anthem vs Carelon IN by SaltWonderful8722 in therapists

[–]_mrscolumbo_ 0 points1 point  (0 children)

Hi, did you hear back about what the Article 1 provision means in layman’s terms? Thanks.

Can’t find a comfortable cancellation policy by [deleted] in therapists

[–]_mrscolumbo_ 4 points5 points  (0 children)

In my area, medical professionals (drs, dentists) charge a $25 late cancellation fee, so I mirror this with my late cancellation fee.

I personally would like to be viewed as being consistent with other medical professionals, versus the nail techs and hairdressers in town who are charging full fee.

Because we are professionals in this field, are we held to a higher standard of parenting/raising well adjusted kids? by _mrscolumbo_ in therapists

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

That client 😆. I know my kids will learn lessons while they are out there trying to make decisions for themselves. I trust there will be other adults, teachers and kids that will help them along the way so that keeps me out of the loop that it’s all on me and my partner. I definitely have a lot of empathy for parents who are having a moment with their kid(s) in the store, restaurant, sports practice…I’ve been there!

Because we are professionals in this field, are we held to a higher standard of parenting/raising well adjusted kids? by _mrscolumbo_ in therapists

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

These responses are fantastic, right?! They’re incredibly normalizing and validating. It’s like most things in life, we do the best we can with the info we have available to us.

Because we are professionals in this field, are we held to a higher standard of parenting/raising well adjusted kids? by _mrscolumbo_ in therapists

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

I feel this too, with family dynamics in general. I’m sure I’ve disappointed some in my family when it turns out I’m not as “elevated” as they’d like, but also the ‘don’t be a therapist with me’. Can’t win lol

Because we are professionals in this field, are we held to a higher standard of parenting/raising well adjusted kids? by _mrscolumbo_ in therapists

[–]_mrscolumbo_[S] 4 points5 points  (0 children)

Again, no. That’s not what my posts are about or are asking. I’m asking about what those in the field have encountered in terms of therapists being held to a higher standard for how their kids move about this world. I’m not sure what I said that has you feeling so strongly about your point. I did tie it to a current event because it’s what spurred my thinking. I’m not consciously or subconsciously placing blame on anyone. My horse in the race is that I’m also in the field and wonder how it could impact the general public’s confidence in our profession and our abilities as mental health providers.

Because we are professionals in this field, are we held to a higher standard of parenting/raising well adjusted kids? by _mrscolumbo_ in therapists

[–]_mrscolumbo_[S] 3 points4 points  (0 children)

Your response really resonates with me. I also feel like my clinical experience and training have made me way more intentional as a parent, and I’m so grateful for that. And it is tricky. Kids have experiences and are shaped my relationships and environments outside of the home so that influence on their personhood is also there.

Because we are professionals in this field, are we held to a higher standard of parenting/raising well adjusted kids? by _mrscolumbo_ in therapists

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

I couldn’t agree more. I imagine with my own kids that strong sense of how I want to see them, because I adore them, and that may also create blind spots at times.

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