14 MayEpisode 150 | More about pet insurance: Will it cover a veterinary behaviorist and any kind of training? What about pre-existing conditions?
This is a follow up episode to last week's "journey" through the world of pet insurance. Annie mentions some companies she's heard good things about from listeners in the wake of the episode airing, and dives deep into what insurance will cover in terms of dealing with behavior issues. Her guest is trainer Briana Balogh, who is the Client Care Coordinator at Behavior Vets.
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Mentioned in this episode:
Briana Balogh at Behavior Vets
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Transcript:
[intro and music]
Annie:
Hey there. So this is sort of a follow-up last week's mammoth pet insurance episode. I just wanted to mention or reiterate a few things and respond to some feedback I've gotten. And then I do have an interesting interview to share.
But I just wanted to reiterate that I think it's a good idea to get pet insurance as early in your dog's life as possible, because I don't think there are any companies out there that are really gonna cover preexisting conditions. So you want to get a plan that you like before your dog or cat has any conditions.
And the sooner that you start out with one company, and the more time you may have to stop working with that company, try a different company, et cetera, et cetera, once your dog or cat has any kind of pre-existing conditions, you're going to kind of be locked into working with whichever brand you're with because you're not going to be able to switch and get that stuff covered.
If you do have a dog who has a pre-existing condition, definitely check out the pet assure discount code, which I talk about in the episode, which is probably the best option in those cases.
I also got some feedback that I was a little dismissive of companies that offered different kinds of insurance. And I think that's totally true. I was just trying to narrow the field a little bit, set some parameters, arbitrary as they may be. But a couple of people have reached out to me for instance, and said that they have Nationwide and said they're really happy with Nationwide.
I ran a quote and it looks like Nationwide would cover just about everything that the the company I ultimately chose would cover. They don't have tons of options to toggle and choose from, which I actually really like. I think it simplifies things. And the quote that I got from them looks like it would be about what I'm going to end up paying per month with a plan I chose with the company I chose, except the deductible would be lower.
I have a thousand dollar deductible. The nationwide one would be 250. The wellness visit would still be covered. And they would cover 90% of bills. Although the plan I got is a hundred percent of bills. So I think definitely that's one worth checking out.
And as I did mention in the last episode, if you already have insurance that you like, a lot of people already have Nationwide for their home insurance or renter's insurance or car insurance or whatever. You might be able to get a deal bundling your insurances together. So again, that is one of my major recommendations.
I think Geico which I know a lot of other people have for like car insurance, they work with Embrace which is a company that was that Bob Capobianco, who I spoke to last last episode, who is a rep from Crum and Forster. He uses Embrace, which is funny because that's not one of the companies he represents. but he had good things to say about them.
Anyway, I think there are a lot of really good options out there. And as I said in the last episode I think it probably, not that it doesn't matter, but I think it's so much more important that you have pet insurance at this point, I have figured out, than not have pet insurance, that which one you choose, chances are it's gonna be pretty good. Because overall I was pretty impressed with most of the companies I looked at.
I also have had people reach out about Trupanion, saying that they have had good experience with Trupanion. I ran a quote for Trupanion. It would be about the same again, roughly the same as what I ended up with. Although the deductible is a little bit lower, they also cover 90% versus a hundred percent for an extra, roughly $12 a month.
I could get add-ons including acupuncture, behavioral modification, chiropractic, homeopathy, hydrotherapy, natural therapy, physical therapy, rehabilitative therapy, and boarding fees in the event of my hospitalization. Holiday vacation, vacation cancellation costs, I guess, because of a pet's illness or death, cremation, or burial for deaths due to an accident. They cover those costs and liability coverage for third party property damage, which is interesting.
I actually asked Daniel Caughill of the pet tale about this the other day, and he said though that most of the time, if you have home insurance that will cover any damage that is done by your dog. But interesting that they do offer that as an extra perk. And they will also help towards the cost of advertising if you lose your dog, and providing a reward, if you lose your dog or cat.
Worth noting that true Panion is underwritten by American pet insurance, which is also the underwriter of AKC pet insurance and pets best and pet partners. So I guess this is like another Crum and Forster situation of like one company in different brands, which I admit I'm still a little fuzzy about.
And I had someone from Pumpkin reach out to me saying that I was overly dismissive of the differences between Pumpkin and the other brands, which I was kind of lumping together. And again, this is not my specialty, I'm doing my best, just like you to understand all of this. But I still kind of like that the brand I chose is like an independent brand that is not in any way, like a marketing effort of a larger brand. But that's that's just me.
And again, I think sometimes we make choices in these areas that maybe don't make a huge amount of sense, but you have to set some sort of criteria. Right?
Anyway, a major thing that I neglected to discuss last week was coverage for things relating to behavior. Specifically, if you need your dog to see a veterinary behaviorist. And some of you might be listening and saying, what the heck is a veterinary behaviorist? So I asked Briana Balogh of Behavior Vets to talk to me about what veterinary behaviors do and what kind of insurance will cover their work with clients. Briana is not a veterinary behaviorist, but she is the person who is helping a lot of clients deal with their bills. I'll have her explain exactly what she does in a moment.
And I should say that most of the Crum and Forster companies look like they will indeed cover visits to a veterinary behaviorist. Eusoh said they will cover an initial visit, but a little unclear to me what happens after that initial visit. Looks like a lot of these companies say that they cover if there is some medical need for treatment, but of course mental issues can certainly be medical issues.
And Wagmo says they will cover veterinary behaviorists if there's a referral from a regular vet. Trupanion will cover things having to do with behavior, if you get that additional one of those additional add-ons that I just mentioned, which looks like it's something around five or $6 a month.
And it was also explained to me that some of these companies treat problems that you might think as a pre-existing condition as something that could go away. If it's gone away for six months and then comes back, it is luckily for you considered a new condition, not a preexisting condition.
So it's possible, you might say, gosh, I want my dog to continue going to her veterinary behaviorist for these issues she's having, or even just to a regular vet for these issues she's having. I don't know if it will be covered. You could talk to your vet to see if it's something that might fall under this this like Coda of conditions that are allowed to be considered vanished and then reappearing.
And if you're already seeing a veterinary behaviorist for an issue, you could also reach out to the veterinary behaviorist and see if there's some way that they could perhaps code the problem differently on the bill. Again, this is not my area of expertise, not talking about ethics here, not sure what's right and wrong, but if you're hoping to get coverage for an animal who's already seeing a veterinary behaviorist, definitely bring this up with them beforehand so that you don't find that all of it's considered a preexisting condition and nothing is going to be covered.
Anyway, for more information on this topic, I'm now going to share with you my conversation with Briana.
Briana:
Hi everybody. My name is Briana and I am currently an employee of Behavior Vets of New York city. We also have another location in Colorado, as well as we're able to service clients from all over the country. Currently I am a client and administrative service coordinator for the business. But I am also a certified veterinary technician. I currently live in Colorado. I've been a technician for longer than I'd like to admit.
Before joining behavior vets, I was an internal medicine and emergency technician at a big referral hospital for about 11 years. So I bring a lot of that experience. and I also have associates degrees in exotic animal training. I attended a program out in Moore Park, California called the exotic animal training and management program. So I have a lot of experience with exotics and also working as a trainer with Behavior Vets shortly in the beginning of my career with them. But currently I've been with behavior vets for about four years.
Annie:
Great. So to people who aren't clear on this I would love if you can explain what a veterinary behaviorist is and how you work with dog, or how you, as a representative of behavior vets, how you work with dog trainers.
Briana:
Absolutely. So yeah, working with behavior vets, so a behavior veterinarian is going to be a different from just your normal say general practitioner. They are specialized in behavior, and we see everything from separation, anxiety cases, aggression cases, noise fears and phobias, anything behavior related that you can think of we see over here.
So the behavior veterinarian will tackle the case from a medical standpoint, they'll be able to offer official diagnosis, prognosis for conditions, and lead the treatment plan from a medical perspective. Also incorporating into the fact that we want to make sure that our patients are physically healthy because oftentimes physical ailments can certainly contribute to worsening of existing behavioral issues or start to cause them in cases of pain, things like that.
We work very closely with trainers around the city and we also have trainers and consultants in house as well to enact the therapy portion of the doctor's behavior plan. Now, not everybody needs a behavior vet to start with. We also just do like basic obedience and manners training with puppies without seeing a behavior vet as well, but the trainer consultants will enact any plans that the behavior vet has as far as what we need to work with this cat, dog, bunny, we see all species, what they need to do as far as therapy is concerned. So that could be muzzle training, or training a hand target, training a dog to take breaths on cue. I mean, the list could really just go on and on.
I often described the behavior vet trainer relationship as exactly like psychiatrist, psychologist, right? So some people, they just need to go see a therapist and on the couch, talk about their problems and they can manage their anxiety conditions quite well. Which, that would be what a trainer or consultant does. If you need a little extra help in your treatment plan, then that's typically when you get the doctor involved to discuss it from a medical standpoint as well.
Annie:
Right. And we have worked with Dr. Tu and Dr. Christiansen of behavior vets for many years, but you guys also have your own stable of dog trainers who work exclusively for behavior vets. And I'm assuming — is that common? And we should also mention that there's really only what, like 50 or 60 veterinary behaviorists in the country. Right?
Briana:
I don't know how many in the country. Last I knew it was around 80 in the entire world. So yes, we're few and far in between as far as finding us. But yes, we definitely, we have our own staff of trainers and consultants over here. I think we're up to eight to 10 of them now. We do service a wide range in the New York area. We go up into Westchester down into Brooklyn, Queens.
And then areas that we cannot service for in-person appointments simply because of travel time. We try to serve as many people virtually as possible, and also in conjunction in working with qualified trainers and consultants around the area as well. Which, School for the Dogs, we love working with you guys. You've got great trainers on your staff.
Annie:
Thanks. So is it pretty typical then that veterinary behaviorists will have trainers that are working for them?
Briana:
It is pretty typical, you know, in the websites that I've seen when cruising around you know, it's a pretty small field, so we all kind of know each other. I do think we have one of the biggest staffs as far as trainers and consultants go. The majority of the behavior vets that I've seen may just have a couple on staff, but it is very common for them to have their own trainers or consultants on staff just to provide continuity of care mainly.
Annie:
And one thing that people ask all the time, what is the difference between a behaviorist or a veterinary behaviorist, or a behaviorist and a dog trainer? Can you speak to that?
Briana:
Yeah, I get those calls often, you know, people reach out and they're saying I'm seeking a behaviorist for my dog, which I feel is a very, a very generalized term that kind of gets tossed around and clients usually don't know what that means. So, it's oftentimes talking about just the difference between a behavior vet and a consultant or a trainer. There's lots of different levels as far as education experience goes all over. So it's just really our job to educate people on what the difference between them is.
But typically if they're asking to see a behaviorist, I'm going to assume that they mean a behavior vet, but that's not always the case. Sometimes they're just seeking a qualified consultant or a trainer.
Annie:
Right. I often explain to people that, as trainers at School for the Dogs, we’re behaviorists with a small B. We believe in using the science of behavior to affect change in the animals that we work with. But we are not veterinary behaviorists or certified, applied animal behaviorists. And there are very, very, very, very, very, very, very, very few people who really can call themselves behaviorists because– Well. So you could also be a behaviorist with a PhD. Right?
Briana:
Exactly. Yeah. Yeah. There's a lot of different roads to the spectrum. Yeah.
Annie:
But even that, there are not that many actual behaviorists who are not vets who are working with dogs. So yeah, I agree that it’s a word that I've heard people throw around and misunderstand, and it's a little frustrating, but it's not like they have bad intentions.
Briana:
Absolutely. Yeah. And it's just you know, what are we called basically with our definition?
Annie:
I call myself a dog trainer, basically.
Briana:
There we go.
Annie:
I think this is an interesting conversation just because I think most people have no idea what a veterinary behaviorist is. So thank you for chatting in order to even just explain what a veterinary behaviorist is.
And I wanted to talk specifically about insurance, but I think it's worth mentioning, and please tell me if I'm wrong, but there are people who have a puppy who is having like pretty basic puppy issues who will seek out a veterinary behaviorist, even though a run of the mill dog trainer like me could probably help them. Am I right?
And to be clear for those who are listening who don't understand, veterinary behaviorists often, I mean, I know from experience, you guys often have wait lists three, four months long, and the fees for seeing a veterinary behaviorist. I don't know if you want to share what your fees are, but I know they can be like a hundred dollars billed in 15 minute increments. It's no small thing, right?
When people go to see a veterinary behaviorist they're often getting on very long wait lists and investing a lot of money.
Briana:
Very much so.
Annie:
I guess I have two questions, one. So there are people who go to veterinary behaviors that maybe don't really need it without understanding the kind of commitment that's involved?
Briana:
Yeah, absolutely. I mean, I feel like it's a constant educational experience, you know, behavior, as far as a veterinary specialty is the newest subset of specialties in veterinary medicine. So, we're still trying to get our methodology out there. Really trying to educate not only clients about their personal pets, but it's also a lot of re-educating within the veterinary community as well. Just because previously there hasn't been a lot of education about behavior and specifics. So, it's important for us to have these conversations so that everybody can make those adjustments as necessary and get their treatment for their animals.
But yes, so to see a behavior vet, again, because there are so few around the world, it can be quite a wait to get in to see them, but, you know, that's really our job. And part of my job as a client and an administrative service coordinator is to have these conversations the first time that clients reach out to us, because they're often confused or they've just gotten our name or our number from somebody. And they often say, Hey, I don't really know what I'm looking for, but my dog has behavior issues.
And I always start with, I'm so sorry to hear that. Tell me the story, what's going on. Because through listening through the client, our goal is always to support the client and what their goals are because not everybody has the same goals. So it's our job to listen to them, figure out what is the behavior of concern to you? What exactly are you wanting to work on? And from there, we can decide as an admin team, is it appropriate for you to start with training?
If it's basic puppy manners and obedience, and I've got to wait, I know that, Hey, maybe I want to get this dog over to School for the Dogs, because number one, a puppy needs trained while they're still in that important sponge period. Right. So I don't want to have puppies wait four months to see us. So that's where those relationships with you guys come in really handy for us to be able to refer out to trainers that we know your methods are conducive to our treatment plans. Right. So yeah.
Annie:
So you do have people who say like, I'm not quite sure what I need, and you can, you help guide those people?
Briana:
All the time. Absolutely. Multiple times a day,
Annie:
Although I've, I've also seen a kind of extreme, people who feel they need extreme care, who probably are able to talk you into getting an appointment anyway, and then probably sit there with Dr. Tu or Dr. Christiansen or whoever. And they're like, you didn't need to see a psychiatrist for this issue necessarily.
Briana:
Yeah. I mean, we really try to address that before we're scheduling because the doctors are in such high demand. So again, that's our job as admin is to determine, is it appropriate to start with training or therapy, you know, in those cases I'm going, absolutely. There's really, number one, no real reason for you to see a behaviorist right now, the behavior issues in concern are not that severe at this point.
Number two, we got to really reserve our behavior vets for cases that we know absolutely need to see us. I mean, if you're going to see a behavior vet, you're definitely going to need to be hooked up with a trainer or a consultant as well. But if you hook up with a trainer or a consultant, if your patient has mild behavior symptoms, rhat could be enough and you may not even need to see them. And clients appreciate it from like a cost savings perspective as well.
Annie:
Can you tell us what the costs are, which is, I guess, a good segue into our question about getting it covered?
Briana:
Absolutely. As far as right now for seeing a behavior vet for an initial consultation, the cost is $900. Follow up appointments, we're doing the majority of them virtually. We schedule them for a half an hour, and the rates are $450 per hour. And we bill in 15 minute increments, cause some conversations may be short with some clients. Some of them may be a little bit longer, that can always be adjusted as necessary.
Typically I would say, if you see a behavior vet, most often these cases, I would plan on staying with us for at least six months. At that point, a lot of our patients do quote unquote graduate our program. You know, everything seems to be much better by that six month mark. And we can transfer them back to their primary vet for all future followups, medication, refills, anything like that. And of course, with the understanding that they're welcome to come back and see us at any time.
So whenever a client wants to transfer back to their primary vet we're happy to do that at any time. But typically most of these patients, we're going to recommend that they're at least with us for six months. Now, granted, we still do have clients and patients who have been with us longer than that, you know, up to a year. Some of them five years, longer, very much depends on the individual patient.
Because also as a patient ages, their behavior issues tend to kind of morph and evolve, just based off of things that happen as they grow older, they might be losing their hearing, their sight. They may develop arthritis, again where we go back to talking about how this pain affects behavior.
So oftentimes, through the animal's life, even if they've graduated our program, they may be needing more assistance in the future to deal with these unforeseen changes, medically. Maybe the owner moved and that was really upsetting to the dog. There's a lot of different reasons that a dog could need a behavior vet kind of long-term, but maybe not every week long-term, but just have some supportive care throughout the lifetime of the animal.
Annie:
Interesting. So let's talk about how insurance works into all of this. I guess first of all, what kind of percentage of your clients do you think are using insurance, and then secondly what is, or isn't covered and how are those claims working?
Briana:
Yeah. Absolutely. And that's a great question. I don't feel like enough of our clients have insurance. Let's start there because it can really just be so helpful to have that peace of mind in the event of an emergency or worsening behavior issues. Whatever it may be, insurance can really provide a stable peace of mind if you ever are in that moment where you're forced to make a tough decision between treating your dog or paying the bills next month.
So, I mean, I do see insurance, more clients are purchasing insurance every year, which we love to see in the veterinary community. Because again, it allows us that that safeguard to be able to give the patients the treatment that they need. Right now I would say maybe 10% or so of our clients have insurance, which is pretty high to be honest, but would we like to get it up to, you know, 90 or a hundred percent? Absolutely. Because again, like I said, just having that safe guard to use in these situations, to avoid sticker shock, can be very helpful.
And I can start off by saying, most people are like, well, when should I enroll in these types of programs? My recommendation, and from having pet insurance as a pet owner myself, the earlier that you get them started in life, even though they're puppies, that can really be beneficial. Because insurances, from my experience, none of them cover preexisting conditions.
So you're going to want to have the insurance already purchased. Most of these companies are going to make you have a 30 day grace period before you can even start to use it. You know, so it's not like you can sign up real quick and keep it a secret and use it the next day. They are going to have a grace period for that. So if you can start them out when they're younger, very helpful.
And a lot of these companies will even have provisions for wellness care that can really help with flea and tick prevention, vaccines. All of those things are very important in a puppy or a kitten's life as well. So we always recommend starting off as early as possible.
Another reason this is beneficial is because how old the pet is when you enroll them is going to give you your cost. Okay. So if you're signing up a four or five month old puppy, that's going to be less money out of your pocket than say, if you're trying to sign up your 11 year old dog who's about to have end of life issues. Right? So the sooner that you can start them, they’re looking at the specific age, the breed of the pet and your location when determining insurance.
And it's very much just like car insurance, what are they looking at? The make, the model, where are you located so that they can determine, okay, this is the claims that happen in this area. And then everybody kind of splits the cost, if you will, insurance wise.
So when you sign up for these insurances,they're pretty flexible on their plans as far as what can you pay for. Oftentimes you can select what kind of deductible that you want for each condition. So you can select like a $250 deductible, or you could select a $2,000 dollar deductible. And the 2000 is going to be cheaper. Cause again, you would be responsible for that first 2000 for any given condition. And then they would start to reimburse after you've reached your deductible.
But if you pay a little extra every month for a lower deductible, you know, if you've got a big bill with broken legs, something like that, you know, you may only have to pay that 200. And then the majority of these insurance companies they'll pay a certain percentage of things afterwards.
Annie:
Right. What is your experience with insurances covering veterinary behaviorists?
Briana:
Yeah, the majority of them absolutely will cover our services. Where it gets tricky, and again, I'll always encourage clients to really call the companies that you're interested in working with. Because again, it's going to depend on the breed of your dog, the age, what kind of records are already written in your primary vet’s medical records, those sorts of things.
But yeah, so they will typically cover behavior veterinarians. They have to be a diplomat of the DAC VB, which we are. And I'll talk about training in a little bit. That's kind of a different subject, but for the behavior vet, yes, the majority of them are covering our services.
Now some of these companies may want a written referral from their primary vet is saying, Hey, you know, Fluffy has this behavior issue. I'm referring them over to behavior vets before the insurance would cover it. Oftentimes if you're not sure, the majority of these companies will have a pre-approval form that you can send us, we can fill out with an estimate for the cost of the initial consultations. You can send it back to them, they can do whatever they do on their end to make sure that your particular policy covers our services.
Most veterinarians in general are happy to submit claims for any company. We don't really have in network and out of network type of things with pet insurance. It may go that way someday, but for right now we don't. So yeah, we're happy to submit claims for any company. We just ask that then the particular client verifies that their insurance company and their particular policy covers our services.
Annie:
And have you found that there are services that are easier or harder to work with, or that just blanket won't cover what you guys do?
Briana:
You know, the last I knew, the only company that I knew that covered zero behavior issues is healthy paws. I've definitely had a conversation with them about this. I don't know if a lot of clients know, but more dogs are euthanized every year because of behavior issues than any other reason. Medical cancer, old age, any other reasons.
So, it's really important for us to also educate these insurance companies on the benefit of treating dogs with behavior issues, because this also will cut down on the amount of dogs that are rehomed, in shelters, thrown out on the street. Behavior is a major thing. There's a lot of anxiety in the world today with people and with dogs. Even with COVID, we've really seen an uptick in canine anxiety because of COVID as well. So again, very important to have that coverage at this point.
But the rest of them, at least the ones that I have experienced with, and granted there's a new, a pet insurance company kind of popping up daily, but the majority of them yes, will absolutely cover behavior issues
Annie:
Up to a certain point or to whatever the limit is? And do you think that veterinary behaviorists get treated differently than other kinds of specialists that someone might want to bring their dog to and then submit a claim to insurance?
Briana:
I haven't heard of that being an issue again, I've worked in veterinary behavior. I've worked in veterinary, internal medicine, specialty medicine, you know, pretty much my whole career, and the claims process is pretty much the same across the board. So I don't feel like we're treated any differently than the other specialists. But oftentimes again, it's just a little bit of education and actually talking with the companies about their behavior coverage.
I do know that there are a few companies out there that, you have to purchase the main policy, but then you may also have to purchase what they call an additional rider. So some companies will lump us into the category, you know, veterinary behavior, water treadmill, acupuncture, you know, holistic care. We're kind of lumped in with those guys in some of the policies as well.
So again, just important to check with your insurance company, you know, is my main policy enough to cover that behavior or is there additional coverage that I should purchase on top of that.
Annie:
Interesting. So this is not something that I'm suggesting anyone do, but I'm curious if this happens, because I do know that we sometimes have people who are quite disappointed that we don't take insurance as dog trainers. Are there situations where people will seek out a veterinary behaviorist who can then refer them to one of their trainers in order to get coverage? I mean, are people who work with your trainers covered as it's billed through a veterinarian?
Briana:
Yeah. So for the majority of these insurance companies, what I've seen from their policies is that they will cover training as long as it's under the umbrella of the DACVB, which behavior vets is. Because they're viewing it as, okay, you work for a veterinary behaviorist. So we know we can trust you basically.
Typically, not only DAC VB, but also certified applied animal behaviorists as well, which you were talking about. Those are kind of a little bit harder to locate around, but they'll usually cover services from them also. But I have heard, and again, this is where it's important just to take your policy into consideration. If you had just recently signed up your eight week old puppy and you just wanted to work on training for basic manners and obedience, that's where things get kind of tricky.
And it may be more difficult to get that covered because again, that's kind of seen as preventative or wellness care at that point. Now, should your dog, say its 12 weeks old, but it already is having leash aggression. Then that's a problem behavior. And yes, typically they will cover those. But if you're just looking to work on the basic, sit, down, stay, strong recall, things of that nature, then they potentially may not cover those services with us or outside of the DACVB or CAA as well.
Annie:
Interesting. So it sounds like it would be unlikely that like Dr. Christiansen or Dr. Tu would see someone who has a puppy who has no issues and then refer them to training for which they could then get reimbursed. Because as veterinarian, they would honestly say,we don't think this puppy has severe enough issues to warrant–
Briana:
Correct. Yeah. Luckily that's a situation that I haven't run into yet, you know, but that's something I'm always talking with clients with is like, okay, you're going to need to find out from your insurance company, what do they need to make sure that our services are covered?
Because say even that we're seeing a dog with separation anxiety, right. Something kind of minor, but existing. So they may not cover therapy sessions with us until they see a behavior vet. So that's where it's important to, again, just check with the insurance company to see what do they require.
Now I haven't had that situation come up before. Certainly I have had clients who tell us that they have insurance and are only signing up for therapy at this point, which in all honesty, I do think that they should cover those because I can get you in with a trainer or consultant much sooner than I can get you in with a behavior vet at this point. And oftentimes it's really important that we start the therapy now. Even if they end up having to see Dr. Tu or Dr [inaudible] in the future, we've got some therapies and basic stuff down that we're already working on.
So they should cover those. But again, I just encourage clients to please just verify with your particular insurance company and your particular policy, what they need to make sure that everything's covered. And these companies should be more than happy to help you out with that.
And like I said, there's always these pre-approval forms too. I get those sent to me all the time. I'll fill them out, send them back to you. You can send them back to your insurance and they'll be able to do what they need to do on their end to make their decision again, to give you that peace of mind that yes, we will cover this appointment for you. So that you're going in knowing that you'll get reimbursed for that.
Annie:
So you're saying sometimes — I was under the impression that usually people did see one of the doctors and then were referred to one of your trainers, but you're saying sometimes people start with the trainers before they have an appointment, or might never have an appointment with one of the veterinarians? But because those trainers are working for a veterinarian, the services are therefore covered, am I correct?
Briana:
Yeah, exactly. And back in the day, when we weren't as busy and it was like, okay, I can get you in with a behavior vet or the consultant both within a week. At that point, it's really the owner's choice. Like, do you want to start with therapy? See if you're making the improvements that you're hoping for that way. And if you are great, then you don't even need to see a behavior that.
Or if you really want to get to the bottom of this, if you're one of those gung ho owners, that's just ready to tackle the problem and do whatever you need to do, absolutely. We can get you scheduled with a behavior vet first and she can write the prescription over to the consultant. And then you guys can start therapy after that.
But given the nature of the business, that Dr Tu and Dr. Spann are booked out for about three months in advance right now, oftentimes we are definitely recommending starting therapy work immediately. So that way, you know, you can talk about relaxation exercises. There's a lot of things that consultants can do to try and manage the behavior as best as we can now.
I'm thinking specifically in those cases with dogs that are aggressive to children in the house, right? That's an emergent situation that we need to start working with right away. If they're not going to respond to the therap, the way that we had hoped, there's still a lot of things that we can talk about. How do we manage this from a day-to-day standpoint? Where's the dog when your babies and the high chair eating Cheerio's Where's your dog when the baby's in the bathtub, screaming? All of those things are very important to educate owners on as soon as possible.
So really it's the owner's choice, which route that they decide to go first. Nature of the business right now, I can get you in with a consultant much sooner than a behavior vet.
Annie:
It makes me wonder why there aren't more trainers working for non veterinary behaviorists who are clued into behavior to some extent? Would those trainers be covered? Do you think?
Briana:
If they worked for a non boarded behavior vet?
Annie:
Yeah, I mean, I don't know.
Briana:
No, because the facility has to be DAC VB. So, you know, what Annie is asking is like, there are veterinarians out there who are not yet specialized, and haven't actually taken their board exams to become a boarded behavior vet, but they may be a general medicine veterinarian who has a specific interest in behavior, but is not interested in going the full 10 to 15 year residency and becoming boarded as specialized behavior vet.
So those types of vets do exist. But from what I've seen from these insurance companies, it must be a DACVB facility in order for them to cover anything.
Annie:
So when you're working with people and doing the preapproval and dealing with people who aren't getting reimbursed, have you heard any like great wins or great horror stories?
Briana:
I mean, the majority of patients’ insurance claims seem to go pretty smoothly if I'm being honest. I mean, certainly there are those instances, where I have seen clients reach out, like my company's not wanting to cover the services again. That's where doing a pre-approval can really come in handy.
Because what these insurance companies are looking for is, number one. When did the client purchase the policy? Number two, when is the first mention in the primary vet’s medical records that this dog is dealing with any behavior issues, if your policy was purchased after any indication in the records about anxiety, I mean, any behavior word that's in there, it gets put into the category of preexisting condition, right?
We certainly have cases too, the owner will say, you know, Hey, I want to work on leash aggression. And they're trying to make that their primary concern, but come to find out like the dog has actually bit four people. So they're trying to work around the system a little bit if you will, in those cases.
And those can be a little bit difficult. That's when typically Dr. Tu or Dr. Spanno, I've seen them have to get on the phone with insurance companies before, help them out with the appeal process. Cause there's only so much we can do on our end. There's usually official appeal process, paperwork, and things like that, that any admin can help with.
But sometimes it gets to the point where the doctor actually has to call and chat with the insurance company. Okay. Why are you guys denying this claim? This is what I'm seeing from my end, blah, blah, blah. And then the insurance companies will make their decision from there.
Unfortunately, I have found that I have actually not yet seeing one appeal, be reversed. They're pretty diligent on their end as far as insurance companies go about. I have not really seen any appeal process that we have done over here, come out successful for the client. And the insurance companies are pretty on top of their stuff with knowing and you know, scanning those medical records with a magnifying glass to see if any of this was preexisting.
So again, we're happy to help with appeals process, but at that point, if you have been denied, it's most likely going to stay that way. So doing the pre-approval process to avoid the surprises where it’s like, wow, I really thought my insurance company was going to cover this while we didn't actually check. You know, so it's always helpful to check,
Annie:
But a client doesn't need like a referral to go to, to go to a veterinary behaviorist. Right?
Briana:
It depends on the company.
Annie:
Ah, okay. Well, that's interesting too. So some insurances are going to say your primary vet has to suggest this and others will…
Briana:
Absolutely. Yep. And that's not something that we need. We're not going to require a referral from a primary vet to treat behavior problems, because certainly we just have clients that found us online, just trying to do some research, get some help. So that's not something that we require as a business, but some insurance companies may want an official letter from the primary vet saying, Hey, this dog has problem A, B and C referring to behavior vets for help. And then they're like, oh, okay, great.
Annie:
It's possible you could go to your vet. Your vet could write in your file, This dog has severe separation issues. And then you get insurance and then you go to the veterinary behaviorist. And that would be denied because it'll be on the record as a previously existing condition.
Briana:
Yeah. I mean, it can actually be a little bit worse than that. Unfortunately, like I have seen a couple of cases where the owner was denied coverage and reading back through the primary vet's records, I saw like one sentence that had the word anxiety in it. And that in and of itself is enough to put it as a preexisting condition, unfortunately.
Again, it very much depends on the specific patient. You know, anxiety is a very general word. So it holds a lot of weight to it. Now if the primary that had something in the records like, it was starting to grow with the housemate, something like that, some of that can just be normal behavior. Right?
So that's where it gets frustrating from our perspective in working with insurances is like, okay, well, you can't ever expect a dog to not growl. It doesn't necessarily mean that that's a pre-existing condition for something that ended up being an issue, you know, months later. That's where it just gets tough. It's tough dealing with insurance companies because ultimately it's their call and it's whatever that they're reading in the primary vet’s records, all this can be figured out what you've done before they come to see us.
Annie:
One of the companies that I've been talking to, I asked them if they would cover veterinary behaviorists, and their response was it would only be covered if it was linked to a specific injury or illness. And I wasn't sure how to parse that. How would you interpret that?
Briana:
So to me, that sounds like that's a company that's going to want a referral from the primary vet.
Annie:
Illness could be mental.
Briana:
Exactly. Yeah. And that's a very general term, right. Where you're left going, Well, I really understand this insurance crap. Right. So what is, exactly what does that mean? But to me it means like they want to see in the primary vets records that like, Hey, this dog, I guess I see that it has a problem, and I want it to get over to behavior vets for treatment at that point.
As opposed to somebody, you know, who's like, oh, I haven't actually been to my primary vet in three years, because my dog is super aggressive and I can't go there, but now I want to seek out the help of a veterinary behaviorist.
Annie:
Sounds pretty iffy to me.
Briana:
It's all very iffy, which is why we just encourage clients to have that conversation with your insurance company about your particular policy. What do they need, what are they looking for? Because again, neither one of us, we don't work for these insurance companies. Right. We're just here to try to interpret as best as we can.
Annie:
Right. Do you have insurance for your pets?
Briana:
I do. Yeah. And I'm very happy with that. I have a dog and a cat, about nine and 10 years old now. And I started them both when they were very young and I'm so incredibly grateful that I did.
Annie:
So who do you have?
Briana:
I have Trupanion. I'm definitely happy to be a good advocate for that company. I absolutely love it. You know, my dog at a very young age, she just stopped eating one day. Come to find out she needed an endoscopy with biopsy. She's diagnosed with inflammatory bowel disease. She's going to be on medications for the rest of her life. Then she ended up needing a back surgery through a veterinary neurologist, which runs you about 12 grand out of pocket. And then she needed a second back surgery and then believe it or not, she needed a third back surgery as well.
So you know, that would have put me in a very difficult decision emotionally and financially. And, during all those times, if I could afford to treat my dog who I love very much. And same thing for my cat, she's got a lifelong illness and one of her medications is $200 a month that she's on. So having that peace of mind that I know that my girls are taken care of and I can pay my bills next month is just absolutely priceless. As far as we're concerned, we definitely recommend every client sign your pets out for pet insurance. It will be worth it in the long run.
Annie:
And do you suggest going then, given your experiences, for whatever the highest yearly limit is?
Briana:
Not a lot of them. That's where different insurance companies are going to come into play because some of these companies may have lifetime limits on specific illnesses. Some of them do not. Okay. So, I'm pretty happy with Trupanion. I don't have a lifetime limit per illness which is certainly great, but I have seen those companies that do have that out there. But again, it's all a pick and choose kind of what works for you, those types of things.
So either way, they're pretty helpful, but I really just encourage people to do their research when it comes to pet insurance. Again, I'm very happy with Trupanion. A lot of our clients use Nationwide. I've heard very good things about them. Pet's best, Pumpkin insurance, ASPCA insurance. I would say that those are probably the five top that we see over here.
But again, there's little ones popping up here and there all the time where I'm like, oh, this is a new company. Let me look into them, see what they're offering.
Annie:
Well, this has been so helpful. I've learned a lot. I think I might title this episode something like what is a veterinary behaviorist and will my insurance cover it?
Briana:
I love it. It sounds perfect to me.
Annie:
Kind of seems like it sums it up anyway. And are you in Denver or Boulder?
Briana:
Yep. I'm in Denver. I actually came out when, like, when we were just getting behavior vets, getting full-time a few years ago, and did a couple consults at School for the Dogs, met Kate, met a lot of you guys down there. Oh yeah. I don't know. I'm not sure where you were at that point, but yeah. I love it out there in New York and it's a great place to visit. I'm not sure I would want to live there. [laughs]
Annie:
All right. Well, I do hope that you'll stop by if you are in New York this summer and
Briana:
Yeah, I haven't seen your guys’s new place yet. I'd love to stop by.
Annie:
Oh yeah. Yeah. Well, for those listening, who don't know you guys, Behavior Vets used to rent space from us and operate and see clients from through us. I mean, at our studio, but not since we moved to our east seventh street location. Yeah. Definitely have to come see.
Briana:
Yeah. We’ve teamed up with the heart of Chelsea veterinary clinics. They've got three of them in the area and right now we see appointments out of their west 46th street location, which is their newest location.
Annie:
Awesome, great. They're a wonderful vet.
Briana:
Yes they are.
Annie:
We'll chat again soon, I hope. Thanks a lot.
Briana:
All right. Thank you so much, Annie. Have a great day.
[music and outro]
