Providing For EPISD’s Mental Health Becomes A Challenge
By Celina Avila
EL PASO — Some local doctors are refusing to sign on with the El Paso School District’s new health insurance provider, Aetna. They say some reimbursement rates are lower than Medicare.
Starting2008,EPISD employees will have Aetna as their insurance provider. The district recently ended their contract with their former provider, Access Health Insurance, after it was alleged that thecompanywas part of the ongoing public corruption investigation.
Some medical caregivers, are debating the judgement of that switch. Dr. Walter Allberg, apyschologist,said mental health providers are being singled outbyAetna.The reimbursement rates for mental healthproviders are not fair, he said.
“Aetna is wanting to reimburse me at 23 percentless than with Access Healthsource. Of the five psychologists who were there in private practice, all five said they weren’t going to becontractproviders withAetna,” Allberg said.
Allberg said Access used to reimburse providers around$120 for a consultation. For a similar service, Aetna reimbursesits providers between $50 & $76. Aetna officials claimthe rates are based ona national standard.
Despite several attempts from Allberg to get theEPISD board to review Aetna’s reimbursement rates to mental health providers, trustees say they aresatisfied with the number of doctors providing services at these rates.
Officials with EPISD saidthey currently have about 100 mental health providers signed with the Aetna network to provide services to employees and their families. Board trustee Carlos Flores said he was concerned that there are only two providers for marriage and family counseling.
Allberg fears that this reduction in provision can have devastating effects on EPISD employees, families and the community at large.
“What happened last week in the shopping mall [in Nebraska], that was one individual, one young man who went berserk,” Allberg said.
“You can sit there and say, ‘Well, not a lot of people utilize mental health benefits,’ but the reality is thosewho do, need those services,” he said.
