Fee-Splitting
When it comes to hiring someone to help provide services or navigate finding appropriate services, it’s hard to trust if you aren’t certain of the intentions of each provider. In seeking out help, you are in a very vulnerable and overwhelming situation. Sometimes, families blindly trust a provider and can only hope they aren’t being led astray. This is place of vulnerability inclusive of both Medical Providers and Mental Health providers. Behind the scenes you never know who is truly being honest about where they’re getting paid. Not sure what I’m referring to? It’s called fee-splitting.
Recently, I was asked by a therapy practice if I did fee-splitting with referrals. The casual nature of the question caught me off guard. I thought I’d always made it abundantly clear that I have integrity in being objective in making referrals for the clients I work with. I emphasize that I am an independent consultant, but apparently I need to emphasize that more. Any time I a tour a program or meet with a referral, I often say “I may refer to you next week, in two years, or maybe never at all,” because I want to ensure clear expectations that just because I’ve seen their program or met with their team doesn’t mean I have a client to refer. Apparently I didn’t have this business (and personal) value on display in flashing neon lights like I’d thought. So, I’m out to change that.
Fee splitting is defined as payment by a specialist to a third-party who referred a patient to that specialist. An example of this in the role of a Therapeutic Consultant would be if I referred a young adult client of mine to a specific therapist or program, and then that therapist or program paid me as a way of saying thanks for that referral. To be clear, this exchange has never, and will never, happen. I do get asked by parents often if I receive payment from programs, and I appreciate it when that question is asked. My answer is always, and will always be, “no.”
Here’s where it gets murky. According to the American Counseling Association, it’s not that fee-splitting isn’t legal, it’s just unethical. So technically, if you are hiring a specialist to work with, there is a possibility that behind the scenes there is fee-splitting. Same goes for the American Medical Association. It’s not illegal for a doctor to fee-split, yet if their licensing board finds out they risk losing their membership within AMA and their ability to practice medicine. When you see the money you can make this way, some providers are willing to risk it. I’m not one of those people.
I’m not licensed as a clinician. I’ve also said this before, but I’ve been certified as a Nationally Certified Counselor since 2013. I abide by the NBCC Code of Ethics, and in an effort to ensure I continue to remain objective for the clients I serve, I do not allow myself to be persuaded to refer a client to a program or professional because they are waiving the fee-splitting carrot. To those providers, I say “goodbye.”
For questions or comments contact Joanna.
