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Comment by faitswulff | Hacker News Reader

That is a significant amount of work to engage in for someone who is already in a compromised mental state :'(

My wife has called over 10 therapists in the last few months. All of them have had no openings for new patients unless you agree to see them off the insurance. The rejection from so many therapists is taking it's toll. It's even more depressing to get up the motivation to research a new batch of therapists, get up the nerve to call, only to be rejected again. The act of finding a therapist is more depressing than just having depression.

That is technically insurance fraud. As a provider, when you accept insurance from a specific company you sign a contract that says you are required to accept that insurance as payment if you see a client who is a customer of that insurance company. You cannot hold specific "insurance" and "cash pay" slots. A large practice in Boston is being investigated for this right now, and it might put them out of business.

Is it fraud to have cash pay slots that require you not have insurance? From your description it sounds like it isn't.

They might (They do, this has happened to me, and the end result was not getting care I needed, but anyway) suggest you not inform them of your insurance, then it's your fraud, not theirs.

As a provider, if you do this you're putting yourself at massive risk. A patient could at any point (maybe you annoyed them that day) decide to request reimbursement from their insurance for your past sessions with them. That would probably trigger an audit, and could get you kicked off the insurance panel — and worse, be on the hook to pay back the insurance company for every cash payment you took that should have been covered.

That sounds horrible. It gets to one of the main problems with finding a therapist where you do some research and find someone that you think you will connect with, then reach out and risk rejection because they are full or don't have availability when you need it. Even if they offer you a referral it isn't the person who you were excited (on some level) about.

My wife is a therapist and tries to prevent this by being as transparent as possible. She posts her rates, her calendar, and makes it very clear that she is private pay only on her website. By the time someone reaches out to her, they usually know that it is going to work because they have had the opportunity to see all of that information.

That's very true. Sometimes the work only comes once you start to get better (and then don't think you need the help). This advice could work if someone has noticed a loved one needs help and has to seek out help on another's behalf. It took me years to finally reach the step of starting the search which was super hard. I'm getting good results though.

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