Private health insurance rebates for hypnotherapists

HypnosisAustralia, May 2006

By Dr Tracie O'Keefe DCH, Clinical Hypnotherapist, Psychotherapist & Counsellor
Editorial Director of HypnosisAustralia Online.

The progress of hypnotherapy associations securing agreements with private health funds is still painstaking slow. The associations often cite the healthcare funds as being difficult but the truth is it is can also be a certain apathy on associations' parts. At very best there is a hot-potch of available refunds to clients for members of varying health funds for hypnotherapy.

If a practitioner is a psychologist or a medical practitioner, they can bill the client for medical or psychological services without ever mentioning hypnosis. This can generally be partly refundable from the health fund even without a Medicare equivalent item number. The humble hypnotherapists, however, are in a difficult position because they rely on their associations to negotiate individual contracts with each health company and these tend to be very limited.

Many clients do tend to want to go specifically to a hypnotherapist because the practitioner has trained intensively in hypnotherapy as a primary discipline and, unlike many medical doctors and psychologists, do not simply have hypnosis as an add-on service. This often means they will have to pay the full cost of their treatment out of their own pockets. Some hypnotherapists sometimes see this as a good thing because it indicates motivation for change and expression of commitment to the process. It does, however, mean that to many people, who have already paid health insurance, hypnotherapy is perceived as unaffordable.

We spoke to a random varied selection of members of different associations and canvassed their opinion on the performance of their associations to secure health fund rebates for clients. The responses were varied:

In general the members of most associations were not happy with the performance of their association's efforts to form contracts with private health funds. What was also very evident was that associations in general also operated very secretively and neglected to inform members of their progress in this field. In a couple of cases associations purposely kept information on the subject secret from their members.

Some of the large associations came off worse than the small associations because with their resources they could only be described as negligent; whereas small associations often did not have the knowledge or the resources to carry out the work. The Australian Counselling Association with over 2500 members was only able to get secure rebates for their members' clients from one insurance company and that insurance company's guidelines were presently under review.

The performance of PACFA, with 3000 members, was uninspiring. In the autumn of 2005 PACFA had the opportunity to negotiate with a major insurance company to get rebates for clients seeing hypnotherapists on the PACFA register. The secretary of PACFA, at the time, said she was told by a board member that if an insurance company would not give rebates to the clients of every PACFA registrant, they did not see why the hypnotherapy section should get rebates. This attitude of PACFA severely disadvantages hypnotherapists on the PACFA register. Coincidentally a much smaller hypnotherapy association had managed to negotiate a contract with that same insurance company and appeared as recommended in the end-of-year health journal to the insurance company's customers.

The association that came off the best was the Australian Traditional Medicine Society. Although it did not seem to have cracked the major health funds, it does seem to have the experience in handling health funds for many of its other disciplines when dealing with non-allopathic medicine. It also seemed to be the best at being honest with and informing its members about its progress in the area of securing health fund rebates.

The major problem for the insurance companies is that they are very wary about with hypnotherapists because they are often unable to determine if those practitioners have been trained to a sufficient standard. This is a reasonable approach for the insurance companies to take but ultimately it comes down to the hypnotherapy associations themselves to show that their members have reached what could be described a professional standard and are constantly reviewed by clinical supervision.

Insurance companies used to accept certificate IV in many professions to prove professional standards although recently they have raised the bar to diploma level. PACFA in years to come intends to raise the bar itself by requiring therapists on the register to be at postgraduate level of training.

In the UK the UKCP (United Kingdom Council of Psyhotherpists), the model on which PACFA was based, has for many years required therapists on their register to be regarded as being of postgraduate level of education, which give those registrants real credibility. When PACFA also implements these standards it will give their registrants that level of credibility.

There are of course many therapists who do not want to have to train to that standard but in all reality it does look quite seriously as if that will become the standard accepted by the insurance companies in the future years. For anyone in the industry, well-planned continual professional development could over time take them to that level of training.

In Australia the health market is heavily focused on the private health insurance companies as Medicare funds have always been restricted. A fully funded social medicine system looks unlikely for the future, particularly with a fast-ageing baby boomer generation. The companies do not generally want to reimburse for counselling and only some will reimburse for psychotherapy but quite a few will reimburse for hypnotherapy because it is seem a much more brief therapy and therefore more cost effective. Associations need to deal more with the real world now and should be far more active in fighting for health fund rebates for clients of their registrants.

©HypnosisAustralia, May 2006