Billing Issues In Counseling

Ethical Minute Paper 2

Latisha M. Gibson

Liberty University

Abstract

The purpose of a counselor records is to benefit the client and in some cases the counselor. A counselor must document relevant information pertaining to the client. Conducting records is the best way to provide counseling services. Clinical case notes benefit the client and they allow the counselor to summarize the relevant information pertaining to the session for future sessions. It is an ethical obligation to let clients access their records. Nevertheless, a counselor can limit the access of clients to their records when it would cause harm to the client. Billing is also a problem in the counseling profession. An issue that seems to be a problem

in the counseling profession is fraud. Some counselors misrepresent to healthcare companies services that are render to the client. If evidence of fraud is found, a civil lawsuit could be filed. However, some new counselors have modeled fraudulent practices of seasoned practitioners. In this paper, I am going to address two scenarios. One of the scenarios deals with a client no longer wanting services and she wants to see her records. The second scenario deals with a client wanting the counselor to diagnose him with a disorder to receive counseling services. However, these two scenario’s applies ethics and it important that the counselor relies on the rules and regulations of the counseling profession to eliminate legal action.
Keywords: records, fraud, civil lawsuit

Before a client enters counseling he or she should be informed by the counselor of the rights as a client.

A counselor should give their client a copy of an informed consent document. Rights that are listed on the informed consent document is not absolute, and there may be exceptions based on certain situations. One of the codes that I will be discussing in this paper is, “a client has the right to have access to one’s records” (American Counseling Association, 2014, p.8). I will also be discussing billing issues in the counseling profession. Some counselors have misrepresented information to health insurance companies to get a client reimbursed for services render. Nevertheless, it is unethical for a counselor to engage in fraudulent situations. It is critical for a counselor to follow the rules and regulations according to their state where he or she practice

counseling.
Whose Records
A client has been receiving counseling services. The counselor and client have been discussing referring her to another counselor (Whose Records, n.d). The client feels like counseling have not been helping her (Whose Records, n.d). She informs the counselor that she wants her records and clinical notes. The counselor thinks if she let her client see the records, and clinical notes it would not help her (Whose Records, n.d). The counselor should give the client her records. According to the ACA Code of Ethics, a counselor should provide a client with a copy of their records when requested by the client (American Counseling Association, 2014). When the counselor told the client that her records would not help her, it caused me to believe that the records had information that would harm the client. Therefore, the counselor should limit the access of clients to their records when there is evidence that such access would cause harm to the client (American Counseling Association, 2014). The counselor can give the client a copy of the records that benefit her, review the records with the client, and provide the client with a summary of the records. The counselor should document the client request for records and the reason for withholdings some of the records in the file. If the client wants to go to another practice for counseling, the client new counselor can request for the client records if the client signs a release form. If a counselor lack competence within their clients, they can avoid continuing the counseling relationship (American Counseling Association, 2014). Counselors are knowledgeable about culturally and clinically appropriate referral resources and he or she will give the client alternatives (American Counseling Association, 2014). If the client declines the suggested referrals, counselors will discontinue the relationship with the client. A counselor will terminate a counseling relationship when it becomes reasonably apparent that the client no longer needs assistance. A counselor can provide termination counseling and recommend other service providers when it is necessary (American Counseling Association, 2014). In the NC Marriage and Family Therapy Board, there is no code that would be relevant to a client assessing their records.
Billing Issues in Counseling
A client goes to counseling talking about all the hardships he has gone through (Billing Issues in Counseling, n.d).

The client cannot seem to come to the reality that his wife dead. The client is listing some of the problems he is experiencing since his wife dead. He feels like he needs someone to talk to and his insurance does not cover counseling. The client feels like he cannot afford counseling services. The client insurance will not cover counseling unless he has a mental health diagnosis. The client insists that the counselor gives him a diagnosis (Billing Issues in Counseling, n.d). The counselor is thinking the client is going through bereavement, but he wants her to say he is depressed because he really needs counseling (Billing Issues in Counseling, n.d). Recording a diagnosis in a client record is harmful and it could be used against the client as a third party. It is better to refrain from making a diagnosis than to guess one incorrectly. The ethical purpose of diagnosing is to help the client get help. The counselor should not commit fraud to giving the client a mental diagnose. Counselors who are trained to diagnose mental health disorders have an ethical and legal obligation according to the standards in the mental health field (American Counseling Association, 2014). The counselor determined that the client did not have a DSM disorder that the health care plan would not reimburse or

pay.

The counselor must not assign a disorder to allow a client to obtain healthcare plan assistance (Remley & Herlihy, 2016). When a client have a mental health diagnose and the information is not accurate, it is fraud (Remley & Herlihy, 2016). If the counselor believes the client does not have a DSM diagnose he or she should not assign a disorder to help a client receive assistance from their health care plan. A counselor must be careful when diagnosing a client because it can cause harm to the client (American Counseling Association, 2014). When a counselor makes a mental health diagnose, he or she think about the positives and the negatives. A counselor must take special care when diagnosing a mental health disorder. An assessment is used to determine client care, the locus of treatment, and it is appropriately used (American Counseling Association, 2014).
Conclusion
Although, records are necessary for the counseling profession. A counselor has an ethical responsibility to maintain documentation for rendering service to their clients (Remley & Herlihy, 2016). A counselor is required to provide their clients with their records if necessary. Billing issues are a problem when he or she diagnose wrongfully to get healthcare reimbursement. A counselor has the responsibility to let their client have access to their records when necessary and it is unethical for a counselor to engage in fraudulent acts in the counseling profession. Nevertheless, it is important that a counselor follows the rules and regulations in their state on how to assess client records when necessary, assist their clients with records, disclose records, and diagnosing mental health disorders in the counseling profession.

References
American Counseling Association. (2014). ACA code of ethics. Retrieved from, http:www.counseling.org/Resources/aca code-of-ethics.pdf

Billing Issues In Counseling[Video file]. (n.d). Retrieved from, http://mediaplayer.pearsoncmg.com

NCMFTLB. (2016). North carolina marriage and family therapy licensure board. Retrieved from, http://www.nclmft.org
Remley, T.P., & Herlihy, B.P. (2016). Ethical, legal, and professional issues in counseling (Custom 5th ed.). Boston, MA: Pearson.
Whose Records [Video file]. (n.d). Retrieved from, http://mediaplayer.pearsoncmg.com