Cream of Consciousness

If you have medical insurance through Horizon, Aetna or Amerihealth chances are that responsibility for your mental health coverage has been carved out (contracted) to a company called Magellan. Like any managed healthcare organization, they have a set network of providers. Being treated by a professional outside of this network incurs significantly greater costs. Well for Cumberland County there is exactly one (1) in-network psychiatrist, and he has a 3 month waiting list. If you call Magellan and ask for a list of providers they will give you several names. but their provider network database is woefully out of date. It includes providers who are not taking new patients, providers who are no longer in private practice and even one doctor who's dead (that's right DEAD). If you have no provider locally, they will insist that you drive up to 45 minutes to an in-network provider. Getting authorization to see an out-of-network doctor at in-network rates requires patience, determination and stamina that most depressed folks don't have. Now Cumberland County is rural, but there are 3 good sized municipalities in the area (Vineland, Bridgeton and Millville) and a sizable population in need of a psychiatrist.

Why are there so few providers? The process of joining the provider network is an ordeal of hoop jumping and delays and many decide it's not worth the effort due to the reimbursement rates that Magellan is offering. The number of providers in more populous area is greater, but it is still inadequate to meet the needs of the population. Therapists (the gross majority not being medical doctors) are frequently in the position of knowing their clients are in need of medication, but being unable to refer them to a psychiatrist in a reasonable time frame.