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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Lindenblüte on November 11, 2006, at 23:40:14
address
name
license #
in-office psychotherapy
insurance plan
DIAGNOSIS: DSM-IV Axis ... [code] Depressive....
Co-Payments received to date
blah blah blah.
***********************
um, does this mean that I'm going to be confronted with my Dx EVERY SINGLE time that I open a letter with T's name on it?why can't they just put a little code on there?
I was really shocked. a little hurt. I really hope that letter never ends up in the wrong mailbox.
:(
do your bills have your diagnosis on them?
-Li
Posted by Adrift on November 11, 2006, at 23:55:03
In reply to got my first bill from newT today, posted by Lindenblüte on November 11, 2006, at 23:40:14
> address
>
> name
>
> license #
>
> in-office psychotherapy
>
> insurance plan
>That is about all mine includes. Ask your T, that seems like TMI to be floating around in the mail to me.
Posted by Jost on November 12, 2006, at 1:58:30
In reply to Re: got my first bill from newT today, posted by Adrift on November 11, 2006, at 23:55:03
I agree with Adrift that you should certainly ask your T to change the bill.
I've gotten bills like that from some Ts-- but I empathize with your not wanting to have to deal with that sort of dx, and also the frame of mind, ie categorization of you in an impersonal way.
Maybe it's part of some idea she has about keeping you informed, or not hiding anything that she's doing in regard to you.
I'm suspect she'll be more than willing to oblige your very understandable request.
Jost
Posted by sunnydays on November 12, 2006, at 9:43:46
In reply to got my first bill from newT today, posted by Lindenblüte on November 11, 2006, at 23:40:14
I don't get bills, and it's not covered by insurance, so I don't see my Dx, but I know that insurance companies have a standard format for how they want things and when I use to get receipts, every appointment it had my diagnosis. Just try not to look at that part if you can.
sunnydays
Posted by Daisym on November 12, 2006, at 11:31:58
In reply to Re: got my first bill from newT today » Lindenblüte, posted by sunnydays on November 12, 2006, at 9:43:46
Typically the DSM-IV code is plenty. Then you don't have to see it written out.
Ask her to give you the bills at the end of a session. My therapist and I have a routine. I leave the checks on a side table and he lives the bill there too. That way I can pick it up and tuck t away as part of getting there or leaving there. He doesn't actually have to hand it to me and I don't have to say, "OH thank you for the bill." Too weird already, you know?
I'd never trust the mail unless I absolutely had to.
Posted by Declan on November 12, 2006, at 13:19:33
In reply to got my first bill from newT today, posted by Lindenblüte on November 11, 2006, at 23:40:14
My T wrote mine out by hand, which meant a lot of writing because I saw her everyday, each day with a date and a fee.
Certainly no diagnosis. I'm not that keen on *any* diagnosis, now that I think about it
Truly, Lurps, bad office procedures, at the least.
Posted by Declan on November 12, 2006, at 13:25:34
In reply to Re: got my first bill from newT today » Lindenblüte, posted by sunnydays on November 12, 2006, at 9:43:46
I was lucky enough not to have a diagnosis. Once I saw my Ts opinion and even that was not really a diagnosis. ('deprived')
I couldn't hack a diagnosis, I think they suck. Why is that?
Maybe Klein/Winnicott Ts don't bugger around with them?
Posted by Declan on November 12, 2006, at 13:31:05
In reply to Good grief, posted by Declan on November 12, 2006, at 13:25:34
My T called depression 'the rag bag of psychiatry', (very 70s?), so maybe she didn't believe in then either?
Perhaps she was holistic? Very new age.
Posted by Lindenblüte on November 12, 2006, at 14:29:35
In reply to Diagnoses, posted by Declan on November 12, 2006, at 13:31:05
Well, my current T has never given me a label or a syndrome or anything. She talks to me about experiences, and thoughts and behavior and feelings.
I asked my oldT point-blank a few times about my diagnosis. After a month of psychotherapy, he reluctantly said, I'm considering either major depression or dysthymia. (I was sorry i asked)
I'm pretty sure that oldT is forced to stick me with a diagnostic code so that I can get services paid for by my insurance. So he gave me a kind of generic diagnosis.
I'm pretty sure that I fit different diagnostic criteria every couple of weeks. Right now, I fit diagnostic criteria for caffeine intoxication. A month or so ago, depersonalization syndrome, la di la.
I think your T's got the right idea. I'm not sure that the DSM-IV makes an appropriate distinction between symptoms that are acute and present (like when I was "MDD". Now that I'm not crying, losing weight, losing sleep, having problems concentrating, etc, I'm not sure why I would be classified as having MDD. Yet, I'm still taking an anti-depressant.
Is it like cancer? Is it like an infection? Is it like an auto-immune disorder?
I think my mind (and my mental illness) is like a performance of a concerto. Kind of predictable. You know the tunes, but sometimes it moves too fast, and sometimes it moves too slowly. Sometimes all is going well, and sometimes the soloist breaks a string or the horn player cracks on a high note. Heaven forbid if the conductor should lose her place, or the soloist forget his memorized part. The oboe may tune the orchestra to the wrong frequency. All kinds of things can go wrong. One forms an opinion of the piece and the performance as it unfolds. As soon as the concert is over, it may be immediately recognized as outstanding, or this realization may not come to mind until a few days or years later.
Too complicated to assign a number to, at any rate.
Crazy brains on sale: $4.99 a pound.
-Li
Posted by Declan on November 12, 2006, at 15:41:23
In reply to Re: Diagnoses » Declan, posted by Lindenblüte on November 12, 2006, at 14:29:35
Perhaps one too readily assume that psychiatry is in alignment with the categories of the dominant culture?
I'd been thinking that 'loser' has the advantage of transparency, clarity and brevity.
('Depleted narcissist' has a bit of an overeducated university feel, no?)
Whereas 'depression' just feels opaque to me.Must get round to reading Swift.
Posted by bent on November 12, 2006, at 16:12:28
In reply to got my first bill from newT today, posted by Lindenblüte on November 11, 2006, at 23:40:14
my statements are similar to these too. i only get one once every 3months though. but,for dx, they just use dsm codes. i'm fine with that. most people cant depcipher them without help and if they have to be on there i'd rather they be cryptic...not saying i didnt look them up tho. :-)
in just about all cases involving insurance, a dx has to be on there one way or another.
Posted by Declan on November 12, 2006, at 16:17:49
In reply to Re: Diagnoses » Declan, posted by Lindenblüte on November 12, 2006, at 14:29:35
These categories existed in the past, of course. Before we had 'losers' there were 'no hopers'. It is interesting to compare the ambient difference here. 'No hopers' brings to mind hobos who at least live in the country, whereas 'losers' are homeless and you have to step over them in the streets.
Posted by SatinDoll on November 12, 2006, at 16:18:55
In reply to Diagnostic categories: transparency and opacity » Lindenblüte, posted by Declan on November 12, 2006, at 15:41:23
Li,
Are you filling your own insurance claim? If you are some companies require there to be a dx. But if you are paying it all yourself, all that extra info other than the amount is not needed. Maybe it was because it was your first bill too.
My T doesn't bill me, I pay upfront my fee in cash when I see him. Nobody sees anything except the tax man, and he doesn't see the names.
Posted by Poet on November 12, 2006, at 17:38:44
In reply to got my first bill from newT today, posted by Lindenblüte on November 11, 2006, at 23:40:14
Hi Li,
I would make your T take that description off the bill. When the insurance runs out my therapist doesn't send a bill, she just says it's time to settle up. The insurance statements just say psychotherapy.
I wouldn't want a DSM staring me in the face every month. Your T needs to remove it or use white out on your copy.
Poet
Posted by Lindenblüte on November 12, 2006, at 18:08:00
In reply to Re: got my first bill from newT today » Lindenblüte, posted by Poet on November 12, 2006, at 17:38:44
Okay- thanks guys. I thought I was just being touchy, but I guess this is pretty unusual.
I could just have my husband open the mail?
I still have warm fuzzy feelings for my T. I saved both of her voicemails to me from last week, and I like the sound of her voice. She has a Southern drawl, ever so slight. :)
As far as Declan's suggestions- I suppose I would like my personal diagnosis to be written in Greek-
Melancholia with side order of Anxiety and Post-traumatic Stress, hold the Sauerkraut.
-Li
Posted by muffled on November 15, 2006, at 14:10:53
In reply to got my first bill from newT today, posted by Lindenblüte on November 11, 2006, at 23:40:14
There is NO DX on my bills.
DX sh*t is seriously f*cked.
Everybody is differnt in their way.
I think youy should tell youyr T to go f*ck herself if she don't get that sh*t off the bill. It got NO reason to be there. It is WRONG.
IMHO anyways.
Muffled
Posted by Lindenblüte on November 15, 2006, at 17:50:05
In reply to Re: got my first bill from newT today » Lindenblüte, posted by muffled on November 15, 2006, at 14:10:53
> There is NO DX on my bills.
> DX sh*t is seriously f*cked.
> Everybody is differnt in their way.
> I think youy should tell youyr T to go f*ck herself if she don't get that sh*t off the bill. It got NO reason to be there. It is WRONG.
> IMHO anyways.
> MuffledHmm,
I phrased it "slightly" differently, my dear Muffled.Um, T, I was wondering, I got my first bill from you and it has the DSM-IV ### NAME OF DIAGNOSIS WRITTEN OUT IN ALL CAPS. Is this necessary? She said, oh? WHAT does it say? I told her again. She said, well, the insurance probably needs a code, but she'll see if it's necessary to write it out. I told her thanks for checking, because i really don't like to be confronted with MY MENTAL ILLNESS in all caps when I open an envelop from my dearT.
-Li
Muffly- you sound upset. I hope you can come join me in peacefull meditation later on this evening. I'll be thinking of you. (((Muffled)))
Posted by Dinah on November 17, 2006, at 11:08:11
In reply to Re: got my first bill from newT today » muffled, posted by Lindenblüte on November 15, 2006, at 17:50:05
The code is enough for insurance purposes. No one I've seen has put more than the code.
She might not do her own billing... My therapist has me pay at each session, but I know his insurance billing is done by someone who does that sort of thing.
At any rate, it's good that you brought it to her attention.
I always looove to know my diagnoses, and religiously look up each one and put the results on at least one receipt along with the code. :)
And I'll agree that it doesn't really mean anything. My pdoc used to put down different diagnoses depending on what was most prominent at any given time, but I'm pretty sure some of them were technically inaccurate. They just need to put down something for insurance purposes. They're usually quite careful only to use nonstigmatizing ones for insurance purposes.
My therapist hasn't needed to put down diagnosis codes yet. I guess the ones from my pdoc establish the purpose of therapy. But we once got in a huge multiweek argument over it. The one he thought was most appropriate I adamantly didn't want. I proposed others that were by his own admission completely accurate, but that he didn't think were as directly related to therapy. He was holding the moral high ground that he had to be completely truthful. I was holding that being truthful was good enough. He finally consulted with others, and decided it was enough to be correct. That he didn't have to bare my soul for insurance purposes. That if my pdoc diagnosed me with something, he could too, as long as he agreed with it. But he was reluctant. I guess he was afraid "correct" but not total honesty wasn't enough to justify the number of years in therapy that I've spent. :)
Posted by Dinah on November 17, 2006, at 11:11:56
In reply to Re: got my first bill from newT today » muffled, posted by Lindenblüte on November 15, 2006, at 17:50:05
P.S. I do have reasons.
I've gotten one "Congratulations on your pregnancy." and two "So, you have diabetes." letters from my insurance companies. I've found them all unbearably intrusive, despite their helpful intent (offering phone specialists, etc.).
I really didn't want a "So, you are xxxx" letter.
Posted by Lindenblüte on November 17, 2006, at 12:08:20
In reply to Re: got my first bill from newT today » Lindenblüte, posted by Dinah on November 17, 2006, at 11:11:56
Dear Lindenblüte,
congratulations on your depression. This is an exciting time in your life, a time when you can ponder all of the great existential dilemmas and yet cannot manage to brush your teeth.You may be wondering- what are my options?
Well, research has shown that a combination of psychotherapy and medication is effective in treating depression. Some people may need long-term medication and psychotherapy to prevent recurrance of symptoms. Unfortunately, your health benefits do not include more than 10 weeks of therapy at your current rate of consumptions. Don't worry, though-- your neighborhood bookstore has a number of self-help books that will tide you over until your new policy year begins, and/or you cease to be a policy holder.We have noticed that you are taking mood stabilizers and antidepressants. Have you ever thought about alternative therapies? These are available without a prescription, and while not approved by the FDA, they are much cheaper for us to not provide you with. These therapies include vitamins, exercise, fish oil, acupuncture, ice cream, divorce, and napping.
Whatever you decide, we are completely behind you at this exciting time of your life, as long as you stay within your policy maximum and avoid hospitalization, expensive prescriptions and long-term treatment.
Warm wishes for the upcoming holidays,
Your Insurance Megaconglomerate
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