heads up on HMO funded counseling
I just came from the HMO counseling clinic on Riverside where I was able to get an appointment at 2pm today. They told me to come in at 1:15pm to fill out a 20 page questionaire which covers, extensively, personal and medical histories for yourself and for your family - along with very specific and frank self-evaluations regarding personal problems, alcohol and drug use, family history, mental history, etc.
At first I thought the intake form was an excellent way to lay out the ground work, and I took the opportunity to lay it all out completely onto their extensive records. However, I had no idea what their confidentiality agreement was regarding what the HMO could utilize from the forms I was filling out, so I did not sign any release forms.
My counselor, who I immediately recognized as the kind of soft-ball guy that would get steam rolled by my mind, was very nice. I asked him if he shared his office because there was just a piece of paper in the office door name area. He said it was indeed his office but he had made the sign himself. He joked the HMO wouldn't pay the $10 to get a permanent one.
Insurance companies looking for reasons not to pay.
My counselor opens immediately to the release part of the page. I ask him about confidentiality and he begins to describe what rights I have regarding keeping information from the government. I tell him I am concerned about information getting to the HMO from the paper work he just filled out. There is a tremendous amount of information in the packet I have just handed him. Luckily he only has it open to the HMO's release page - we're talking about that and here is what he says:
My question is, "Does the HMO have access to these records for any reason?"
He answers, "If the HMO does not agree with a diagnosis and wants to do their own evaluation to determine what level of treatment you will be insured for, they have the right to all of these records." He went on to describe other instances the HMO can look at the records: Pretty much whenever they feel like it.
My next question: "Can the HMO use the information contained in my counseling records to deny service, diagnosis pre-existing conditions, catch me doing something they don't like and otherwise finding reasons to not offer me coverage for future problems."
He answers, "They can do whatever they want with the information contained in your counseling records."
"And then, for all I know, when I switch insurers, this information has passed into the free trade information vortex for HMOs and could easily come up for the rest of my life?"
"I can't say that definitely would not happen."
That settled it. I was out of there. How could I be frank with a man who has been made the agent of an insurance company? Everything I tell him can possibly be used against me for the rest of my life. I asked him if this was true of every counseling service paid for by the HMO, he said they all must agree to these terms to hold an account with the HMO and that any covered counseling service is subjected to the same standards.
What an incredible trap.
I asked him about outside counseling. He said I could pay for it myself. I said I can't pay for it myself. He then referred me quite quickly, like he'd done it before a hundred times, to the "Walk In Counseling Center" on Chicago and 24th (612-870-0565). It's free for 10 sessions he says, run by volunteers - grad students and the like, ask for donation, much like NIP in Uptown.
He even called them on the phone to get the hours and ask if they charged anything. I swear it was a practiced performance. During the hours, which include non-business hours, you can just walk in and get counseling. No HMO. No permanent record they can use against you. He said you don't even have to use your real name.
The paperwork took me - and I am fast yet thorough - 45 minutes solid. I was in the session at 2:05pm with the HMO counselor. He was shaking my hand, saying "I completely understand you want your privacy." and sending me on my way by 2:15pm. He said he wouldn't even charge me the copay, mark it as a cancellation. I swear to god he was happy to see an intelligent person flee the system. And I was happy as hell to get out of there.
I took my paperwork with me, as you might imagine.
"Did you get your parking validated?" was the last thing I heard on the way out. I don't think he's a big fan of the system either.
-Tobin
At first I thought the intake form was an excellent way to lay out the ground work, and I took the opportunity to lay it all out completely onto their extensive records. However, I had no idea what their confidentiality agreement was regarding what the HMO could utilize from the forms I was filling out, so I did not sign any release forms.
My counselor, who I immediately recognized as the kind of soft-ball guy that would get steam rolled by my mind, was very nice. I asked him if he shared his office because there was just a piece of paper in the office door name area. He said it was indeed his office but he had made the sign himself. He joked the HMO wouldn't pay the $10 to get a permanent one.
Insurance companies looking for reasons not to pay.
My counselor opens immediately to the release part of the page. I ask him about confidentiality and he begins to describe what rights I have regarding keeping information from the government. I tell him I am concerned about information getting to the HMO from the paper work he just filled out. There is a tremendous amount of information in the packet I have just handed him. Luckily he only has it open to the HMO's release page - we're talking about that and here is what he says:
My question is, "Does the HMO have access to these records for any reason?"
He answers, "If the HMO does not agree with a diagnosis and wants to do their own evaluation to determine what level of treatment you will be insured for, they have the right to all of these records." He went on to describe other instances the HMO can look at the records: Pretty much whenever they feel like it.
My next question: "Can the HMO use the information contained in my counseling records to deny service, diagnosis pre-existing conditions, catch me doing something they don't like and otherwise finding reasons to not offer me coverage for future problems."
He answers, "They can do whatever they want with the information contained in your counseling records."
"And then, for all I know, when I switch insurers, this information has passed into the free trade information vortex for HMOs and could easily come up for the rest of my life?"
"I can't say that definitely would not happen."
That settled it. I was out of there. How could I be frank with a man who has been made the agent of an insurance company? Everything I tell him can possibly be used against me for the rest of my life. I asked him if this was true of every counseling service paid for by the HMO, he said they all must agree to these terms to hold an account with the HMO and that any covered counseling service is subjected to the same standards.
What an incredible trap.
I asked him about outside counseling. He said I could pay for it myself. I said I can't pay for it myself. He then referred me quite quickly, like he'd done it before a hundred times, to the "Walk In Counseling Center" on Chicago and 24th (612-870-0565). It's free for 10 sessions he says, run by volunteers - grad students and the like, ask for donation, much like NIP in Uptown.
He even called them on the phone to get the hours and ask if they charged anything. I swear it was a practiced performance. During the hours, which include non-business hours, you can just walk in and get counseling. No HMO. No permanent record they can use against you. He said you don't even have to use your real name.
The paperwork took me - and I am fast yet thorough - 45 minutes solid. I was in the session at 2:05pm with the HMO counselor. He was shaking my hand, saying "I completely understand you want your privacy." and sending me on my way by 2:15pm. He said he wouldn't even charge me the copay, mark it as a cancellation. I swear to god he was happy to see an intelligent person flee the system. And I was happy as hell to get out of there.
I took my paperwork with me, as you might imagine.
"Did you get your parking validated?" was the last thing I heard on the way out. I don't think he's a big fan of the system either.
-Tobin
posted by tobin at
1:03 PM
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