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I think it’s the first time I’ve experienced rage tears with a client. I’ve been angry. I’ve been sad. And I’ve cried with clients. Oh yes, I’ve cried.
My client can’t see me, but they hear the tears in my choked speech on our call. I name the tears for them so they doesn’t misunderstand. I don’t need my client to caregive me, I want to show them how much this upsets me too.
It’s been two months since we’ve had a call.
Six months of fighting with their insurance.
One year of unpaid claims.
And weekly phone calls of the insurance panel stating claims aren’t being paid because they only pay for one diagnosis. Suddenly. In 2025. No other diagnoses will do.
I can’t make sense of it. As a Type-A, detailed therapist, I jump all the hoops they want me to jump through.
File a certification request. Fax it.
File an appeal. Fax it.
The appeal was lost in their department. Start over.
An appeal that they will approve when they want to, no timeline is guaranteed.
Thousands of dollars unpaid, a ticking timeline of when claims will be “out of timely filing.”
Of course I have rage.
I have rage for a broken system. A system that I’ve worked with for 16 years. I proudly took Medicaid until I didn’t. Then I told other insurance panels I was done. And yet with this client, I’d told myself I would see them until the end. Only I thought the end would be the illness that shortens their life.
So now here I sit, the tears just below the surface as I tell my client their options. Options they can’t afford. And yet they say they don’t want to start over. They don’t want another therapist. Weeks away from our ten year anniversary of working together, I remind them of their hard work up to this point, reflecting on how much they’ve accomplished. How much they’ve grown.
Just in case we can’t work together.
In case their insurance decides their mental health doesn’t matter.
So I write this to process the rage. And I wait. And they wait. And we wait.