Penelope A. Moore, MA

"Penelope was unreliable as an in-network provider. She neglected to bill insurance for 10 sessions over 70 days, I had to pay for those sessions out of pocket instead of through insurance. That added $2100 to my cost of therapy. It took setting a boundary with Penelope that we could not continue to meet to get her to finally bill insurance for subsequent sessions. I let her know months in advance that my insurance plan was being transferred to a new provider. I provided her with my new insurance information so that she could submit claims for our sessions. Instead of billing insurance, she handed me a $1000 invoice to be paid out of pocket and told me the insurance company couldn't find my information when she called. I gave her my insurance information again, and asked her to communicate anything I could do to help on my end. She did not communicate that she made a further effort to work with my insurance. Instead, she continued to hand me $1000 invoices to pay out out of pocket, totalling $2500 out-of-pocket. Had she billed insurance, those sessions would have cost me $400. After she handed me another personal invoice for $1000, I told her I had to pause meeting until she was able to work in-network, as she had told me she would. Within hours, she told me she could now bill in-network, but still handed me an additional out-of-pocket invoice for $250. She did not explain why, after 70 days elapsed without billing insurance, when told sessions would stop, she was able to resolve the issue within hours. Her only explanation was to say she was not surprised that she had issues working with insurance, this happens a lot. When asked about submitting a claim to insurance for those 10 sessions she had not submitted, her only explanation was "we can't go back in time". I gave her the form to get a reimbursement from insurance for paying her out of pocket, she decided she did not want to fill that out. She shifted her responsibility in our relationship to effectively work with the insurance company onto me. When I would hand her personal checks, she would linger over them to communicate her delight, remarking on my signature, handwriting, the date, the graphics on the checks. When I asked her about billing insurance, she told me she 'loves checks'. It is the responsibility of an in-network provider to work with the insurance company, no client can handle that side of the relationship for a provider. No client should have to halt a relationship to incentivize a provider to honor their responsibility to file in network claims. Billing in network is not an optional favor, it is a core responsibility of an in-network provider to build a healthy and sustainable therapeutic relationship. If you are considering working with Penelope, I would prioritize holding her accountable for honoring her responsibilities as an in-network provider, as she demonstrated a willingness to cross boundaries by shifting her responsibility for reliably working with the insurance company for reimbursement onto me the client. If she tells you there was an issue billing insurance in network, and she would like to be reimbursed via personal invoice, recognize this is her pattern, she will perpetuate this behavior until you set a firm boundary with her, and in the past her pattern has added thousands extra to her client's personal cost. She repeatedly emphasized that the only therapeutic intervention she was capable of was building a relationship, but when it came to honoring her responsibility in that relationship, she couldn't do it."