TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
THERAPIST: [inaudible] something and on time [inaudible]
CLIENT: It’s just with the family.
THERAPIST: Hm?
CLIENT: Just with the family that you seem to be late, when the family comes on Mondays. [1:10] Do they not come today?
THERAPIST: Before I forget, so I looked over the billing stuff and I counted 35 sessions including ten… plus ten from the [inaudible] Thursday [inaudible] meeting from October 1 through the end of the year. So…
CLIENT: August 1 or October 1?
THERAPIST: October 1. So the snag is this. I can go back and submit for five more visits to get to 40 from August and September, but they’re probably going to deny them because it’s been more than 90 days, which is the timely filing limit which I figured wouldn’t matter because I didn’t know they weren’t going to pay out those others then. [2:26] So we should figure out what to do about that. But I guess otherwise [inaudible] would just owe me for what they paid you I think. Something like that.
CLIENT: How would you like to go back to hearing it out?
THERAPIST: I don’t know.
CLIENT: I could call them.
THERAPIST: Okay.
CLIENT: And say these claims were denied. [3:28]
THERAPIST: Right, we intended to use the 40 this way. These were denied. Can you [inaudible] exceptions to the five earlier claims.
CLIENT: They might not care what I say.
THERAPIST: You mean you think they’re more likely to care if I say it?
CLIENT: What do you think?
THERAPIST: I don’t think that piece will make a difference. I don’t know, why don’t you try it and if it doesn’t work maybe… let me think about it. You have a negative balance anyway; you could just call it a loss [ph?] or something.
CLIENT: I have that much of a negative balance? [4:40] According to my…
THERAPIST: …your calculations.
CLIENT: Calculations. Okay.
THERAPIST: I don’t know. If that doesn’t work, what seems fair?
CLIENT: That I pay you for the five sessions. (pause)
THERAPIST: Actually, let me think about that as A. And B, it occurs to me this is going to result in a bigger issue, which is what about Thursdays going forward, right?
CLIENT: Yeah, that’s true.
THERAPIST: Okay, you haven’t thought about that either.
CLIENT: I thought about it for a second and then I didn’t…
THERAPIST: Think about it anymore.
CLIENT: Think about it anymore. I guess it didn’t occur to me that it’s the same…
THERAPIST: Issue.
CLIENT: Insurer. It’s the same people but it’s the same… it’s effectively the same people… [5:54]
THERAPIST: Right. After this happened I went back because I… there was a mother and a kid who I was seeing, mostly separately, and who I, I think, very occasionally saw the same day. So I went back to look, and sure enough, they had a visit from, I don’t know, late summer or something that was on the same day where the insurance only covered one of them. It’s a relatively new issue because there are new codes for submitting claims that started last year, and so it’s a long story but it’s relatively new issues. I don’t have to bother you with any more than that. So… and they have the type of insurance that you are now using. In other words they have the PPO. I wondered if it’d work any differently under the student insurance and the PPO because [inaudible]
CLIENT: Right.
THERAPIST: And it does not, I don’t think. [7:02]
CLIENT: Okay. And it’s not on the table to submit for a fake day?
THERAPIST: I wouldn’t submit for a fake day. The reason I thought this would work is because I mean, as an example, with… the mother and son shows that should work. I mean now that they’ve made the code the same for a family session and individual session, they should let you submit for two on the same day because one session I met with the kid and the other I met with the mother. And they have no way of knowing your [inaudible] with you and me. I wouldn’t lie to them and tell them, but there’s no rule against submitting twice for the same day.
CLIENT: But they didn’t cover the mom and the son.
THERAPIST: They didn’t, right. I don’t know how they can do that. But I guess I could call them about that one. [8:11] My point being to see if there’s anyway… I’m not going to lie and tell them I’m meeting with your mother and then with you but I…
CLIENT: But you could use them as an example.
THERAPIST: Right, and if they say there’s no way around it then I could do that. But yeah… no, I… yeah.
CLIENT: We’ll figure it out. (pause) The way we have it worked out is that I’m getting some money back from you every month, and if $200 of that… it’s going to be less than $200 I think.
THERAPIST: I think we set your fee $110 a visit. I’ll just do the math every month and see. Right, and you’re saying…
CLIENT: I’m saying $200 of that could just go back to you. I could just pay for that extra Thursday visit. What are they paying me? They’re paying $97 plus $50 for the recordings. [10:01]
THERAPIST: I don’t think they’re paying $97.
CLIENT: That sounds wrong. Oh, they… that’s their maximum.
THERAPIST: [inaudible] may be $97.
CLIENT: Right.
THERAPIST: They were probably paying $82 or something. I would doubt they’d [overlapping talk] copay.
CLIENT: Yeah, something like that, like $79 or $82. So yeah, that’s a possibility. But will you look into it?
THERAPIST: Yeah.
CLIENT: Okay. (pause) So based on what they say to you I will call after I hear from you about it. [11:26] Because if there’s no way to get around it then I can call and say we didn’t know. Can we submit… resubmit earlier claims.
THERAPIST: All right. I mean if… all right. Yeah, let me see what I can get from [inaudible] (pause)
CLIENT: I’m thinking about how infuriating it is to talk about insurance in my short 45-minute session. (pause) It’s like Jay, why don’t you just call me about it. [13:11] (pause) I feel like you heard that as a serious thing and I didn’t really say it as a serious thing. That’s what I want.
THERAPIST: I see. Yeah, I wasn’t sure.
CLIENT: But it’s kind of in the same vein as well why don’t you just call me anyway about anything.
THERAPIST: Right. I see. (pause)
CLIENT: Do you feel bad? [17:38] (pause) Maybe because of… what is it about the insurance or maybe before I even got here [inaudible] was making you feel bad. [19:19] (pause) But [ph?] you have stamina for holding tension. [23:22] [inaudible] (pause) Is the resting position of your tongue up against the roof of your mouth? [26:13] Wow. I’m retraining my tongue to rest there. It’s probably an itch. It affects everything, like your jaws, [inaudible] I’ve been holding onto pretty painful chronic neck pain.
Wish I had [inaudible] neck [inaudible] area, I guess, is pretty common in this day and age. And I don’t think it’s looking at a… only looking at a computer for [inaudible] where I hold emotional tension. That’s where I seize up when I feel bad [inaudible] scared or upset. [28:14] [inaudible] screaming way loud in my sittings, the pain. (pause) I think because sitting is sometimes hard on my neck and then what comes up probably makes me tense. And then it’s just an easy thing to perceverate [ph?] on. It’s very open. It’s an open time to focus a lot on something that feels really bad. But I think that it’s like the center of my… or one of the centers of my sittings is a good thing because I think it won’t pass until I deal with it that way. And I think I’ve done my [inaudible] morning or using it as a excuse not to center. I haven’t really been dealing with it so now I’m dealing with it. [30:28] (pause) You knew right away where your tongue went. I had to… it took me several minutes of is this resting, this resting. And I polled Jeremy about it and he knew right away too. But I think my tongue sits on the bottom of my mouth. (pause) I’m sort of preoccupied with how you feel, how you feel and how you see. [33:55] (pause) Like when I came in and started (pause) You asked me to stand there for holding tension [inaudible] (pause)
THERAPIST: Maybe better tension than sadness. [38:28]
CLIENT: The tension feels pretty sad. But it also feels pretty exciting. Exciting (pause) maybe better fighting sadness than surrender sadness. [40:22]
THERAPIST: [inaudible]
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