Navigating the world of health insurance as a customer can be hard. However, as one mental health therapist just laid out, it can be difficult and restrictive for health care providers too. The therapist, lesleypsyd, took to TikTok to share a frustrating interaction she had with United Healthcare regarding her therapy sessions. To illustrate her interaction, she set up a skit, filming from two angles to play the parts of herself and United.
She noted in the on-screen text that her post was “based on actual letter I recently received from United health care.” The video started with lesleypsyd taking a sip from her drink, filming from her left, and exclaiming, “Oh, god,” pretending she spotted someone. She then switches to the right side of the frame to portray the insurance, who says, “Hi there. We at United Healthcare recently conducted a full audit of all of our behavioural health providers.”
Then she lays out United’s alleged problem. “We recently noticed that your utilization of code 90837 is at 75% of your sessions,” she claims as the representative. Lesleypsyd clarifies in her on-screen text that code 90837 refers to a 53- to 60-minute session, while code 90836 is for 45 minutes. When the therapist asks about the goal of this audit, the representative responds, “We at United Healthcare would like to see that utilization at 63%.”
Mandating how the sessions must run
Lesleypsyd portrays frustration at the ask. She states, “Do you remember who I service? Like, I treat often times very young kids with behavioural challenges. It’s very hard to do all that in 45 minutes.” She then portrays the insurance representative as rigid, alleging, “That’s 63%. Thank you for your attention.”
When the therapist asks what the consequences might be for not meeting this requested quota, she alleges that she got an ultimatum. “We, United Healthcare, take your concerns very seriously,” she claims in her skit. “ And we wanna let you know that if you don’t hit 63%, we may take an unspecified amount of money back or terminate your contract entirely. It’s up to our discretion at any time.”
Lesleypsyd expressed her anger in the caption, writing, “This is real and it’s evil.” It should be noted that this is her version of the interaction and it cannot be verified. However, Evolve Counseling Services indicated that these restrictions are some of the reasons why mental health professionals don’t usually work with insurance companies.
According to Evolve, therapists face a variety of complex issues when deciding whether to be in-network. They noted that insurance companies often set rates that are significantly lower than a therapist’s actual fees for their time and expertise. This financial strain makes it difficult for providers to sustain a practice while maintaining high-quality care. They also point to the administrative toll of billing and sorting out pre-authorization, which can be overwhelming.
Evolve Counseling Services explains that the time spent navigating these requirements often diverts a therapist’s focus away from their primary goal, which is providing effective therapy. Another problem they note is that billing requires them to share private information like diagnoses and treatment plans, which many therapists and clients find uncomfortable.
The biggest problem, which matches lesleypsyd’s story, is that Evolve claims that insurance providers limit therapists’ autonomy in developing personalized treatment plans. They claim that insurance providers dictate what kind of therapies are allowed, how many sessions will be covered, and require extensive documentation to justify treatment. As seen with physical healthcare, they can also deny care.
Evolve Counseling Services pointed out that this impacts the therapy process. It also pressures therapists to conform to insurance guidelines that serve the individual needs of their client.
TikTok was overwhelmingly supportive. One user commented, “The only thing worse than dealing with these companies as a patient is dealing with them as a provider.” Another user expressed frustration with the broader system, stating, “We are in such desperate need of insurance reform.”
Others were even more blunt about their frustrations, with one user writing, “UHC and BCBS can f–k off with this s–t. I’m the licensed professional and my client is the expert of their life, so WE dictate treatment, not some uninvolved random employee who hasn’t even spent a millisecond with my client. So over these insurance companies.”
Some users suggested that lesleypsyd should push back. One person advised, “File a complaint immediately with the state insurance bureau.” The general sentiment among her viewers is one of deep disgust with the prioritization of profits. As one commenter put it, “Profits over actually providing health care is just wrong.”
Published: Aug 24, 2026 06:48 am