Providing therapy when managed care organizations deny reimbursement: Are private practitioners and their clients taking the fall?

Robert H. Keefe, Michael L. Hall, Kenneth N Corvo

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Sampled private practitioners from the Register of Clinical Social Workers, American Psychological and Psychiatric Associations were used to evaluate what percentage of these practitioners' caseloads are made up of clients who have been denied reimbursement by managed care organizations for ongoing therapy. The results indicate that 39% of the respondents' caseloads are of managed care insured clients, of whom nearly one-third have been denied reimbursement for ongoing therapy, and of whom 42% later reenter therapy with an acute exacerbation of symptoms. The results have potential ethical and legal complications for private practitioners treating clients insured by managed care organizations.

Original languageEnglish (US)
Pages (from-to)49-64
Number of pages16
JournalSocial Work in Health Care
Volume36
Issue number2
DOIs
StatePublished - Jun 2002

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Keywords

  • Behavioral health
  • Managed care
  • Private practice
  • Psychotherapy
  • Reimbursement
  • Social work services

ASJC Scopus subject areas

  • Social Sciences (miscellaneous)
  • Health Policy

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