Trouble with Insurance Companies

Good Afternoon Everyone! I'll be honest, I am not nearly as dedicated to this blog as I was hoping when originally setting out on this journey! I often think of writing you but then, life happens and it gets away from me! However, I do want you to know that i truly am grateful for the 5 minutes that you take out of your day to share with me when reading these. Today, I would unfortunately like to talk briefly about insurance. Insurance companies are making it harder and harder to provide care under their respective umbrellas for a multitide of reasons, all but one of which, I won't go into today. However, this most recent interaction I believe is worthy enough to share with you about ZTS continuing to fight for a healthy society, healthy clinical staff to serve you, and ultimately, a healthier you. Below is a snippet of correspondence that I have been having with DHHS regarding a multi-million dollar program that would allow them to check a box stating that they did work to provide access to service for a range of Medicaid patients across the state for a variety of services, including therapy. On paper, at a casual glance only, it sounds like a wonderful thing right! - (and maybe even one that I've visited with some of you about) However, upon some, imo, minimal prompting, the result as it stands is not only irresponsible, it is for me, unacceptable. Feel free to draw your own conclusions yourself from below (names and other identifying information other than my own have been redacted to preserve the privacy of the individuals) :

"Hi Joe,

  What information is going to be required for providers to provide DHHS regarding patients? Identifying information or simply the verification from employer that they are, in fact, meeting the percentage requirement - as in yes, I confirm that I am in fact seeing at least 5%+ of my caseload as medicaid or insured….or more than that amount of information? What will be done with that information once DHHS has it? We don’t have specific answers for these yet, as we are still ironing out all the details regarding the verification process. However, all responses given for verifications are subject to an audit.

Signed (Insert representative signature here)"

What I am inquiring about on your behalf is what information are they requiring to be turned over as part of the contract and, imo more importantly, what is going to be done with your information once they have it.....and they don't have a response!

That should be MAJORLY concerning not just to you as patients, but to every. single.

person. just as a member of our collective society. Every day we hear and experience more and more about our information, including our private health information, being bought and sold for any number of purposes. Again, this is only a snippet of some of the questions that I had, but this one alone was enough for me not to partake in this program, as you can see in my response below on behalf of the clinic. HOWEVER- I can not say that your PCP, specialist, chiropractor, physical therapist, etc. have taken the same considerations. I would encourage you all to inquire about these sorts of things with your respective healthcare team members so that you have answers that you can understand and are comfortable with. Again- therapeutic loving reminder that the ONLY dumb questions...are the ones that you don't ask! I firmly believe that we are entering an era of unprecedented information being given away. Here at Ziemba Therapeutic Services, we not only are taking a proactive approach to prevent this, we will continue to work as hard as we can to make sure that "what happens in therapy, stays in therapy". Until next time...

Be Well!

-JZ

"Hello (DHHS Representative)-

Thank you for getting back to me and I apologize if I had addressed it incorrectly to the wrong person/department.

The first point is a real sticking point and should be a no go for all responsible clinicians. We’re being asked to sign a contract to provide services and data for DHHS without even knowing what the exact details of that contract are. As a matter of principle alone, blindly signing a contract without knowing what is in it should be a gigantic red flag. I would imagine this is making it difficult to attract quality clinicians to the program. Once you have more information regarding the specific details, I would love to hear them and pass them along to the rest of the clinicians in my office so that they may make an informed decision. At this time however, in good conscience, none of us can move forward. I’m sure that you understand.

Thank you and look forward to hearing from you with more details if and when you have them

Joe Ziemba, LIMHP, Owner

Ziemba Therapeutic Services"