Things to Consider

Information provided in kind by A Path to Hope

Not all emergency rooms have a psychiatrist on staff

Before you head to the Emergency Room, make a call to see if the facility is equipped to handle a psychiatric emergency. If not, ask for recommendations of where to go.

Not all therapists or psychiatrists accept insurance

However, they will provide a receipt to submit to your insurance. Check with your insurance provider to understand your coverage and request a list of in-network providers. Make sure you get a receipt marked, “paid” with an ICD-10 code, signed by the physician. Make a copy for your records before submitting as well.

Understand your insurance coverage

Speak with your insurance provider to better understand your coverage. Request a list of in-network providers. Ask about the process of submitting claims for out-of-network reimbursements, specifically what your insurance provider requires in terms of documentation (ICD-10 codes, receipts, etc.). Bring forms to all appointments, make sure they are signed and dated, with receipts for each visit. Make copies of all receipts before you submit them.

Apply for medical assistance

In PA, most children under age 19 and with serious emotional and behavioral concerns qualify for services covered by medical assistance, regardless of family income.

Genetic testing is available

Many companies, like Genomind, offer testing that offers insight into which medications work best with your DNA. Check out this link.

Child over 18? Understand how things change

To ensure you are able to continue having access to your child’s medical and financial information, it is important that you have the following three specific legal documents in place. When your child turns 18, consider having these documents drafted by an attorney. You do not have the right to their information, under the law, if you do not have these in place.

Legal Documents

Three legal documents all parents should have for their kids, from the Law Office of Beth Rondinelli

General Durable Power of Attorney (POA)

This legal document allows the child’s named “agent” to make financial decisions on the adult child’s behalf. Without this document, court intervention would be needed to handle financial or legal matters, such as managing bank accounts, paying bills, and applying for government benefits.

Healthcare Power of Attorney

Also referred to as an “Advance Directive” or “Living Will”, the parent or other guardian named as “medical agent” through this document is authorized to review the adult child’s medical records and to make medical decisions on their behalf. Without this document, healthcare treatment and decisions will be made by medical personnel.

HIPAA Authorization Form

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides, subject to severe penalties, that healthcare providers are not legally permitted to disclose health information

When Searching for a Provider

REMEMBER YOUR ABC’S

Advice from a friend from a few things A Path to Hope learned along their journey and from personal experience.

A is for ASK

A great place to start is always with your primary care doctor, they are a valuable resource in this process. Consider also asking friends, neighbors, co-workers, or mental health advocates like Rhy’s Above. This can even be done discreetly, “I have a friend who is struggling to find a therapist/psychiatrist/program for their child/parent, etc. Would you happen to know of any good providers in the area or know anyone who might?” It is not as awkward as you think, and you may be surprised at just how many people are in the same situation.

Check with your insurance company for a list of in-network providers, and a comprehensive understanding of your out-of-network provider coverage. Understand what the insurance company will need in terms of documentation for reimbursement; receipts with clearly stated ICD-10 (diagnosis codes) and clearly stated proof of payment.

B is for BE Diligent

Looking for a mental health resource is not like picking a painter, it will take time and real attention to detail. When searching online, use reputable sites, such as Psychology Today and NAMI, which Holly from A Path to Hope personally found to be best for out of Chester County searches.

Be Diligent. Look for providers’ educational information; Where did they practice previously? Are they published? Are they members of professional organizations?

Be Your Own Detective. We have a wealth of information at our fingertips, use it! A simple Google search can provide great insight.

When recently researching providers, something did not seem right with this one potential I had considered. So, I searched the provider’s address in Google. It was a rundown house with an abandoned car in the front. This and the fact that the only form of education listed for this provider was “attended a college” led me to feel that this was not a legitimate professional practice. Remember, anyone online can claim to be a provider; be a detective!

Be Patient with Your Search. Use the free phone consultations, you can learn a lot; Does the person seem interested in your situation? Do they offer their experience on the subject? Do they take time to talk with you?

C is for CONSULTATION

If you think you’ve found a potential provider, ask for a phone consultation, most offer these free of charge. Ask about previous experience with the symptoms you need help with. Ask about treatment style, get a “vibe,” and trust your gut! In addition, reach out to those with experience. If you’d like a sounding board or have hit a wall and need help - email or call Rhy’s Above. Our volunteers are equipped with a variety of direct lived experiences and training, and can help along your journey.