Insurance and Private Pay?

[barb2512]

I do billing for a mental health therapy practice and we have a client whose insurance, bcbs of KS, wants her to cut back on weekly appointments to twice a month or less. The client wants to know if she can pay out of pocket for two sessions a month and then only bill the insurance for what ever the insurance decides is sufficient. Is this allowed? My thinking is that she should be able to privately do whatever she likes, but perhaps there is a portion of the contract or agreement that stipulates the client can only be seen for authorized sessions?

Any help is appreciated.

Thank you,
Barbara

[PMRNC]

Even with a contract if the patient has set amount of visits but patient is aware of it they can pay out of pocket for the additional sessions. However, what I would do is bill all sessions and make sure you get all authorizations, have the patient begin to pay out of pocket AFTER the insurance has exhausted. I have seen plans authorize additional sessions, especially ERISA plans that are self-funded.