Insurance Info. Request

  • Insurance Info. Request

    Posted by Tricia Toth on November 17, 2020 at 10:00 am

    I have met with a client for a few sessions and have just been sent a letter from his insurance provider asking for very detailed information regarding his ‘medical status’ on diagnosis, clinical findings, prognosis, etc. I know that this particular client had already participated in a full psychological assessment and former counselling (within this past year); both who recommended ongoing counselling. It is my impression that the information may be being sought in an effort to disqualify him from his long term disability claim. I am reluctant to comment on ‘medical status’ as I do not have a doctorate (I have a clinical MSW, RCC, RSW). The client provided the insurance provider with authorization (which is ineligible) though I know he is concerned it may impact his benefits. Has anyone had this experience? Advice?

    Insurance-Sample-Letter.docx

    Tricia Toth replied 3 years, 6 months ago 2 Members · 2 Replies
  • 2 Replies
  • Denise Byford

    Member
    November 18, 2020 at 9:56 am

    Hi Tricia,

    It feels uncomfortable when we are trying to help a client and are asked for reporting that may hinder client successful outcomes. In my graduate program we learned how to advocate for the client while reporting for an agency. If you have also had this training and know the following information please know that my intention is to share my experience. 🙂

    Since we are not “qualified” to make any diagnosis it would be best to be the advocate for your client and point out the supports that (backed by research) would benefit the client.

    Also if you use measured outcome scales to support the success of counselling you may be able to report on the scale of how “the client” feels they have improved. It may also allow the client for other supports (ie occupational therapist).

    Your first priority is helping the client and “do no harm”. In your report language as “the client reported”. “In my observation” “the client explained” will steer you clear of diagnosis.

    Measured self report scales are also helpful. I used these when working with a client and having to report to WorkSafe BC. If you want to discuss further – you can call me or we can chat over video.

    • Tricia Toth

      Member
      November 19, 2020 at 12:52 pm

      Thank you very much! I would be interested in hearing more as to which measurement tools you use.

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