Counselors' agreement regarding intentional misdiagnosis of mental disorders for receipt of insurance reimbursement
This study had two purposes. The first was to obtain internal consistency and validity of the Assessment of Counseling Dilemmas Questionnaire (ACD) used for analyses. The second was to assess the extent to which American Mental Health Counselor Association (AMHCA) members' agree/disagree that intentional misdiagnosis of mental disorders, intentional miscoding of therapy sessions, and intentional misassigning actively suicidal for receipt of insurance reimbursement, involves ethical/legal or unethical/illegal behavior. AMHCA members' desire for addenda to ACA and AMHCA Codes of Ethics setting forth explicit guidelines for when insurance reimbursement has been denied in certain counseling situations, was also examined.
Six hundred and fifty AMHCA members were randomly selected to participate in this study. Of the ACA membership, AMHCA members are the most likely to be practicing counselors and, as such, most likely to have the greatest exposure to issues involving delivery of counseling services, managed mental health care, and insurance reimbursement. Participants included Licensed Professional Counselors, Licensed Psychologists, Licensed Mental Health Counselors, Licensed Couple and Family Counselors, Licensed Clinical Social Workers, Licensed Rehabilitation Counselors, and unlicensed counselors. Data collected via a Demographic Questionnaire were used for testing differences of each variable including gender, age, type of license, primary counseling sector, counseling setting, years in practice, and percent of clients using insurance.
The results of analyses indicated that in almost all subgroups of each demographic variable, most respondents recognized proper mental diagnosis. Respondents employed at private group practice settings agreed that intentional misassigning the client actively suicidal was unethical/illegal behavior, whereas respondents working at K–12 settings agreed that it was ethical/legal behavior. There was not one demographic variable in which respondents for all of its subgroups strongly agreed that intentional miscoding of therapy sessions, intentional misdiagnosis of mental disorders, and intentional misassigning actively suicidal, involved unethical/illegal behavior. There were only two subgroups for age whose respondents strongly agreed that intentional miscoding of therapy sessions and intentional misdiagnosis of mental disorders, involved unethical/illegal behavior. Most AMHCA members strongly desired addenda to ACA and AMHCA Codes of Ethics setting fourth explicit guidelines when insurance reimbursement has been denied in certain counseling situations.
0347: Mental health