Experiences with Insurance Reimbursement During Covid

Experiences with Insurance Companies

Dear Colleague,

This survey from the Connecticut Psychological Association (CPA) has two purposes:

1. We have heard from many of you that you've had higher levels of issues with reimbursement lately. We would like to document those problems so we can work to address them.

2. CPA worked hard in 2019 to help pass The Mental Health Parity Bill. It takes effect this spring. CPA needs to bring concerns and problems to the Insurance Committee. Please let us know if you are encountering situations that may reflect Parity problems.

If a question is not relevant to you, or you prefer not to answer, feel free to skip it.

Thank you,

Your colleagues at CPA

Question Title

* 1. Do you provide out-patient psychological services that could be reimbursed by insurance, including Medicare, Husky Health (CT Medicare), or commercial insurance (e.g., Aetna, Cigna, etc.)?

Yes

No. If no, thank you, you don't need to answer any more questions on this survey

Question Title

* 2. Approximately what percentage of your professional time do you spend (just enter number, no percent sign):

Treating patients with psychotherapy in out-patient setting?

Out-patient testing or assessment?

Question Title

* 3. Approximately what percent of your clinical work has been provided via Telehealth since last March (the beginning of the Public Health Emergency)?

75% or higher

50-75%

25-50%

Less than 25%

Question Title

* 4. How do you manage your billings?

I do my own billings and use electronic billing software

I submit paper claims

I use a billing service

My organization handles billings

My patients handle their own submissions

Other (please specify)

Question Title

* 5. Are you an IN-NETWORK provider for any insurance plans--including Medicare, Husky Health (CT Medicare), or any commercial insurance?

Yes

Question Title

* 6. What plans do you accept--what IN-NETWORK benefits do you accept?

Medicare

Husky Health (CT Medicaid)

Aetna

Anthem Blue Cross, or any Blue Cross

Cigna

Emblem/GHI

Magnacare

Union Behavioral Health Plans

United Health Care/Oxford/Optum

Any other commercial Insurance (please specify)

Question Title

* 7. Have you seen an increase in problems or delays with reimbursement with insurance companies for which you are IN-NETWORK since March 2020, the beginning of the Public Health Emergency (PHE)?

Yes, quite a lot

Yes, some increases

No, the same level

No, I do not encounter problems

Question Title

* 8. Have you had any of these problems in the past year (since the PHE) with Medicare?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

I am not in-network for this plan

Other (please specify)

None of the above

Question Title

* 9. Have you had any of these problems in the past year (since the PHE) with Husky (Medicaid)?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

I am not in-network for this plan

Other (please specify)

None of the above

Question Title

* 10. Have you had any of these problems in the past year (since the PHE) with Anthem Blue Cross (or any Blue Cross billed through Anthem)?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

Clawbacks (demand for refund) for reimbursement provided in the past

I am not in-network for this plan

Other (please specify)

None of the above

Question Title

* 11. Have you had any of these problems in the past year (since the PHE) with Aetna?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

Clawbacks (demand for refund) for reimbursement provided in the past

I am not in-network for this plan

Other (please specify)

None of the above

Question Title

* 12. Have you had any of these problems in the past year (since the PHE) with Cigna?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

Clawbacks (demand for refund) for reimbursement provided in the past

I am not in-network for this plan

Other (please specify)

None of the above

Question Title

* 13. Have you had any of these problems in the past year (since the PHE) with United Health Care/Oxford/Optum?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

Clawbacks (demand for refund) for reimbursement provided in the past

I am not in-network for this plan

Other (please specify)

None of the above

Question Title

* 14. Have you had any of these problems in the past year (since the PHE) with a union insurance plan?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

I am not in-network for this plan/do not submit to union plans

Other (please specify)

None of the above

Question Title

* 15. Have you had any of these problems in the past year (since the PHE) with Emblem/GHI?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

I am not in-network for this plan

Other (please specify)

None of the above

Question Title

* 16. Please rate the IN-NETWORK reimbursement you receive from each insurance plan in which you participate SINCE LAST MARCH (PHE).

	Above average for in-network benefits	Average for in-network benefits	Below average for in-network benefits	Unacceptably low	N/A
Traditional Medicare	Traditional Medicare Above average for in-network benefits	Traditional Medicare Average for in-network benefits	Traditional Medicare Below average for in-network benefits	Traditional Medicare Unacceptably low	Traditional Medicare N/A
Medicare Advantage	Medicare Advantage Above average for in-network benefits	Medicare Advantage Average for in-network benefits	Medicare Advantage Below average for in-network benefits	Medicare Advantage Unacceptably low	Medicare Advantage N/A
Husky Health (CT Medicaid)	Husky Health (CT Medicaid) Above average for in-network benefits	Husky Health (CT Medicaid) Average for in-network benefits	Husky Health (CT Medicaid) Below average for in-network benefits	Husky Health (CT Medicaid) Unacceptably low	Husky Health (CT Medicaid) N/A
Anthem Blue Cross, or any Blue Cross	Anthem Blue Cross, or any Blue Cross Above average for in-network benefits	Anthem Blue Cross, or any Blue Cross Average for in-network benefits	Anthem Blue Cross, or any Blue Cross Below average for in-network benefits	Anthem Blue Cross, or any Blue Cross Unacceptably low	Anthem Blue Cross, or any Blue Cross N/A
Aetna	Aetna Above average for in-network benefits	Aetna Average for in-network benefits	Aetna Below average for in-network benefits	Aetna Unacceptably low	Aetna N/A
Cigna	Cigna Above average for in-network benefits	Cigna Average for in-network benefits	Cigna Below average for in-network benefits	Cigna Unacceptably low	Cigna N/A
Emblem/GHI	Emblem/GHI Above average for in-network benefits	Emblem/GHI Average for in-network benefits	Emblem/GHI Below average for in-network benefits	Emblem/GHI Unacceptably low	Emblem/GHI N/A
Magnacare	Magnacare Above average for in-network benefits	Magnacare Average for in-network benefits	Magnacare Below average for in-network benefits	Magnacare Unacceptably low	Magnacare N/A
Union Behavioral Health Plans	Union Behavioral Health Plans Above average for in-network benefits	Union Behavioral Health Plans Average for in-network benefits	Union Behavioral Health Plans Below average for in-network benefits	Union Behavioral Health Plans Unacceptably low	Union Behavioral Health Plans N/A
United Health Care/Oxford/Optum	United Health Care/Oxford/Optum Above average for in-network benefits	United Health Care/Oxford/Optum Average for in-network benefits	United Health Care/Oxford/Optum Below average for in-network benefits	United Health Care/Oxford/Optum Unacceptably low	United Health Care/Oxford/Optum N/A
Other insurance company you identified in Q5	Other insurance company you identified in Q5 Above average for in-network benefits	Other insurance company you identified in Q5 Average for in-network benefits	Other insurance company you identified in Q5 Below average for in-network benefits	Other insurance company you identified in Q5 Unacceptably low	Other insurance company you identified in Q5 N/A

Question Title

* 17. Please describe any other changes you saw last year in reimbursement levels.

Question Title

* 18. Have you resigned, or do you plan to resign next year, from any panels because you were dissatisfied with reimbursement rates?

Yes

Question Title

* 19. Which panels did you, or will you, resign from?

Medicare

Husky Health (CT Medicaid)

Anthem Blue Cross, or any Blue Cross

Aetna

Cigna

Emblem/GHI

Magnacare

Union Behavioral Health Plans

United Health Care/Oxford/Optum

Other insurance plan (please specify)

Question Title

* 20. Have you seen an increase in problems or delays with reimbursement with insurance companies for which you are OUT OF NETWORK since last March (PHE)?

Yes, quite a lot

Yes, some increases

No, the same level of problems

No, I do not encounter problems

Question Title

* 21. Have you had any of these problems in the past year (since the PHE) with Anthem Blue Cross (or any other Blue Cross you bill through Anthem) as an OUT OF NETWORK PROVIDER since last March (PHE)?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

I am in-network for this plan

Other (please specify)

None of the above

Question Title

* 22. Have you had any of these problems in the past year (since the PHE) with AETNA as an OUT OF NETWORK PROVIDER since last March (PHE)?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

I am in-network for this plan

Other (please specify)

None of the above

Question Title

* 23. Have you had any of these problems in the past year (since the PHE) with CIGNA as an OUT OF NETWORK PROVIDER since last March (PHE)?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

I am in-network for this plan

Other (please specify)

None of the above

Question Title

* 24. Have you had any of these problems in the past year (since the PHE) with UNITED HEATH CARE/OXFORD/OPTUM as an OUT OF NETWORK PROVIDER since last March (PHE)?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

I am in-network with this plan

Other (please specify)

None of the above

Question Title

* 25. Have you had any of these problems in the past year (since the PHE) with a union-based health plan as an OUT OF NETWORK PROVIDER since last March (PHE)?

Lower reimbursement for telehealth than office visits

Denial of reimbursement for telehealth

Denial of coverage that was previously reimbursed

Longer lag time for reimbursement

I am in-network for this plan

Other (please specify)

None of the above

Question Title

* 26. Please rate the out-of-network reimbursement you or your patients receive from each insurance plan below, taking into consideration both deductibles and amount covered

	Above average for out-of-network benefits	Average for out-of-network benefits	Below average out-of-network benefits	Unacceptably low	I am in-network for this plan, so I cannot bill as out-of-network
Anthem Blue Cross, or any Blue Cross	Anthem Blue Cross, or any Blue Cross Above average for out-of-network benefits	Anthem Blue Cross, or any Blue Cross Average for out-of-network benefits	Anthem Blue Cross, or any Blue Cross Below average out-of-network benefits	Anthem Blue Cross, or any Blue Cross Unacceptably low	Anthem Blue Cross, or any Blue Cross I am in-network for this plan, so I cannot bill as out-of-network
Aetna	Aetna Above average for out-of-network benefits	Aetna Average for out-of-network benefits	Aetna Below average out-of-network benefits	Aetna Unacceptably low	Aetna I am in-network for this plan, so I cannot bill as out-of-network
Cigna	Cigna Above average for out-of-network benefits	Cigna Average for out-of-network benefits	Cigna Below average out-of-network benefits	Cigna Unacceptably low	Cigna I am in-network for this plan, so I cannot bill as out-of-network
Union Behavioral Health Plans	Union Behavioral Health Plans Above average for out-of-network benefits	Union Behavioral Health Plans Average for out-of-network benefits	Union Behavioral Health Plans Below average out-of-network benefits	Union Behavioral Health Plans Unacceptably low	Union Behavioral Health Plans I am in-network for this plan, so I cannot bill as out-of-network
United Health Care/Oxford/Optum	United Health Care/Oxford/Optum Above average for out-of-network benefits	United Health Care/Oxford/Optum Average for out-of-network benefits	United Health Care/Oxford/Optum Below average out-of-network benefits	United Health Care/Oxford/Optum Unacceptably low	United Health Care/Oxford/Optum I am in-network for this plan, so I cannot bill as out-of-network
Other commercial insurance plan	Other commercial insurance plan Above average for out-of-network benefits	Other commercial insurance plan Average for out-of-network benefits	Other commercial insurance plan Below average out-of-network benefits	Other commercial insurance plan Unacceptably low	Other commercial insurance plan I am in-network for this plan, so I cannot bill as out-of-network

Please identify "other insurance plan"

Question Title

* 27. When you have to call provider services with a billing or coverage problem that, how satisfied are you with how easily and quickly you can reach a representative?

	Very satisfied	Somewhat satisfied	Not at all satisfied	Have never called this plan
Medicare	Medicare Very satisfied	Medicare Somewhat satisfied	Medicare Not at all satisfied	Medicare Have never called this plan
Husky Health	Husky Health Very satisfied	Husky Health Somewhat satisfied	Husky Health Not at all satisfied	Husky Health Have never called this plan
Anthem Blue Cross, or any Blue Cross	Anthem Blue Cross, or any Blue Cross Very satisfied	Anthem Blue Cross, or any Blue Cross Somewhat satisfied	Anthem Blue Cross, or any Blue Cross Not at all satisfied	Anthem Blue Cross, or any Blue Cross Have never called this plan
Aetna	Aetna Very satisfied	Aetna Somewhat satisfied	Aetna Not at all satisfied	Aetna Have never called this plan
Cigna	Cigna Very satisfied	Cigna Somewhat satisfied	Cigna Not at all satisfied	Cigna Have never called this plan
Emblem/GHI	Emblem/GHI Very satisfied	Emblem/GHI Somewhat satisfied	Emblem/GHI Not at all satisfied	Emblem/GHI Have never called this plan
Magnacare	Magnacare Very satisfied	Magnacare Somewhat satisfied	Magnacare Not at all satisfied	Magnacare Have never called this plan
Union Behavioral Health Plans	Union Behavioral Health Plans Very satisfied	Union Behavioral Health Plans Somewhat satisfied	Union Behavioral Health Plans Not at all satisfied	Union Behavioral Health Plans Have never called this plan
United Health Care/Oxford/Optum	United Health Care/Oxford/Optum Very satisfied	United Health Care/Oxford/Optum Somewhat satisfied	United Health Care/Oxford/Optum Not at all satisfied	United Health Care/Oxford/Optum Have never called this plan
Any other commercial insurance plan	Any other commercial insurance plan Very satisfied	Any other commercial insurance plan Somewhat satisfied	Any other commercial insurance plan Not at all satisfied	Any other commercial insurance plan Have never called this plan

Please identify "other" insurance plan

Question Title

* 28. Is there anything you'd like to tell us about regarding contacting insurance companies?

Question Title

* 29. The new Mental Health Parity Law calls for concerns to be submitted to the Insurance Committee of the State Legislature. Companies will be required to explain how they are following the law. Do you have concerns about whether any of the following companies are not treating mental health claims and coverage the same way they handle physical health claims and coverage?

	Yes, strong specific concerns	Maybe, but I'm not sure	No, not at this time
Medicare	Medicare Yes, strong specific concerns	Medicare Maybe, but I'm not sure	Medicare No, not at this time
Husky Health	Husky Health Yes, strong specific concerns	Husky Health Maybe, but I'm not sure	Husky Health No, not at this time
Anthem Blue Cross, or any Blue Cross	Anthem Blue Cross, or any Blue Cross Yes, strong specific concerns	Anthem Blue Cross, or any Blue Cross Maybe, but I'm not sure	Anthem Blue Cross, or any Blue Cross No, not at this time
Aetna	Aetna Yes, strong specific concerns	Aetna Maybe, but I'm not sure	Aetna No, not at this time
Cigna	Cigna Yes, strong specific concerns	Cigna Maybe, but I'm not sure	Cigna No, not at this time
Emblem/GHI	Emblem/GHI Yes, strong specific concerns	Emblem/GHI Maybe, but I'm not sure	Emblem/GHI No, not at this time
Magnacare	Magnacare Yes, strong specific concerns	Magnacare Maybe, but I'm not sure	Magnacare No, not at this time
Union Behavioral Health Plans	Union Behavioral Health Plans Yes, strong specific concerns	Union Behavioral Health Plans Maybe, but I'm not sure	Union Behavioral Health Plans No, not at this time
United Health Care/Oxford/Optum	United Health Care/Oxford/Optum Yes, strong specific concerns	United Health Care/Oxford/Optum Maybe, but I'm not sure	United Health Care/Oxford/Optum No, not at this time
Other insurance plan	Other insurance plan Yes, strong specific concerns	Other insurance plan Maybe, but I'm not sure	Other insurance plan No, not at this time

Question Title

* 30. If you answered yes to Q19, please describe your concerns about parity problems

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* 31. Is there anything else you would like to tell us about your experiences with insurance companies?

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* 32. What is your professional discipline?

APRN

LMFT

Mental health counselor

Psychiatrist

Psychologist

Social Worker

Other (please specify)

Question Title

* 33. Please tell us about your professional memberships

CPA member

Former CPA member

Never a member of CPA

APA Member

Other professional organization membership (please specify)