Ricardo’s approach to counseling to providing mental health services to lower-income adolescents and families is a remarkable ideal but on the other hand there are ethical guidelines that he must follow as a counselor. Ricardo is taking a big chance in trying to help his clients.
His ideal of billing and using an individual diagnosis for the family members may seem as if he is practicing fraudulent billing procedure.According to the ACA (2005), Standard C. 6. b. Reports to Third Parties, wherein “Counselors are accurate, honest, and objective in reporting their professional activities and judgments to appropriate third parties, including courts, health insurance companies, those who are the recipients of evaluation reports and others” (p. 10).
The diagnosis that he reported to the insurance company was not the correct diagnosis. ACA (2005), Standard E. 5. a. Proper Diagnosis, “Counselors take special care to provide proper diagnosis of mental disorders” (p.
12).It is very good for counselors to try to do what they can for a client but the counselor has to think about the ethical guidelines that are set up to practice counseling. Counselors have a legal obligation to follow these guidelines. One of the key ethical issues in this case include Ricardo provides services for clients who have a limited ability to pay for ongoing counseling. The ACA Code of Ethics (2005), Standard A.
10. b. ) states that in establishing fees, counselors should consider the financial status of clients and locality.Another ethical issue in this case is Ricardo lowers his fee substantially so the clients can afford their counseling sessions. Remley and Herlihy (2009), discovered that legally, counselors and other professionals may set any fees that they wish for their services.
The counselor can even charge different clients different amounts for the same service as long as they do not discriminate based on constitutionally protection categories of persons.Ricardo allows his clients to go without payment because he knows that they really need the help. This ethical issue proves that Ricardo is a good and honest counselor that wants to help underprivileged adolescents and their families afford counseling services. Ricardo must realize that counseling services is a business, so he must generate enough income to cover his business expenses.
However, he can provide his clients with referrals where counseling services may be free or available at rates below those he charge (Remley & Herlihy 2009).Ricardo must not allow himself to get caught up in insurance fraud. In the last information that is provide in the case study it shows that he receives referral from his friend for his upscale section of town. He also charges these clients $135. 00 an hour for the same type of services and knowing that the clients’ insurance companies reimburse at a high rate for these assessments.
Counselors who complete the forms required by PPOs or other health insurance companies must be careful to avoid fraudulent practices.Fraud occurs when counselors misrepresent to health care companies any facts regarding their services so their client will receive payment or reimbursement for the counselors’ services (Remley & Herlihy 2009). The recommendation that the counselor would make to Ricardo is he must be careful in his practice in order to avoid the pitfalls of practicing unethically. Many of the issue in his case are ethical and of good nature but can lead to doing the wrong thing.If he is not careful he will be misrepresenting information to insurance companies and that can lead to unethical practice and fraudulent practices.
And lastly, providing free services can lead him to a dead end because he has operating expenses that he is responsible for. It would be a good idea to use the sliding scale or make referrals to free clinics for his client that can’t afford to pay for their services.
