Healthcare Loopholes

Did you know that if there's a doctor who provides a service you're interested in & your health insurance doesn't cover it, you can have that doctor credentialed through your insurance company so that they will cover the service?

If you know me, you know that I have a crippling fear of thunderstorms. With Summer rapidly approaching (Thunderstorm "season" on the East coast), I decided that I would look into having hypnotherapy to treat my phobia. (Hypnotherapy=the use of hypnosis in treating illness).

Hypnotherapy has been used to effectively rid people of unhealthy eating habits, anxiety, phobias, weight loss, smoking cessation & more.

Because I am unemployed, I have Affinity health plan managed through Medicaid. The mental health services are managed through Beacon Health System. Long story short, I called and asked if there was anyone in the provider network who performs Hypnotherapy and there were, but... Beacon, Medicaid and Affinity won't cover it.

I conducted an internet search and came across a doctor who performs hypnotherapy in my area, she explained to me that I could have her credentialed through the network of insurance providers and she would bill me for psychotherapy, while treating me with hypnotherapy. (Thank God for loopholes in a system designed so that WE could not penetrate it). If I had to pay out of pocket it would be $90 per session and I have to have a minimum of 3 sessions.

Here's what you need to know:

1. Call the "Provider Relations" division/department of your insurance company (You can find a 1800 number in the "Contact Us" section of their website.)
2. Tell them you are interested in having a doctor credentialed and what the process entails. 
3. They will tell you that the doctor needs to send a letter of interest. The letter should consist of:

• Doctor's contact information
• Practice address
• Hours of operation
• Types of services offered
• Languages spoken
• Certifications, Registrations, etc.

3. Have the doctor email, send or fax that letter to the Provider Relations department of your insurance company.
4. After the doctor has been reviewed (based on the need for that particular service in your area), they will receive an application to become a member of the insurance network.

Yes, it is quite a process, but if you're someone in need of a particular service, it is worth the work opposed to money out of your pocket.

Please share with your friends and family. This is information that can save us thousands per household and millions as communities/a nation. Imagine if we all demanded that there be doctors in our provider networks... it would change the bureaucracy in the healthcare system. This applies to ALL insurance companies... not just those managed through Medicaid.