The College, along with the professional associations – the Ontario Association of Social Workers and the Ontario Social Service Workers Association – have received numerous reports related to insurance claims for psychotherapy services provided by social workers and social service workers being denied by insurance providers. The refusal of these claims creates barriers to client care and is a matter of public protection.
Employers can refer to the information below if they experience issues with insurance claims being denied for psychotherapy services provided by their employees.
Addressing misconceptions with insurance providers
The College has reached out to nearly 20 insurance providers to address misinformation about the role of social workers and social service workers and the scope of their practice. Some insurance providers have inaccurately described social workers’ and social service workers’ roles in a very limited way, such as helping individuals and families through referrals to community resources. This description omits, among other things, our registrants’ important role in providing psychotherapy and counselling to treat stress, relationships and mental health disorders.
There is also confusion about educational qualifications required to register with the College, as well as misunderstandings around supervision requirements for practising the controlled act of psychotherapy.
Although the College has no authority to impose changes on what services insurance companies will reimburse, we hope that the information provided to these companies will allow them to reconsider their reimbursement policies and practices.
What employers can do
If an employer encounters insurance providers who are not reimbursing their employees’ clients for their services, they can:
- Send a copy of the College’s letter to insurance companies to inform the provider that registrants are qualified and authorized to perform the controlled act of psychotherapy; and
- Inform insurance providers to contact the Professional Practice Department at practice@ocswssw.org for clarification on registrants’ scope of practice.
Supporting clients in navigating insurance coverage
Employers can also let their employees know that clients can reach out directly to their insurance provider to confirm their benefits. That way, your social work and social service work employees can bill clients for their services accordingly. Your social work and social service work employees should work in the best interest of their clients when billing. For example, if an insurance provider covers “social work services” but not psychotherapy performed by a social worker, registrants can bill for social work services, as psychotherapy falls under this umbrella term.
More information
For questions regarding performing the controlled act of psychotherapy or registrants’ scope of practice, contact the Professional Practice Department at practice@ocswssw.org.