“For years, health insurers have occasionally demanded a look at psychotherapists’ notes of their sessions with patients, to ensure that the care they were paying for was appropriate, or that it actually took place.

But now one insurer, Oxford Health Plans, is saying that in many cases, the notes are not enough evidence that the patients received what Oxford paid for. Oxford has audited hundreds of psychiatrists, psychologists and social workers in the New York metropolitan area, deemed their notes inadequate documentation of the sessions, and demanded repayment of thousands of dollars from each provider — in some cases, more than $100,000.

The therapists and their professional associations paint Oxford’s actions as another skirmish in a decade-long campaign by insurers to save money by denying coverage — but one that sets a new standard for aggressiveness. They say that no other insurance company has denied payment because session notes were not detailed enough or long enough…” NY Times

Let’s face facts: health insurers will do anything they can to deny coverage and save money. The only thing surprising about this maneuver is that it hasn’t been tried until now. You know that the rest of the industry will follow suit if this works. While psychiatry visit notes relating to the patient’s use of medications have to be detailed enough to show a thorough evaluation of medical factors, it is customary for a ‘talk therapist’s’ session notes to go no further than documenting that the patient was there, which billing category the visit fell under, and what diagnosis the patient carries (for insurance purposes; don’t get me started on the problems with this ‘pigeonholing’…). Anything more will have a chilling effect on the patient’s candor in the psychotherapy and set the therapist up in an open-ended fashion for an ethical violation of thier client’s privilege.