Telemedicine Troubles: The Battle Between Mental Health Providers and Insurers

NBC 5 Responds takes a look at what’s happening behind the scenes and why it may be hurting those with mental health issues

NBCUniversal, Inc.

As the coronavirus crisis continues to take hold of the country, so has the need for virtual doctor appointments.

Especially for those struggling with mental health issues. The therapists treating them are struggling too, trying to get answers from insurers about telehealth coverage.

Like Erin Deidling, a therapist who worries because so many clients are stuck inside their own homes and heads.

“They want in because they want to relieve suffering,” Deidling said.

She is one of many mental health care providers who say they sit on endless hold, struggling to get pre-approvals and answers from insurance companies:

 Will virtual visits be covered? Will therapists be paid at full rate for their services?

 “A lot of therapists were doing a pro bono sliding scale just making it like get in, get the care, we'll worry about the billing later, which is what therapists do,” Deidling said.

She reached out to NBC 5 Responds after bumping into numerous insurance denials and delays. Many providers putting patients first, and billing second. A risk that adds yet another layer of worry.

“Every therapist I know was going from their baseline client load to double. And what a lot of the insurances were saying at the time there was no telehealth unless it's already built into the policy which very few policies have that,” Deidling said.

When they couldn’t get answers from insurers, some providers took to social media – their frustration at a boiling point:

One writing “it’s criminal that you’re unwilling to pay for telehealth during an international pandemic. I don’t have the time, man power or energy to fight you on every claim.”

Another who says an insurer “informed me today that I would be receiving 70% of my contracted rate for all online sessions. I will not be able to afford to continue to see insured clients” at that cut rate.

Could their voices be the reason the government and insurers are now coming around?

Just last weekend, Illinois Gov. J.B. Pritzker announced a new telehealth program and a mental health support hotline: care for anyone who needs it, statewide, whether they’re insured or not.

“It’s ok to feel. And please know you don’t have to feel it alone,” Pritzker said. “This program serves to reduce barriers to physical and mental health services in all communities and income levels.”

Pritzker’s plan is up and running in central and southern Illinois. The northern region should be operational soon.

That same day, the Federal Communications Commission announced its COVID-19 telehealth program that will provide $200 million in funding to help healthcare providers by fully funding connected care services. That program is now in motion.

Major insurers NBC 5 Responds spoke to say they do now cover mental health virtual visits, but to varying degrees, pointing us to rules spelled out on their websites.

There’s no denying telehealth is a growing issue, evolving in real time: the longer we stay at home, the more these services will be a lifeline.

“Absolutely. And I'm glad that the insurance companies are coming along and saying, we're going to cover this, we're going to do this, we're going to step up. Thank goodness,” Deidling said.

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