A crisis and complaint about Anthem mental healthcare coverage
We write on behalf of the Mental Health Clinicians Action Network of Connecticut (MHCAN-CT), a multidisciplinary group of mental health professionals aiming to improve access to mental health care by bridging the gaps between clients, clinicians in private practice, legislators, governing bodies, and insurance companies. Since the COVID-19 pandemic, we have been advocating for permanent pay parity for telehealth services as well as more power to hold insurance companies accountable for meeting the standard of care.
We as providers are prohibited from organizing or unionizing, which impedes our ability to advocate and be heard by some of our governing bodies as well as the insurance companies. Based on concerns regarding widespread provider challenges with Anthem BCBS, MHCAN-CT ran an informal survey of over 450 private practice mental health providers, which can be found here on our website.
The results were astounding. Clinicians described working with Anthem BCBS as “a nightmare,” “a total complete mess” and “being in an abusive relationship.” Over and over again, we heard phrases like “abysmal customer service,” “outrageously poor service quality” and “appalling lack of collaboration and basic decency.” One of the most noteworthy statistics is that 349 providers, 84% of clinicians surveyed, either were considering leaving Anthem’s panel within the next 12 months or have recently left Anthem BCBS’s panel. Reasons for this include difficulty being paid, frequent unexplained recoupment of funds, hour-plus wait times before speaking with a representative who often is unable to help, and the lack of a pay raise for over a decade.
We submitted the survey results as a formal complaint to the office of the insurance commissioner weeks ago with no response, not even an acknowledgment of receipt. Beyond that? Frankly, we are out of ideas. Clients and providers alike are desperate to make Anthem BCBS hear these concerns, but to do so we need more support from the general public and our legislators.
The entire purpose of health insurance for behavioral health is to increase access to care, and Anthem BCBS serves an incredibly large client base in Connecticut. State employees, teachers, first responders, frontline workers, and all of the populations who have been through the most during the pandemic are facing a mass exodus of mental health providers from Anthem’s insurance panel, which means that thousands of people in need may not be able to access in-network mental healthcare if Anthem does not make changes. Given the already increasing rates of mental illness and suicide due to the pandemic, this could be a crisis of epic proportions.
On behalf of Connecticut mental health providers, MHCAN-CT has two specific requests. First, that Anthem BCBS hear our complaint and address our two most egregious concerns–the substandard pay rate and lack of pay raise for over 10 years, as well as the appallingly poor quality of customer service. We request a meeting with Anthem executives to review these concerns and hear about concrete and measurable ways Anthem plans to address them, with the ability to follow up if deadlines are not met by Anthem (as has been the case numerous times before).
Our second request is that Connecticut legislators address these hundreds of provider concerns by passing bills to protect Connecticut mental health providers against practices such as Anthem’s, like a bill to ensure prompt payment for services rendered, and/or a bill to limit the interval during which a recoupment can be requested.
Please contact your representatives with your concerns over this information, and if you are an Anthem customer who wishes to continue to have access to your healthcare, please know that MHCAN-CT is working tirelessly for you to preserve this at all costs. We simply need Anthem to be willing to work with us.
For MHCAN-CT: Rebecca Burton, LMFT, Rebecca Toner, LPC, Jorge Fernandez, LCSW, Emily Stagg, APRN and Carrissa Phipps, PhD.
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