Question

the therapist is informed by the managed care company that authorization for additional treatment with a patient has been denied. the therapist is concerned stopping treatment will jeopardize the patients safety and realizes which of the following are the best ethical actions?

a. the therapist continues to work with the patient to ensure ongoing treatment while working with the managed care company on payment solutions.
b. stop treatment immediately.
c. attempt to work out a payment plan with the patient for ongoing treatment
d. both a and c are correct

Explanation:

🆕 New Concept Discovered: Ethical Management of Treatment Termination
How clinicians handle insurance denials to prevent patient abandonment.

Step 1: Analyze the clinical and ethical dilemma

The therapist is faced with a situation where a managed care company (insurance) has denied authorization for additional treatment. However, the therapist is concerned that stopping treatment immediately will jeopardize the patient's safety.

In clinical ethics, therapists have a primary duty of care to ensure patient safety and avoid client abandonment (abruptly ending therapy when the client still needs care and is at risk).

Step 2: Evaluate the options

• Option A: The therapist continues to work with the patient to ensure ongoing treatment while working with the managed care company on payment solutions.
• Analysis: This is highly ethical. It prioritizes the patient's immediate safety by preventing abandonment, while concurrently attempting to resolve the systemic funding issue through advocacy or appeals with the insurance company.

• Option B: Stop treatment immediately.
• Analysis: This violates ethical standards. Stopping treatment abruptly when a patient's safety is at risk constitutes abandonment and can cause severe harm.

• Option C: Attempt to work out a payment plan with the patient for ongoing treatment.
• Analysis: This is also an ethical and practical solution. If insurance coverage is lost or denied, offering a sliding scale, a payment plan, or alternative payment options allows the patient to continue receiving necessary care without facing sudden financial hardship or termination of services.

• Option D: Both A and C are correct.
• Analysis: Since both Option A (advocating with insurance while continuing care) and Option C (offering a direct payment plan to sustain care) are ethically sound, proactive measures to protect the patient's well-being, this combined option is the most comprehensive and correct choice.

Answer:

D. Both A and C are correct