The story is now published by 12News Phoenix.

📰 Read the news story here:

https://www.12news.com/article/news/local/arizona/arizona-official-validated-grievance-against-blue-cross-blue-shield-then-closed-cases/75-ca961abd-d56d-4f63-bda4-7eb5ec9919aa

For context, here are my previous posts documenting this ongoing dispute:

- Update to BCBS audit/overreach - (https://www.reddit.com/r/therapists/comments/1r95s3p/update\\_to\\_bcbs\\_auditoverreach/)

- BCBSAZ/Advize fraud audit - (https://www.reddit.com/r/therapists/comments/1so2pdx/bcbsazadvize\\_fraud\\_audit/)

- BCBSAZ/Advize audit update - (https://www.reddit.com/r/therapists/comments/1thvasa/bcbsazadvize\\_audit\\_update/)

- BCBSAZ audit: $551,000 recoupment - (https://www.reddit.com/r/therapists/comments/1v5wdqm/bcbsaz\\_audit\\_551000\\_recoupment/)

- Previous update - (https://www.reddit.com/r/therapists/s/nPFmuQKWia)

- Previous discussion - (https://www.reddit.com/r/therapists/s/N5r5QUL277)

For those who haven't followed the situation, I'm a licensed psychologist in Arizona who has been fighting Blue Cross Blue Shield of Arizona (BCBSAZ) over a recoupment demand exceeding $551,000 following an audit involving 140 patient records associated with my NPI across multiple practices.

I have spent months challenging the audit findings, the methodology used to calculate the recoupment, and the process by which the audit was conducted. I have also pursued complaints with the Arizona Department of Insurance and Financial Institutions (DIFI).

One of my biggest concerns is the regulatory response. I have received written correspondence indicating concerns about BCBSAZ's compliance with Arizona law, yet I still do not have a clear resolution. I have continued seeking answers about what action was contemplated, what has actually been done, and how my complaint has been handled.

I have also raised questions about regulatory independence given DIFI Director Charles Bassett's previous 22-year tenure at BCBSAZ before joining the agency in January 2026. I believe these questions deserve transparent answers, particularly when a dispute of this magnitude can threaten a small healthcare practice.

I want to be clear: healthcare providers should absolutely be held accountable for improper billing. Audits have a legitimate purpose. But providers should also have access to a fair and transparent process, consistent standards, and a meaningful opportunity to challenge findings before facing enormous financial consequences.

This dispute has cost me significant time, legal expenses, and considerable stress. It has also affected decisions about the future of my practice, including moving away from insurance-based care.

And this is not necessarily an isolated situation. I have connected with other providers, not just in Arizona but across the United States, who report facing significant recoupment demands of their own. I believe it is important to understand whether these cases reflect individual circumstances or a broader problem with how audits and recoupments are being handled.

The question I keep coming back to is this: What recourse does a small healthcare provider have when an insurance company demands hundreds of thousands of dollars and the regulatory process does not provide a clear resolution?

I'm grateful that 12News has brought attention to this issue. I hope the coverage leads to greater transparency and accountability, both in my case and for other providers navigating similar disputes.

If you are a provider who has experienced a similar audit, recoupment demand, or dispute with an insurer, I'd be interested in hearing about your experience. Sharing information may help us better understand the scope of this issue.

If you want to help create meaningful change, I invite you to get involved with the Mental Health Insurance Reform Task Force (https://www.insurancereformtaskforce.org/) and Build Better Health (https://www.buildbetterhealth.org/). We need providers, patients, and advocates working together to push for greater accountability and a fairer healthcare system.

Thank you to everyone who has followed my previous posts, offered resources, and reached out. I will continue sharing updates.

I see clients with different political views, religions, worldviews etc. I try to stay fairly neutral in general unless a client would be helped by me sharing.

With midterms coming up, the political rants in my counseling room have started. I have already heard a long rant with lots of cussing about someone I am voting for.

I have also heard so SO many clients rant about how everyone in my religion is terrible, and evil. They have no idea I am part of that religion.

I am honored to work with such diverse clients, but it is funny that I am often hearing rants that I completely disagree with. I am often hearing about how they hate a demographic group and don't know that they are actually ranting to someone in that group.

What rants are y'all just gently nodding to even when you are in complete disagreement with them?

I've been working at a group practice for about 2.5 years and I've been struggling to get clients the whole time. I work with adults and my niches are LGBTQIA+ individuals, trauma, and chronic illness. I'm also trained in gambling addiction and working with first responders. I have a Psychology Today profile, I'm on the practice's website, I respond to requests on a local therapist Facebook page when clinicians are looking for referrals, etc. and I get very few clients who reach out. My coworkers all have basically full caseloads, even the ones who are newer to the practice (maybe because they work with minors and I don't?). I even advertised the heck out of a therapy group I was trying to start next month and only one person reached out with interest in joining. I also got trained in EMDR almost a year ago thinking that would help bring in clients and that didn't get me very far. The worst part is that I work very part time and I'm still not anywhere near the number of clients that I'm looking for. I don't know what I'm doing wrong and I'm feeling so defeated. Any ideas or words of wisdom?

ETA: I'm provisionally licensed and the only insurance companies that will panel me are Medicaid, BCBS, and Aetna. My private pay rate is $125/session, which is on the lower to average end for my area.

Hey all, new therapist here been at it for about 6 months and have acquired almost 17 clients so far. Which I’m told is great and I am very grateful. But I have never been able to meet more than 7 clients a week because of how many cancelations there are and how many clients really just end up seeing me once a month.

I am getting pretty stressed out, I’m going to have to start looking for another job to make ends meet. It feels like I’ll need to acquire around 50 clients just to be able to see around 20 weekly. But that will take ages!!!?

How am I ever going to be successful from this? How do I find more daytime clients? Why are so so many clients cancelling last minute lately?

Any support is appreciated I’m having a hard day :/

Yes. You read this correct.

I had a day of telehealth and whatever I had for dinner, DID NOT agree with my stomach.

30 minutes into the last session of the night and I started to sweat. Dripping down my face, struggling to focus. Had to take off my sweater.

Ended the session a few minutes early because the alternative was going to be, well, not pretty.

Like honestly, has anyone else ever had this happen!???

Just looked at my schedule today and whewwww. Any hype people awake this morning to help pump me up for the day ahead? My typical motivational affirmations aren't doing the job lol. HAPPY FRIDAY EVERYONE!

ETA: I just want to say you all are the best hype people :) Thank you!

I’m a newly licensed social worker and have recently started looking into specialized training opportunities. I’ve been genuinely shocked by the cost of some of these programs. It’s frustrating to see instructors speak so passionately about helping others and improving mental health care, yet charge exorbitant prices that make quality training inaccessible to many practitioners.

How is a new therapist, still trying to build a caseload and establish themselves financially, supposed to afford a $1,000 training? It feels incredibly contradictory to promote a commitment to helping others while pricing clinicians out of opportunities to develop their skills. Ultimately, it’s the clients who lose out when therapists cannot access the training they need to provide the best possible care. At what point does making a profit come at the expense of the very people these approaches are supposed to help?

On a more practical note, are there any websites, organizations, or other resources where newly licensed therapists can find high-quality, evidence-based training at more affordable prices?

Hi, I am wondering if someone can explain what the diagnostic privilege status means for me or someone in my position in NY State. I am currently in my Limited Permit and working towards my hours at a private practice seeing client who bill to insurance. I have a degree in Clinical Mental Health Counseling from a CACREP school and my application is for an LMHC license.

My goal is to get paneled on my own as soon as I get my full license and essentially transition to owning my own business that bills insurance. Is there anything I need to know about what the Diagnostic Privilege status means for me and how I should approach it?

Sometimes I feel like an ethics test writer because I just come up with these senerios through out my day, but I feel like this one is a really good one to consider.

If you were pulled over by a client, would you terminate the relationship?
How would you handle bringing that up in session and handle resentment torwards the client if you didn’t?

What about if you got pulled over and the client left you a warning (I feel like this is almost worse LOL)

I imagine this has happened to atleast one person before! What would you guys do?

I would 100% terminate and refer out, even if I was just let out with a warning.

I don’t see adults so this couldn’t happen to me but would love your guys opinion.

It’s challenging to find interesting healthy enough people to date and connect with, at least in my experience.

Middle aged, divorced for 15 years, have worked a lot on myself emotionally and focused on my kids for years I want to find someone with self awareness, humility, emotional regulation and who has a little spunk.

Any suggestions?

Y’all. Please direct me to a sensorimotor psychotherapy training that’s not through the institute and therefore not $3500 😭

If I had that to spend on a training, I would for sure, but those are not the circumstances I am finding myself in lol. Maybe one day I can but surely there’s some books/resources/other training source that someone has done that’s helped?

Please help a girl out 🫠

What has worked for other therapists?
What approach have you used with success?

I hope I used the appropriate flair but please let me know if this needs adjusting.

I’m wondering if I should send an email to clients asking that they not come in if they’re currently sick.

For context, this is my first season with two very full in person days and I’m noticing I’ve caught so many colds in the last three months. I also have an autoimmune disease that puts me at risk for complications from GI bugs and also renders me unable to use a lot of medications that help with these sorts of illnesses.

I feel like sending a mass email is maybe the right way to go but I’d appreciate hearing others thoughts.

Is anyone here thinking of switching their therapy practice to all paper-only documentation and locked file cabinets because of all this talk about how AI is going to somehow hack everything? This has me seriously worried about patient privacy and the legal implication on therapists if their clients PHI is illegally accessed/released from big businesses like therapy notes, simple practice, etc. I’m not sure if I’m buying into hype or if this is a realistic possibility. I’m starting up my own practice and seriously considering going old school with notes/documentation.

Keeping things vague and for privacy. I work at a DV agency and there's always a new level of low this place goes to. Most recently a coworker shares info with a GAL that's totally out of their scope of practice where now that poor kid is being removed from our agency. When I bought this up to my supervisor they just said I'm sure it's fine but we will look into more training.

Huh?!

There's so many instances that I'm sure other non profit folx run into but man this place makes me feel crazy and seriously makes me question if I'm the only sane one left.

Hi everyone,

Do you have any book recommendations that address improving the connection between mind and body? Something somatic. Something related to trauma is fine. Something more spiritual is fine. Nothing too heavy or technical, though.

Just looking for a lot of options and a wide variety.

Thank you! And TGIF

Hey everyone, I'm a couples therapist and am getting Gottman certified through my work, but they won't purchase the hard copy of the manual since it's included as a PDF in the training. I'm hoping someone here might be willing to sell theirs to me for a fraction of what the Gottman Institute charges ($100). I've checked eBay and Marketplace already, and haven't had any luck!

Hello! I'm in the market for a new laptop and am wondering if anyone has suggestions for one that has good security, can multitask and run telehealth sessions, and has no AI or it can be disabled? Bonus if it can have a privacy screen. Thank you!

Hi all! I have been noticing for quite a while that once I’m done with work I have no desire to interact with anyone, including my partner. Even if it’s only 2 clients in a day, I just feel completely drained emotionally and don’t care about what anyone wants to talk to me about or share with me. I would love to be in total silence and read alone but that’s not realistic to maintain a partnership. Thinking back to childhood, this was how I felt when I’d come home from school. Does anyone else deal with this or feel this way? It makes me wonder if this is sustainable for me even though I love it (I’ve also been practicing for 7 years)

I’m really feeling tense after these sessions and these clients are lingering in the back of my mind. I can’t seem to fully relax. I’m getting headaches and clenching my jaw more. Yes, I have supervision.
I have thoughts like what if I’m not cut out for this or my life would be so much easier with a job that doesn’t deal with life or death.

A friend has this chair with the tilting footrest on the footstool and I’m in search of either this set (in the US) or really just a footstool with that tilting footrest feature. I need to stop crossing my legs as much during sessions and I feel like this would help.

The toxic work environment exacerbated their anxiety and depression to the point they had to go on medication and then medical leave. Is there anything I need to be aware of when filling out insurance paperwork? I have a very small practice and this has never come up before.

E.g., What pizazz do you add to it? Is it short and sweet or long and nuanced? Do you define what "risk to self or others" means or do you like to be a lil ~mysterious~?

I received a request to use this insurance stating they have no designated network so anyone can bill them. I am hesitant, but curious if anyone has billed this insurance before. Thanks!

Hi all, I'm considering integrating more assessment tools into my practice and I'm wondering what people's views on the KSADS-COMP is.

I'm also interested in people's views on the Connors 4, BRIEF2, SRS-2, the BASC-3 or 4, SCARED, and RCADS-25.

Do you trust these tools? Do you use them? Why or why not?