Donald A. Misch, M.D., PLLC
Health Insurance Reimbursement
I do not file insurance claims and I am not contracted or “in network” with any insurance companies or state (Medicaid) or federal (Medicare) insurance plans. My patients may file, and often be reimbursed for services provided by me as a non-participating provider, through their own health insurance plans. I will provide the appropriate paperwork and receipts for doing so at your request.
Like many mental health professionals, I believe that becoming an “in network” provider and direct billing to health insurance companies is actually an obstacle to best psychiatric care. Participating in such provider networks is expensive and wasteful, not only in time required to be credentialed and to complete paperwork, but also because of onerous pre-authorization requirements and reimbursement practices. One of the ways in which health insurance companies attempt to minimize reimbursement is to limit the work of psychiatrists to medication management (“prescribing pills”) only. Because I believe that medication management alone is often insufficient and unlikely, for most patients, to effect long-standing and significant change, my practice routinely combines psychotherapy with medication management. The rapid “medication check” model required by most insurance companies is not consistent with my beliefs about what is best for patients. Finally, health insurance companies may request access to patient records from a psychiatrist in order to authorize reimbursement to the physician. I not comfortable with providing such personal and confidential information to large health insurance networks.
How Can I Pay for Services?
I ask patients to pay for service at the time of each visit. This can be done by cash, check, or major credit cards. Thereafter, if a patient so desires, a claim for reimbursement can be submitted to the appropriate health insurance company.
Note: A $25.00 surcharge will be applied to each visit not paid at the time of service.