UPHP/MEDICAID
UPPER PENINSULA HEALTH PLAN (UPHP)
*** NOTICE DEC. 2020:
Sorry, I'm currently NOT accepting NEW UPHP / MEDICAID patients. If you saw me previously and had good attendance, I will make exceptions and try to get you in ASAP.
Please consider calling other providers listed in my Dickinson-Area Psychotherapy Guide or call UPHP 800.835.2556 & ask for a list of providers in your area, and share your opinions & concerns w/ them.
"Why aren't you accepting new UPHP members as patients Mark?"
Fluctuations in enrollment made it impossible to keep track of who was active and who wasn't. It's not due to Medicaid's modest reimbursement rate (which has actually decreased over what it was many around 10 years ago), but medicaid rules don't allow any patient payment for un-covered sessions when coverage is dropped, or when a patient late cancels or no-shows, so we eat the entire loss. Many of you are highly responsible with appointments, and though well-intended, Michigan's policy disallowing ANY expense to MA recipients/UPHP members doesn't encourage responsible appointment keeping, resulting in a much higher no-show rate than the general public. All this makes it extremely time consuming & costly for providers to work with medicaid. I'll post if this changes.
Mark
MEDICAID or "Medical Assistance" or "MA" comes in several forms. The type most likely to cover mental health counseling (psychotherapy) is Upper Peninsula Health Plan ("UPHP"). Sometimes the state changes your coverage to another type of MA, resulting in no coverage, so please make sure you currently have "UPHP" (call your assigned DHS worker, or UPHP 800.835.2556), and verify the therapist you wish to see will definitely be covered.
STRICT ATTENDANCE policy:
Unlike other patients, Medicaid patients can not legally be billed or pay anything for missed appointments (late cancel or no-show). All other patients who miss an appointment pay at least a partial charge for missed appointments (many provider charge full rate).
Therefore, regrettably, Medicaid / UPHP members who miss an appointment will usually not be offered another appointment & services will be terminated. Ongoing UPHP member patients with good attendance may be allowed one missed appointment with physician excuse. I realize vehicles break down & if yours does, the office can sometimes reimburse for taxi fare to your appointment if you can't afford it. If you let DHS know you need a ride in advance, they can find a driver to bring you to appointments. (906.779.4100 - ask for transportation coordinator).
Medicaid reimburses providers approximately 40-60% of normal regional rates for services rendered, so many providers don't accept it at all. Each year, this clinic has to decide whether to continue participating as a provider; your consistent attendance and advance notice when needing to change or cancel greatly helps keep this clinic IN-network for UPHP & some other forms of medicaid.
MISSED APPOINTMENTS...
- prevent other needy patients from beings served
- waste an entire clinical hour
- require time rescheduling, phone calls, texting, documentation
- cost most providers and clinics millions of dollars each year
Thank you!
