Need to vent

FlowerGarden

Active Member
Back in Nov., difficult child told us he is addicted to pain killers and marijuana. He wanted help. Detox places said he was not addicted enough for inpatient. He wanted inpatient because he could not handle the pain, etc. when he tried to stop on his own. Insurance would not pay for detox if the places said he wasn't addicted enough. Someone here had suggested going through a doctor and see if we could get him in that way.

After a lot of searching on our insurance plan's list of doctors, I found a psychiatrist on our plan that specializes in drug addiction. difficult child called for an appointment and they said they didn't take our insurance. I called the insurance and questioned it. The clinician on our plan told me that they do accept the insurance and she even called them to find out why they say they don't take it. They told the insurance they weren't getting paid. It was being denied. The clinician gave them the number to call to speak to their rep to make sure they were sending the claim to the right place, etc.

difficult child made an appointment. and wound up changing it because of difficult child being a difficult child. He finally went today and calls me after the appointment to tell me he had to pay the full price for a visit, not our copay, because they don't take our insurance for drug addiction. They only take our insurance for psychiatric problems. I told him he has a psychiatric problem and he said that the doctor said because he is giving him suboxone (sp?) to detox and not a psychiatric drug, it doesn't fall under psychiatry. They claim every appointment will be $200 from now on.

The psychiatrists he had before residential, during residential, and during outpatient rehab a couple of years ago, told us his mood disorder usually goes hand and hand with addiction.

I just needed to vent about this. I am so upset. Thanks everyone for listening.
 

buddy

New Member
OH wow, now what? 200 is just crazy. I would fight this so hard after going through all of those phone calls to make sure in the first place. Why when he is finally ready for tx does all of this have to happen? I am so sorry. Can they do a payment plan??? 25 dollars a month for life? That is what my dr. office does.
 

Hound dog

Nana's are Beautiful
I don't blame you for needing to vent. I'm afraid I'd be venting on the psychiatrist myself.

That said, I'd shop around for psychiatrists that do a sliding scale for patients due to income, and yes believe it or not, they're out there. Mine does although he's one of the best in the area. But like he said, does a patient no good to get stable with medications and then can't get medications due to job loss or something else. County mental health also usually will do psychiatrist visits on sliding scale but there is usually a 6 month wait for psychiatrist......because you have to go through a few therapist visits first.

Hugs
 

exhausted

Active Member
Oh so sorry! The insurance companies can't get it through their heads that the brain is an organ just like the heart. It needs treatment too and addiction issues are most often part of mental health problems-seldom do you have addiction without some mental health problem. They even have seperate offices to handle this and deny treatment that the APA approves calling it experimental. Yes-I would look for sliding scale place. We found one to give our daughter EMDR-which is approved for PTSD but our new insurance refuses to pay for saying it is experimental. We appealed and lost even though we had a continuation of treatment issue as well.
There are some pretty affordable county programs here for addiction. I wish you luck. Hugs
 

FlowerGarden

Active Member
difficult child told me the doctor's office said they would call me today to explain the billing to me. I was going to ask them about a sliding scale based on his wages. Of course, no one called today. I think even if this doctor does have a sliding scale, I am going to look for another doctor for him. It seems his office staff is not very reliable.
 
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