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My mental health care provider is not billing my health care insurance is this illegal

A healthcare provider may bill third party payers directly based upon services provided to their patient. However, if a medical professional does not have direct contractual rights to service fees from a third party insurer, then they are not permitted to bill that insurance company. In other words, your doctor cannot charge your insurance for services rendered. If this situation occurs, you should contact your insurance carrier immediately and file a complaint to obtain reimbursement. There are many resources available to assist you in filing an appeal.

Why Does My Medical Marijuana Patient’s Prescription Have to Be Confidential?

The California Proposition 215, passed in 1996, mandates that patients who use marijuana for medicinal purposes have access to safe and legal dispensaries. As part of this law, prescription records were kept confidential by the Department of Public Health (DPH). However, beginning January 1st, 2018, DPH has allowed local jurisdictions to request these records. Patients do not need to provide their prescribing physician’s name in order to receive a valid medical marijuana card. Instead, physicians and patients only need to sign a declaration stating that they agree to keep the records confidential. However, if the individual has been arrested for possession of a controlled substance, then those records would become public record if requested by law enforcement.

Why Are All My Patients’ Doctor Visits Confidential?

Under California law, certain types of visits between a physician and his or her patients are intended to remain confidential. These include visits where patients seek treatment for emotional stress or psychological problems, visits related to the care of children, and visits associated with abortions. Even though the state mandates confidentiality for these types of visits, it is still possible for third parties to gain access to this type of information through requests filed with local authorities. If you believe your medical history may fall under the category of confidential information, then you should seek legal counsel.

The purpose of a bill is to inform patients about their medical expenses.

Most states have passed laws that require physicians to submit bills to the patient’s insurer. In some instances, the patient may need to pay out-of-pocket before getting reimbursed. However, these are exceptions to the rule. Here is what you should know.

First,

If your physician did not send you a bill, this does not necessarily mean they did not charge you for services rendered. It could just mean that they decided not to file the paperwork. You can always ask them to do so, but realize that this might put additional stress on your relationship.

Second,

If you receive a bill from your doctor, don’t panic! Many doctors will send you a copy of the original bill along with a summary of how much they billed the insurance company. This way you can make sure you received everything listed on the original bill. If you still think you overbilled, call the insurance company directly to find out what the policy is.

Third,

Keep in mind that any charges that were deemed unnecessary will generally not count against your deductible. These include things like tests ordered by your physician that weren’t necessary or items prescribed to help your healing.
Fourth, check with the insurance company to confirm whether they approve all of your claims. Some companies allow only certain providers to submit reports. Other companies require the submitting party to pay for the report and then submit it afterwards as a claim to the insurance company. Find out which method your provider uses.
Fifth, if you get a bill from your insurance company and believe they are incorrect, contact the insurance company directly. They may have overlooked something or maybe they haven’t yet processed the claim. Read More

Mental Health Care Providers are not typically covered under your insurance plan. They are usually billed directly to you at full cost. This is due to them being considered medical professionals.
Your Care Provider can bill your Insurance company but it is not guaranteed that they will get paid. There are many reasons as to why this happens. If you have a high deductible, then you would have to pay out of pocket before your insurance company pays anything back to them. You may have other deductibles or co-pays to deal with first. Also, if you do not use enough service, you could end up paying much less than what your insurance covers.

Mental Health Care

As long as you do not abuse your care provider, they should be able to bill your Insurance Company. In addition, you cannot be denied coverage just because of preexisting conditions. You still need your insurance card to prove your rights and access.
Many times, people feel guilty about taking time off from work to take care of their own issues. Taking time off from work is extremely detrimental to your career. Therefore, you should only take this kind of leave if it is absolutely necessary.
If you do suffer from a mental illness, please contact your state department of Human Services immediately. They can help guide you through the steps needed to ensure you are getting the right treatment.
Please remember to keep yourself informed about your benefits, especially if you are self employed. Do not rely solely on your care provider to inform you of these things.

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