Samuel has a private practice and he receives most of his income

Question # 00861935 Posted By: wildcraft Updated on: 10/17/2024 04:38 AM Due on: 10/17/2024
Subject Education Topic General Education Tutorials:
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Samuel has a private practice and he receives most of his income from clients covered by managed care companies.  He is completing the paperwork to get both reimbursement and approval of the number of sessions for two new clients. Samuel is aware that the diagnosis he gives will affect the responses of the managed care reviewer. The first client, Charlie, has experienced a recent interpersonal loss and has some behaviors that meet the criteria for major depression. The second client, Amanda, has also experienced a recent interpersonal loss and has some behaviors that meet the criteria for a personality disorder. For Charlie, Samuel knows that if he gives a diagnosis of bereavement he will likely be told that the client does not need treatment and he will not be reimbursed, but if the client has Major Depressive Disorder, then the client may be given six or eight sessions. Similarly, if Samuel gives Amanda a diagnosis of Major Depressive Disorder, she will likely be approved for several sessions. However, if he assigns a diagnosis of a personality disorder, then she will not be approved for counseling. Samuel truly believes that both individuals could benefit from counseling with him.

Regarding the case study above, what diagnosis should Samuel give Charlie and Amanda?  Why?  Do you think it is unethical or illegal for Samuel to give Charlie or Amanda one diagnosis or another?  Is it unethical that an insurance company, who has not yet met the client can determine whether they will have services paid for, or how many sessions they can have? Why/why not?

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  1. Tutorial # 00857443 Posted By: wildcraft Posted on: 10/17/2024 04:39 AM
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