Dr had to drop me because I might lose my Medicaid if I continue to see him. Weird situation

[crumpettaser]

@wnnipooh I read in your other comments that your therapist doesn't accept Medicaid in that instance you can pay for it out of pocket that's not illegal. It's only illegal if that doctor's office is contracted with Medicaid and they are doing out of pocket charges instead of billing Medicaid.

 

[wnnipooh]

@crumpettaser My psychiatrist doesn’t accept Medicaid and he let me go Thursday

The therapist is a whole separate issue.

 

[bartholmute]

@wnnipooh Echoing /@mountaintrip98, I have been in the industry for around as long and this was drilled into me quite early on, before I escaped patient-facing care into administration even.

Respectfully, your provider either doesn't know the basics of running their practice if they are independent or their office manager is equally as dysfunctional if they are part of a group.

I hope they were at least giving you a sliding fee rate considering that they knew your financial situation was not good.

 

[wnnipooh]

@bartholmute For a long time they did give me a good price. Started going way up last few years tho. I won’t lie parents have chipped in on occasion because they know how well I do with this Dr

The thing I can’t wrap my head around is the owner is not some dumbass with his head in the sand. He knows a lot about insurance, the latest information on mental health and even told people 5-6 years ago Medicaid would go away(unless self pay)

How could such a smart and well connected person not know this? I mean this guy teaches psychiatristy at Yale. It’s a very “upscale” practice.

Him hiding this shady self pay thing seems so unlike him

 

[resjudicata]

@wnnipooh Being good at the thing he does, psychiatry, doesn’t make him good at insurance. They are human and often find insurance as confusing and nebulous as we do.

 

[wnnipooh]

@resjudicata Wow true yeah. Still shocking as this person has multiple practices. I bet he knew about it but someone found out

 

[aleethia]

@wnnipooh May I ask what state? And edit your post to include that info?

(Only if comfortable)

 

[brownrecluse2470]

@wnnipooh Yah he’s been breaking the rules for 10 years, someone disgruntled prolly just recently ratted him out.

 

[moopy25]

@wnnipooh Because billing may be done by a separate department or billing company, he may not have personally been aware of the rules. It is illegal for doctors to accept cash payments from Medicaid recipients. Since he’s a psychiatrist, do you mainly use him for medication management? If so, can he communicate your care and medication plan with your PCP? And possibly refer you to a psychiatrist at a clinic for ongoing medication management?

 

[elizabethc]

@wnnipooh I think the only solution is to find a new provider and if they don't take Medicaid you'll have to lie and say you don't have Medicaid or SSI or any other insurance and that you are cash pay.

However, I don't know how that factors into your SSI because you need to continue your therapy for redetermination...

 

[thecross22]

@mountaintrip98 Medicaid isn’t always solely income based, the majority of the time it is, but there are situations where Medicaid for that person wasn’t based on income. There’s also a variety of situations where Medicaid is secondary insurance, so it’s not necessarily that the person who has it is “so poor they can’t be paying cash for services”. That might be the typical scenario but it’s unfair to assume that about everyone who has Medicaid.

 

[wnnipooh]

@mountaintrip98 I totally get that but what a fucked up system when the alternative is basically nothing. Almost no Psychological services near me accept Medicaid. So what is a person to do?

I can do Nothing.

I can Pay of out pocket

Or

I potentially have a terrible Dr that is Medicaid but not as qualified

Shitty system

 

[cyclone_105]

@wnnipooh Your Medicaid benefits likely have a Mental and Behavioral Health network with a provider search. Since they're presumably your MCO, their network is likely larger than you think - but finding a new provider, specifically a new psychiatrist and therapist can be extremely stressful. If you have a Care Coordinator, they may be worth speaking to about the situation.

 

[wnnipooh]

@cyclone_105 How can I contact them? Thanks

 

[cyclone_105]

@wnnipooh Call your insurer - your Medicaid carrier. They'll be able to advise.

 

[no1texan]

@wnnipooh Yes this is true.

 

[aleethia]

@no1texan It's true in some states, but not others.

 

[elizabethc]

@aleethia Yea, in Michigan they don't care (in my experience)

 

[wnnipooh]

@no1texan For how long?

 

[poseyka]

@wnnipooh It’s been illegal for a very long time. I think your provider just got warned finally so now he’s gonna comply.