Treating Psychogenic non-epileptic seizures: Only half of US psychiatrists accept payment through health insurance

An article came out earlier this week in USA Today that underscored a very serious problem that persons with psychogenic non epileptic seizures (and other mental health conditions) face.  Only half of psychiatrists accept insurance which means that if you need treatment you need to be prepared to pay large out-of-pocket fees.

This is not news for anyone who has tried to find a psychiatrist for a patient (I run into this often) or for themselves.  Out-of-pocket charges range an average of $150 to $500 for an initial visit at least here in New York City.  You don’t need to be Einstein to figure out that if you are suffering from a serious mental illness such as psychogenic non-epileptic seizures, which affects your daily living skills including ability to work, paying this amount of money is impossible.

On the other hand, it is understandable that many psychiatrists opt to not be on insurance panels.  Although in 2008, Congress passed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, which requires insurances to treat mental illnesses the same as other physical ailments, those of us who work in the field of mental health know very well this problem persists.  Health insurers continue to pay low rates (over the years, reimbursement rates have gone down steadily), put up countless administrative barriers (phone reviews and repetitive filling out of forms), and sometimes “pre-approve” a doctor’s visit, only to deny approval after the doctor provided the service.  To add to the confusion and frustration, sometimes psychiatrists are listed on the insurance panel as a “provider” but when that professional is contacted, it becomes clear that they have not been a part of that panel for some time (these are called “ghost panels” in which on paper it looks like your insurance has plenty of providers for you but this is not the case).

The way psychiatry and mental health are perceived in general and the difficulty that medical schools and residencies have in attracting talented physicians into psychiatry are also big parts of the problem.  Making the profession one that is profitable and less entangled by meaningless paperwork is urgently needed (the same goes for psychologists).  The psychogenic non-epileptic seizure community needs to be aware of this complex problem because it affects you directly.