The practice of third-party insurers demanding information on mental health treatment before paying for services is not a recent phenomenon. Even under fee-for-service arrangements, insurers generally required mental health providers to share the patient's diagnosis, and sometimes even the treatment plan, before reimbursing for these services (Acuff et al., 1999). Mental health providers sometimes maintained two sets of records for each patient: one for clinical use and one for billing purposes only (McDaniel and Erlen, 1996). This allowed the clinicians to share the information that the payers needed, while respecting the client's right to confidentiality of sensitive information shared within the therapy session. However, several of the providers we spoke with said that they did not maintain separate records, due to the administrative burden of keeping such records.
"MHPrivacy.pdf" (pdf, 768.25Kb)
"appen-b.pdf" (pdf, 224.4Kb)