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Would you pay out of pocket for speech therapy?
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debsey




 
 
    
 

Post Fri, Jul 25 2014, 6:37 pm
nylon wrote:
Your time is only worth what someone will pay for it. The insurance company is the payer. Can they force you to take less than what you really want to be paid? Sure. Can they be paying less than what you could make privately? Also possibly.

But if you think your time should be worth $90, but people will only pay $60--it isn't worth $90 unless you can find a customer. This is why medical billing is such a mess (not just therapists): providers make up numbers and then insurance makes up new, lower ones. What's anyone "worth" in a free market? Who knows. We don't have it (not always bad).


exactly. But if your time is worth X amount of dollars in the private pay system, and then people want you to accept insurance, and resent when you don't, that is a resentment that makes no sense. Once you agree to take insurance fees, no one can supplement. You can't charge for cancellations, even if they were 5 minutes before the session. You can't charge for the time you spend on the phone with the insurance company.
So while it's legal to NOT take insurance, it's illegal to do the things that might make it sustainable. And no one has the right to resent that. Unless that person ALSO believes in working for free, and puts her money where her mouth is.
debsey
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anon for this




 
 
    
 

Post Fri, Jul 25 2014, 7:04 pm
debsey wrote:

If you want to use insurance, go to a place that is set up for it. Will you get top-quality therapy? Probably not. Will you get a provider who is very invested in your case because you are one of the few she sees? For sure not, places like that are mills. Will you get someone willing to work with your schedule? Rolling Laughter Not even CLOSE.

Actually, OP said she currently works at an outpatient pediatric center that does take insurance and that there's no difference in the services she provides currently and the services she intends to provide privately. So your argument that providers who take insurance are less-qualified doesn't seem to apply here. In my experience as well, providers at centers that accept insurance are well-trained and qualified.

I agree with you that private pay providers (there's a tongue-twister) can offer better scheduling though.
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anon for this




 
 
    
 

Post Fri, Jul 25 2014, 7:06 pm
debsey wrote:
exactly. But if your time is worth X amount of dollars in the private pay system, and then people want you to accept insurance, and resent when you don't, that is a resentment that makes no sense. Once you agree to take insurance fees, no one can supplement. You can't charge for cancellations, even if they were 5 minutes before the session. You can't charge for the time you spend on the phone with the insurance company.
So while it's legal to NOT take insurance, it's illegal to do the things that might make it sustainable. And no one has the right to resent that. Unless that person ALSO believes in working for free, and puts her money where her mouth is.
debsey

I know of many providers who take insurance but also charge a cancellation fee, so I'm not sure if that's true.
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debsey




 
 
    
 

Post Fri, Jul 25 2014, 7:07 pm
anon for this wrote:
Actually, OP said she currently works at an outpatient pediatric center that does take insurance and that there's no difference in the services she provides currently and the services she intends to provide privately. So your argument that providers who take insurance are less-qualified doesn't seem to apply here. In my experience as well, providers at centers that accept insurance are well-trained and qualified.

I agree with you that private pay providers (there's a tongue-twister) can offer better scheduling though.

Like many excellent people, she's considering "graduating" out of the clinic/hospital/school setting and into private practice. Sure, if you're lucky, you'll get a therapist like this - excellent and in the process of transitioning out of working in a large clinic - but you are not GUARANTEED that when you come into your random large clinic or hospital. But when you pay privately, it's because you're choosing that person. A clinic just assigns whomever.
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amother


 

Post Fri, Jul 25 2014, 8:06 pm
OP here. It's really close to Shabbos but I just wanted to add that the people I work with are all competent. We have a nice team and it's a great environment. However, some of us are passionate about our job and some of us aren't. I've spent thousands of dollars of my own money to get certified in various treatments, to attend conferences, to buy specialized therapy materials, etc. because I care passionately about doing everything I can to help my kiddos. I have colleagues who just don't do this. They enjoy helping kids but they're not on a mission to "save" them. That's the difference. I believe most SLPs with the intelligence necessary to work in a hospital setting could be excellent if they wanted to be, but it's a choice. Some people want to leave their work at home, whereas some of us lie awake at night thinking about how to better reach the kids we work with. (I'm not saying this in a boastful way even though it sounds like it! I'm just explaining my take on this.)
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amother


 

Post Fri, Jul 25 2014, 8:07 pm
*I meant leave their work at work, of course

Good Shabbos!
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anon for this




 
 
    
 

Post Sun, Jul 27 2014, 12:06 am
debsey wrote:
Like many excellent people, she's considering "graduating" out of the clinic/hospital/school setting and into private practice. Sure, if you're lucky, you'll get a therapist like this - excellent and in the process of transitioning out of working in a large clinic - but you are not GUARANTEED that when you come into your random large clinic or hospital. But when you pay privately, it's because you're choosing that person. A clinic just assigns whomever.

That's not been my experience at all. And my friends and neighbors who've used therapists covered by insurance have usually been satisfied with the level of care as well--usually they switch because insurance only covers a limited number of sessions and/or the sessions available don't work with their schedule.

The therapists I've used weren't "graduating" into private practice, they're experienced therapists who deliberately chose a hospital/ clinic setting.

Of course no one has any guarantee of finding an excellent therapist in any setting, clinic, hospital, or privately.

In any case, I wish OP the best of luck.
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MaBelleVie




 
 
    
 

Post Sun, Jul 27 2014, 12:18 am
I think all of this really depends on where you live. In some places, it's true that all the top therapists go private. In other places, you can have excellent therapists working in hospitals and clinics. I think it depends on how much therapists are compensated in different locations, which in turn depends on who the payors are and their rates. I say this based on what therapist friends in various locales have shared with me.
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