Reported by: Hagit Limor
Photographed by: Phil Drechsler
Web produced by: Laura Hornsby
It’s a call for help, a call of desperation: Every day, people in the Tri-State reach out for mental health care, from marriage counseling to children’s issues to thoughts of suicide.
But many are complaining that one large insurance company isn’t providing the help it’s promised.
The I-Team’s Hagit Limor has been investigating since last summer.
That’s when we first told you that the governor of Ohio was asking for an investigation after we made him aware of complaints about Anthem Insurance company.
Since then, the I-Team’s continued to get complaints that the situation is getting worse. So we decided to test the system ourselves, and to find out what happened to that state investigation the Governor promised.
We first met with Kate, and her 22-month-old son, Coen.
"It’s frustrating. Really frustrating," she said. Kate’s been struggling to find someone, anyone, she and her boyfriend could see for relationship counseling.
"You only have a short list of people that you can even call, and when you call them they are like, ‘Well, we are not accepting you because you have Anthem.’"
Kate started with Anthem’s online list of therapists she could see in-network.
She called Anthem’s customer service line to confirm. "It was like one person after the other. They were either had just been dropped by Anthem or they dropped Anthem themselves. I’m like, ‘Are you kidding me? Why do you even have them on your website then, as in-network and covered on my plan?’"
Kate says it took hours on the phone to find that of close to 50 names, only eight still accepted Anthem patients, and of those eight, the first five said she couldn’t get an appointment.
"It does not pay for us to take Anthem. It does not cover our overhead," said an office manager for a local psychiatrist's office who asked us to hide her identity because she fears retaliation from Anthem. She says she hears from patients like Kate every day.
"One of their big complaints is that ‘You are the 14th doctor I’ve called. Are you taking Anthem, period?’ They have called everywhere and they can’t get in or it’s a three- to six-month wait. And they need help right now."
The problem, she says, is that Anthem cut what it pays therapists so significantly, that even ‘though her office officially takes Anthem patients, in reality when they call, "You have to tell them, ‘I’m sorry. We are full. We have no openings. It’s hard to discriminate but we have to screen them. We can’t even provide the care. We can’t afford to."
And she says many other practices are doing the same thing. So the I-Team decided to test Anthem’s list on its website with random calls. Our intern called mental health providers and asked if they were taking new Anthem Patients.
Here’s what we heard from office after office:
"He is not accepting new patients." "She’s no longer with our agency." "He’s not accepting Anthem patients."
We heard this every call. For full article -
http://www.kypost.com/content/wcposhared/story.aspx?content_id=3cbb794b-18e4-4b08-8531-64ac4be39249