Here’s everything you need to know about DENmaar’s new P2P Patient Payment Center!
New state-of-the-art technology has launched this month at DENmaar that is targeted towards filling the gaps of loss revenue for providers and groups in the behavioral healthcare industry.
We’re on a mission to increase the revenue or all of our clients, and to help them improve their patient satisfaction.
This year, we’ve made a lot of exciting updates to further our goals. We recently launched a new Paypal P2P feature (read about it here), and our latest upgrade adds additional patient capabilities to our RCM.
The new technology that has launched this month, has been added to DENmaar’s RCM, which allows for three new important features for patient billing, that will:
- Improve efficiency.
- Reduce time for staff and costs.
- Increase revenue from patient collections.
- Adds two more additional push to click and send statements to the PayPal P2P feature.
This update is incredibly easy to use, with icons made to send a P2P invoice, email statement or postal statement with click of an icon. We’ve also added color coded icons, which indicate the last time any invoice or statements were sent. The new automatic month-end invoicing system reduces staff work by auto posting payments made by credit card to your dashboard and to our RCM. The best part is that all of these premier features have been integrated into the current software, there is no additional cost associated with accessing them, they are included in our billing services.
This new feature targets anyone looking to improve patient billing of their group, specifically those experiencing frequent high revenue loss.
We’re proud of what we do! We’ve got a lot of technology innovation on the horizon — from artificial intelligence, to fintech and virtual reality — aimed to improve and evolve the behavioral provider landscape. Our commitment is to bring the latest tools to the insurance and patient billing and credentialing services we provide.
Have questions? Contact us by phone at 1-888-595-5101 or email us at email@example.com.Learn More
Every month we try to tackle a new software project and this month will be upgrading the co-pay section, creating a thorough Patient Payment Center. We will expand on the PayPal payment capability, making it smarter, showing icons only if email address is in system, and ready for send. We have had very good initial results, it is truly automated, depositing money in to your account and automatically recording the payment.
We will be adding an email statement button and a postal mail button a mailed hard copy. Icons will be smart, color coded showing when it has been 30 days since a statement was sent to help alert you to sending in a standard time frame, without over doing it. The mailed statements will be printed to our printer for mailing, alleviating offices of that burden. It is cloud based printing, an ability we now have by moving to AWS.
The payment entry will function like the Daysheet, when a payment is added it will flow below the entry area, as charges now do on Daysheet. An additional report will be available, a patient payment list by date.
I hope this will close the loop for patient responsibility, except until we create patient account login. That is a little more intensive development, so this will be a nice upgrade until then. We hope it will help in generating additional revenue. If you would like to add suggestions, please do so. It is easier to address during development, than adjusting after. This should be available Oct 1, then we will move on to other areas for improvement.
If interested in any of the below, or have input on features you would like to see, please advise
- Provider App.
- Therapy Notes
- Scheduler with charge to Daysheet confirming
- PayPal payment system
- Online Intake
The health care industry is just getting started with its use of apps and other technology. While we have a long way to go, here are some key ways apps are being utilized in health care now, and beyond!
Technology is revolutionizing health care and behavioral health one app at a time. OK, it’s not all about apps, but mobile and tablet applications are one piece of the technology pie that’s making patient management easier for providers.
Apps are in the frontier of their development and influence in the health care industry. In the not so distant future we expect to see apps that offer reliable patient monitoring, portals for clinical decision-making, prescriptions and even diagnosis.
While there are many ways apps are being utilized in health care, here are three of the key ways providers are using apps to enhance their practices right now.
Knowledge and industry news.
Aside from games, using apps to gather news and stay up-to-date on the best practices of any trade is a huge draw to apps in general. For example the APA Journal has an app that “with just a swipe of your finger, you can glide from article abstracts to press releases explaining the importance of studies. Journal subscribers can also access full-text articles, says Susan J.A. Harris, senior director of APA Journals.’It’s targeted to our researchers, clinicians and students,” she says. “We know they are very busy, so our intention was to have a product that would quickly and easily deliver the latest research to them.’” Check out the app by clicking here!
Most people are familiar with the use of apps for communication in health care and behavioral health. Video, voice and text meetings and consultations have become a mainstream norm. Many apps also offer a platform for all patient and business related communications like e-email and social networking. For example, according to the website apptentive, the app “Medici has made it possible to text with your doctor. The company set out to make health care more accessible for everyone, and they created two mobile applications, one for patients and one for providers. This allows patients to connect with providers in the Medici network for a fraction of the cost of going into a doctor’s office—and a fraction of the time.”
Revenue and health records management.
From accessing EHRs, patient information, history, coding and billing information, apps are evolving to be a one-stop-shop for providers to manage all of the backend information on their patients. The Denmaar app for example, is an active credentialing module that a provider can use just like they would their computer at home. Within the app, providers can manage all patient data, from payments to therapy notes.
Request a free, no-hassle demo of our app today, click the link to contact us!
You might have heard about our new peer-to-peer payment program. It’s a revolutionary way to pay! Here are 5 things you need to know about the new P2P program!
We are excited to be one of the only billing and claims services that offers an modern way to pay.
Our peer-to-peer program (P2P) integrates Paypal with our RCM, to create a seamless way for patients to pay, and to automate payment tracking for providers.
With our software, patients can make payments without any type of account, and can simply make a payment at the office or through an email link in less than a minute.
Here are five things to know about Denmaar’s peer-to-peer program.
The peer-to-peer program automates payment tracking and makes it easier for patients to make payments.
The P2P program is an automated patient payment system that uses invoices generated through Paypal. Payments can be made without any type of account requirement. When payments are made they are automatically recorded and reconciled on Denmaar’s RCM system.
The peer-to-peer program makes it easier for providers to get paid, and track payments.
Our RCM software lists patient balances. Now, there is an email icon next to each patient balance. Our system now allows providers to simply click the icon to send an email to a patient to make a payment. When the patient makes the payment, it is automatically recorded and updated to the RCM system.
Denmaar is one of the only billing companies that offers a peer-to-peer program.
Most software requires patients to access an account to make a payment. The P2P program eliminates this, and makes it easier for providers to use not only use billing technology, but to get paid. Most patients are similar with some type of digital payment system, which makes making payments nearly second nature.
The new peer-to-peer program is available now!
This new system is active, and is currently being tested!
The peer-to-peer program is available to all Denmaar clients.
Every Denmaar client can utilize the peer-to-peer program in any package they have with us!
Want to learn more about our peer-to-peer program or RCM software? Contact us by phone at 1-888-595-5101or email us at firstname.lastname@example.org.
Smart contracts are a high-tech, revolutionary system that claims to have the potential to completely change the current health care model. Here are five facts to know right now!
Smart contracts are another high-tech, revolutionary system that claims to have the potential to completely change the current health care model.
So what is is it? How can it impact health care exactly?
What are smart contracts?
Investopedia explains smart contracts perfectly:
“Smart contracts are self-executing contracts with the terms of the agreement between buyer and seller being directly written into lines of code. The code and the agreements contained therein exist across a distributed, decentralized blockchain network. Smart contracts permit trusted transactions and agreements to be carried out among disparate, anonymous parties without the need for a central authority, legal system, or external enforcement mechanism. They render transactions traceable, transparent, and irreversible.”
Coindesk.com also adds that:
“While a standard contract outlines the terms of a relationship (usually one enforceable by law), a smart contract enforces a relationship with cryptographic code.
Put differently, smart contracts are programs that execute exactly as they are set up to by their creators.”
What can smart contracts do?
The infographic above published by Medium breaks down the potential of smart contracts pretty easily, according to their infographic, smart contracts can:
- Automate and track transactions.
- Log patient-provider relationships that associate medical record.
- Offer viewing permissions and data retrieval instructions.
- Can allow providers to add a new record associated with a particular patient.
- Create automation notifications.
- Verify the proposed record before accepting or rejecting data.
An article by coindesk.com also notes that smart contracts can:
- Function as ‘multi-signature’ accounts, so that funds are spent only when a required percentage of people agree.
- Manage agreements between users, say, if one buys insurance from the other.
- Provide utility to other contracts (similar to how a software library works).
- Store information about an application, such as domain registration information or membership records.
So how can smart contracts impact the health care industry?
Aside from eliminating obvious human error-caused and communication bottlenecks, probably the biggest impact smart contracts could have on the health care industry, is that they can completely cut out the middleman and create much needed transparency between providers, patients, insurance companies and pharmacies.
Pharmacies currently control the cost and supply of most drugs. Unfortunately, they use this power to negotiate prices with drug manufacturers and insurance companies that benefit them, and not the consumer.
Smart contacts make it possible for the entire supply and price process of drug manufacturing and distribution to be automated, completely eliminating the need for pharmacy benefit managers and pharmacies.
Seperately, in an article in HealthIT Analytics, “Ramkrishna Prakash, CEO of TrustedCare, Inc., suggests that smart contracts could make it easier for providers and payers to share the quality data required to fuel value-based reimbursements.
‘The ability to seamlessly track and manage smart contracts in which the benefits can be redeemed with significant ease provides the necessary ‘carrot’ for providers and patients to actively engage in a symbiotic collaboration,’ he wrote.
‘In contrast, if one or more participants tend to misbehave, appropriate penalties, via liabilities, can also be levied with similar ease. This ‘carrot/stick’ approach, we believe, would provide the necessary push that is needed to shift the healthcare industry from a sickness-management mindset to a wellness-lifestyle mindset.’”
Ultimately, the draw of smart contracts is putting the power back into the hands of people, the providers and patients, not corporations.
Are you excited for the adaptation of smart contracts in health care? Are there more ways you think it will impact the industry that we didn’t mention above? Tell us in the comments below!
Many technology-related health care articles are related to cryptocurrency. Although you may have skimmed dozens of articles about it, there’s a good chance that you don’t quite understand it. But you wouldn’t be alone, even many so-called experts still don’t have a complete understanding.
So how exactly is cryptocurrency geared-up to revolutionize health care? First, let’s cover the basics to understanding it.
What is cryptocurrency?
Cryptocurrency is a decentralized digital cash system. For example, Bitcoin is a type of cryptocurrency invented by someone in the same way that someone invented paper money. However, unlike our centralized financial system that relies on banks, people exchange amongst themselves instead of the trust of the government. This takes power away from banks and government, and is instead ran by individuals and businesses.
Why use cryptocurrency?
Cryptocurrencies like Bitcoin are not only used the way cash is, they are traded as more of an investment and a way to make money, which is different than the way we use the dollar. Which is for better or for worse, depending who you ask.
“Bitcoin is not going to make government-backed currencies obsolete. But while the system’s virtues, such as anonymity and the lack of bank fees, may not matter much to most consumers, one can envision it being useful in a variety of niche markets (some legal, others not, like recreational drugs). Where anonymity is valuable, where trusted third parties are hard to find or charge high rates, and where persistently high inflation is a problem, it’s possible that bitcoins could in fact flourish as an alternative currency.” – MIT Technology Review
So, how and why can cryptocurrency be used in healthcare?
Health care, theoretically could be revolutionized by creating its own version of cryptocurrency, one that could be traded and exchanged between patients and providers for services and products.
For example, companies like Health Nexus have already invented “health cash.” The dental industry has created “Dentacoin.” Who’s to say that behavioral health and the pharmaceutical industries couldn’t create their own systems?
Imagine the decentralization of health insurance, pharmaceuticals, in and out patient care?
What do you think about cryptocurrency? Do you think it has staying power in health care? Tell us in the comments below!Learn More
So you’ve seen the headlines about how cryptocurrency could change health care… but do you really understand how? Check out our latest video for more!
Technology has catapulted the healthcare industry into an exciting era, and an even more exciting future. Here are some of the ways we foresee technology completely changing the healthcare industry in the future.
Healthcare is going mobile. We’ve read a lot about talk therapy and now it seems that more providers and independent companies are turning to apps and even wearables in an effort to revolutionize an industry tied together with rigid processes.
Technology in healthcare is a good thing. However, the fundamental problem and “learning curve” we will experience through this evolution is that technology is looking to build bridges between previously closed systems, and share sensitive data across networks in new ways.
Physicians are turning to wearables as new ways to track patient health, and for obvious reasons this seems like a viable way to better monitor patient health and take more of a preventative action against disease and other ailments.
It seems almost inevitable that behavioral and mental health care will eventually follow suit. Co-coordinating tracking physical health with mental health seems like the next step in improved overall patient care. As we learn that a lot of the time mental and physical health problems are linked with each other, and are not as entirely separate as we’ve previously believed. Mobile could help mental health professionals link-up with physicians, to create a much more well-rounded perspective of a patient’s health.
The problem comes with sharing this information. Doctor’s records and notes of patients are protected health information (PHI). Physicians may be weary to write about with patients. In the unfortunate event that a patient dies suddenly, or from an unforeseen physiological issue, physicians who were monitoring the patient data could, in theory, be held liable and sued for not noticing or addressing health conditions accurately.
But wearables could have their benefits. According to Health Data Management, “by 2020 monitoring from smart wearable devices may help save 1.3 million lives thanks to a reduction in mortality from cardiovascular diseases and obesity, according to Soreon Research, which tracks wearable healthcare systems. In fact, Soreon estimates that patients with chronic conditions will help drive the wearables market from $2 billion currently to $41 billion by 2020.”
Electronic health records (EHR) bring a different security issue to light. How safe is it to share extremely personal, not to mention federally protected information like diagnoses, medications, allergies, laboratory and test results etc. on a Smartphone?
While this may seem scary — in a world where we feel like hackers are always trying to reach their shadowy fingers into our data every time we turn out back, mobile devices aren’t more vulnerable than your desktop or laptop. It’s also safe to assume that as technology as a whole progresses, and our understanding of data and security matures with it, that we will be able to better protect information.
While we are eager to see the healthcare industry of the future, where patients meet via Star Wars-like hologram and we are able to be dosed our medications through some computerized form of vapor, it’s best to take things slow and allow for data and security strongholds to form before we rely on them to hold our most valuable records and personal information.
We are excited to be announcing the launch of our Provider Scheduler App this month, which will address scheduling, claims and billing challenges. In addition to that, we have many many exciting new projects in the works, however we believe in working tirelessly to make sure they work, and are secure before we put them in the hands of any of our clients.
Have questions about our new technology or revenue management, claims or billing services? Call us today! 1-888-595-5101.
Know your options when it comes to creating a CAQH profile, check out our latest video “Denmaar Decodes: 8 Things To Know About Creating a CAQH Profile.”
CAQH, the Council for Affordable Quality Healthcare, is a credentialing tool that houses self-reported provider data. CAQH is used by most insurance companies as part of the application process to complete one’s medical credentialing (i.e., to get on insurance panels). Most major insurance companies, like Aetna, BCBS, Cigna, Humana, Magellan and United Behavioral Health use CAQH as a part of their application process.
“CAQH solutions help promote quality interactions between plans, providers, and other stakeholders; reduce costs and frustrations associated with healthcare administration; facilitate administrative healthcare information exchange; and encourage administrative and clinical data integration.” – caqh.org
So, how can you enroll in CAQH and make sure your profile houses all of the information required by behavioral health insurance companies?
Enrolling in CAQH and getting a CAQH profile ID is the easy part. Filling out your profile and insuring all of the information required for the credentialing process is the hard part.
Here are a few things you need to know about CAQH:
- Prepare to spend anywhere from two to four hours to complete a new profile.
- CAQH does not specify exactly what information behavioral health insurers require for their applications.
- Behavioral health insurance companies require more detail and documentation than the basic CAQH profile.
- Pertinent documents are required to be up-to-date and uploaded; licenses, malpractice insurance, board certifications, W9, etc.
- If one part of your profile is either incorrect or your required documents are out of date or not uploaded, your credentialing application will be put on hold until your profile is fixed and reattested.
- Attestation is required every time you update your profile and should be done routinely as insurers require frequent reattestations.
- Denmaar Psychiatric Billing will develop your CAQH profile or review and update your existing profile as part of a one time fee of $350
Why choose a behavioral health billing company to do your CAQH profile? Because a reputable billing company not only does billing, they do credentialing too.
A billing company will be familiar with exactly what behavioral health insurers are looking for to ensure you go through the credentialing process as quickly and painlessly as possible.
Most providers don’t know what different insurance panels are looking for until they have already begun the credentialing process — when it’s too late. Requesting additional information and making corrections takes between 30-120 days.
Contact us today and let us handle your CAQH profile development: 1-888-595-5101, or email at email@example.com!Learn More
Understand the three key ways mental health billing and claims can be revolutionized by blockchain in under 50 seconds!
Before you can understand how blockchain is changing healthcare, specifically billing and claims and revenue management, it’s key to clearly understand what blockchain is. Here’s the definition according to Investopedia:
“A blockchain is a digitized, decentralized, public ledger of all cryptocurrency transactions. Constantly growing as ‘completed’ blocks (the most recent transactions) are recorded and added to it in chronological order, it allows market participants to keep track of digital currency transactions without central record keeping. Each node (a computer connected to the network) gets a copy of the blockchain, which is downloaded automatically.
“Originally developed as the accounting method for the virtual currency Bitcoin, blockchains – which use what’s known as distributed ledger technology (DLT) – are appearing in a variety of commercial applications today. Currently, the technology is primarily used to verify transactions, within digital currencies though it is possible to digitize, code and insert practically any document into the blockchain. Doing so creates an indelible record that cannot be changed; furthermore, the record’s authenticity can be verified by the entire community using the blockchain instead of a single centralized authority.
From that definition alone, it’s easy to gather how the complicated, highly confidential world of billing and claims and revenue management could use the help of a blockchain system. But let’s take a deeper look at some of the ways blockchain could change the game when it comes to billing and claims, and revenue management.
Anyone who has worked in billing and claims knows that it’s an imperfect system. There are dozens of opportunities for error.
Blockchain creates the opportunity to make all information accessible by all parties: insurance providers, clearinghouses and healthcare providers in one central space. This means that regardless of how many payer networks a provider is part of, or if a provider relocates or changes networks: only one system needs to be updated, and everyone uses it.
The idea of everyone accessing provider and patient data from the same central space would revolutionize the system and greatly improve billing and claims accuracy.
According to Lexology, 40% of payer’s provider data contains errors or missing information.
Blockchain eliminates the need for sitting on the phone for two hours to figure out that a patient ID number should have contained a “3” instead of an “E.” Or to figure out that a claim is being denied because at the time of service, the healthcare provider had switched networks.
In his LinkedIn Pulse article, David Houlding — Director of Healthcare Privacy and Security at Intel — explains that “any removal of a block, or tampering with the information stored within a block is easily detectable.” This key characteristic means huge opportunity when it comes to protecting sensitive data. However, he notes that in order for blockchain to be beneficial to security, a group or business must play an active role in implementing protective measures.
“In general blockchain does not automatically provide protections to confidentiality, or unauthorized access to information stored on the blockchain. In the extreme case of public blockchain all information stored on the blockchain is visible to anyone that cares to look. While this may be suitable for certain public health use cases, most healthcare use cases involve highly sensitive and lucrative information that is vulnerable to abuse, and therefore access to this information must be strictly controlled and limited to authorized organizations and individuals only. Supplemental strategies such as private and permissioned blockchains, encryption, and other safeguards can help control access to the blockchain and information stored on it, and mitigate risk of unauthorized access,” Houlding explains.
Have more questions about blockchain? Want to start using new software to improve your business? Contact DENmaar today at 1-888-595-5101, or email at firstname.lastname@example.org.Learn More
Artificial intelligence (AI) will begin to change nearly every industry in 2018. Here are three exciting ways that AI will improve behavioral and mental health billing and claims in 2018 and beyond!
2018 will a be a year where nearly all sectors and industries see the beginnings of the “futuristic” technologies that have graced headlines for the past few years. While we won’t see any dramatic, sci-fi interpretations of robots and artificial intelligence into daily operations quite yet, we will see the foundations laid for the world of tomorrow.
At Denmaar we are currently working on advancing our revenue management software to become more responsive. We are also in the final stages of adapting an app for managing billing and claims. As you’ll see in this blog post, we see these advancements as being essential to the future mental health billing and claims, and offering our clients the absolute best options.
Here are three key ways advanced technology will improve mental health billing and claims in 2018 and beyond:
Blockchain will increase the ability of computer systems or software to exchange and make use of information.
Blockchain has the potential to better manage data and records for mental health professionals. If you look at patient info as collected data, smart technology will eventually be able make your systems easier to manage by locating and organizing this data optimally. David Houlding, Director, Healthcare Privacy & Security at Intel explains the role of blockchain and potential perfectly in a LinkedIn article.
“Blockchains will augment such enterprise systems in the role of enterprise B2B network middleware, and enable secure exchange of minimal but sufficient data to enable specific healthcare use cases. in a given use case such as health information exchange the blockchain could be used to store metadata about healthcare records, enabling the blockchain to function as a “record locator service”. This in turn enables discovery of relevant records as needed by healthcare organizations across blockchain network, and subsequent point to point secure sharing of such records to enable improved quality of patient care, and reduced cost of care.”
Encrypted smart contracts will enable further expansion into secure contracting between many parties.
In an article for VentureBeat, Co Founder of Seal Software, Kevin Gidney says that he expects “that a merging of technology and standards will begin to occur in 2018, with the core functionality for intelligent contracts (IC) becoming available at the protocol level.” He explains that “this is already starting to materialize as smart contracts, which keep sensitive data encrypted at all times, have become available on the blockchain. End-to-end encryption and security can enable further expansion into secure contracting between many parties, and this key component of both IC and AI-enabled secure learning could see applications built on a new IC framework.” Encrypted, secure contracts has the potential to revolutionize the process and systems for mental health billing and claims. If adapted by the insurance industry, it can make the exchange of client information, transactions and payments quicker my minimizing the amount of steps in the process.
Artificial intelligence and machine learning will continue to use data to create
“Blockchain and smart contracts enable secure and efficient data sharing and processing across B2B networks of healthcare organizations, and these technologies pave the way for increased discovery and access to healthcare data across these networks to power AI and ML. As blockchains and smart contracts grow they will increasingly over time provide a foundation that enables AI and ML to fully realize their value to healthcare, radically improving the quality of patient care, while also delivering major reductions in the cost of patient care.” explains Houlding. Artificial intelligence will continue to learn, become stronger and utilize all of the data we collect and manage, and in turn become responsive. Intelligent software that recognizes codes, patterns with patients, and essentially researches and find answers to questions before you need to ask them could make the mental health billing can claims a near instantaneous process.
The alphabet soup of acronyms in claims and billing can be confusing to say the least. Which number/letter combo do you need? Which do you don’t? What do they really all mean anyway? In this video we help you understand the most used, and some of the most important acronyms to understand: EIN, TIN and NPI.
The holidays and the end of the year mark a season for reflection. Not just in our personal lives, but in our professional lives too. It’s the time of year to figure out what’s working and what’s not, and to make the necessary changes to keep your business moving on an upward slope of success.
One key aspect of analyzing potential changes for a practice is considering your current organizational infrastructure. Specifically, your billing and claims processes.
However, it takes time to institute a seamless billing process, several months may be required to fully make a transition. This is why working with and organization that understands and can implement this process is so important: it can save thousands of dollars right from the start.
If you’re considering making a billing switch, now is the time to make your move.
Currently we are waiving all payments for the remaining year for any group that switches their billing to our company. Get ready for 2018, get started now!Learn More
What’s the difference between medical and mental health billing? Why does having a specialization matter? This video explains the key differences between the two.
As technology integrates into all aspects of how we do business and how live, in hindsight it seems inevitable that virtual therapy would increase in popularity.
There are now a handful of prominent telehealth companies in the marketplace, one of them, Talkspace, just closed $31 million in Series C round funding to grow its company, according to MedCityNews.
With the ability to offer mental health services to people who would otherwise not have access to them, the next question is: is it covered like traditional therapy sessions?
The answer is yes and no.
Here is what you need to know if you are considering offering teletherapy.
1. Video sessions are more likely to get covered than phone sessions.
“The good news? There has been a steady shift toward laws that mandate insurance coverage of video sessions. Medicare and Medicaid have reimbursed for these services for over a decade in most states. The bad news? Plans typically don’t reimburse for phone sessions, and in some states, they may reimburse video only in limited conditions,” explains one mental health professional and health insurance blogger. However, she notes that “many experts suggest avoiding Skype, due to the lack of full HIPAA compliance. A list of some platforms that claim HIPAA-compliance (not just encryption) is at telehealth.org/video.”
2. Some services are more likely to get covered than others.
It’s important to know that “Even if a plan covers telehealth, coverage may be very limited. Reimbursement policies vary between insurance plans,” explains Barbara Griswold, LMFT on PsychCentral, “Your therapy is still subject to “medical necessity” treatment reviews by insurance plans.”
In the PsychCentral article, Marlene Maheu, Ph.D., Executive Director of the Telemental Health Institute (TMHI) explains that “Blue Cross may reimburse in one state and not in another… You also will need to be certified and contracted by the insurer, much like if you deliver services for managed care companies.” The article continues to explain that “most frequently covered services are diagnostic intake, psychotherapy, individual and group health and behavior assessment and intervention, neurobehavioral status exams, pharmacologic management, smoking cessation, and alcohol aftercare.”
3. Rates and billing ultimately work the same way.
Barbara Griswold, LMFT explains the process perfectly in her blog: “Use the same CPT code as you would have for in-person, but you’ll need to add a telehealth modifier after the CPT code (Box 24D on the CMS-1500 Form). For years plans have used the modifier GT, but there is a new 2017 telehealth modifier, 95, so you’ll have to contact the plan and ask which to use. Also, for the Place of Service code (Box 24B), put the number 02, which is the new code for a telehealth session as of January 1, 2017. Invoices/superbills should clearly state that it is a telehealth session and use the modifier. Remember: It is fraud to bill for a telehealth session in any way that would give the impression that it was a face-to-face session. How are phone sessions billed? As I said, they usually will not be covered, so shouldn’t be billed to the insurance plan. The CPT codes that exist for phone consultations start with 99- , and designed for medical personnel for brief between-visit questions or updates.”
4. Don’t even bother trying to hack the system.
It’s important to be upfront with the insurance company that you are in fact doing a video session and not an in-person session. “When sessions are knowingly mis-billed, that is, when information is intentionally misrepresented, such practice can be prosecuted as insurance fraud, a serious crime that can result in criminal charges being brought against you. Being found guilty of insurance fraud may include penalties that require you to reimburse the monies previously paid to you, and jail time,” explains Marlene M. Maheu, Ph.D.
5. What about text therapy?
The fact of the matter is that “only 38 percent of adults with mental health problems get the treatment they need. Of the two-thirds of those who are referred to therapy but never go, price is the main hurdle, as many therapists don’t take insurance,” reports Today. Which is why companies like Talkspace, GoLantern and BetterHelp have formed, offering text therapy for as little as $20 – $35 per week! Text therapy is currently not covered by any insurers that we know of, however the affordability fits into more budgets than traditional therapy sessions.
Note that just because a client’s insurance does not cover teletherapy, you can still “Draw up a Private Pay Agreement for the client to sign, stating they understand it is not covered, and will not be billed to insurance, and outlining the costs (a Sample Private Pay Agreement is in the back of my book). You should be able to charge up to your full private-pay fee for the service, since it is not a covered service,” explains Barbara Griswold, LMFT.
She also adds that if you are considering adding teletherapy to your list of services, that you should first get training in “for the different clinical, legal, ethical situations you may face, as well as technological and practical issues (ex. necessary forms and consents).”
For help with mental, behavioral and substance abuse billing, do not hesitate to reach out to us by calling us at 1.888.595.5101 or submitting an inquiry online!Learn More
Are you constantly behind in paying the bills? Do you not have enough money to meet your financial obligations like fixed expenses and paying providers? You might have revenue and cash flow issues. Here’s how you fix them.
August is traditionally a month of incredible highs. For many providers, August is often the best revenue month of the year; there are 23 business days and deductibles have subsided for most patients.
However, what comes up, must come down. September, which kicks-off with a holiday, is considerably slower.
These are the financial considerations to take in to account.
Here’s Why Revenue Drops In September
There are only 20 business days in September and vacations take a heavier toll on revenue than you may realize. Unfortunately, fixed expenses do not take a week vacation or get a last hurrah for the summer season. Rent, electric, air conditioning and all of the basis collect bills whether you, your staff or patients are there or not. In a way, the slump of September ends-up balancing out the income boost of August. It’s smart to roll August profits into September to cover possible losses.
How To Boost Financial Performance In September
What financials will advise you of how you will perform in September? By far open AR is your best indicator. Compare your AR from the beginning of August to the beginning of September. If AR was $100K going into August and it is now at $80K, it would be reasonable to assume a drop in September revenue.
Here’s an example from our dashboard.
Here are some tips for getting revenue into September receipts:
- Stress to slow-to-respond providers the importance of getting charges in to billing,
- Submit claims electronically and have EFT established you can have that claim paid in 1 to 2 weeks.
- Refocus efforts on patient balances, after deductibles have been met. Making payments arrangements will help in September, and taking care of them now will keep them from rolling in to 2018 when deductibles start anew.
There is nothing you can do about vacations, they come every summer, but you can improve upon your processes by stressing the need to submit billing daily.Learn More
A COB, co-ordination of benefits, is the insurance company requesting the patient to verify their insurance coverage with them.
Example: A patient has Anthem Blue Cross and claims are submitted to them as the primary claim. Anthem may keep the claim pending requiring the patient or member to contact them to explain whether they have another insurance plan. What Anthem is saying is they want to verify there is not another plan that may the patient’s primary plan and should therefore be paid first.
The patient MUST contact Anthem in this example, or they will not make payment. It may seem as just a way to avoid paying the claim. However, if you look at what may happen, and all too often does is, a patient comes in with an insurance and the insurance makes payments for the claims. A year goes by and they do a take-back stating there was another insurance that was primary. Now the patient has disappeared and can no longer provide that other insurance information to get claims to that other carrier.
Solution: A COB is easily resolved, a phone call from the member will take care of the issue. It may also keep the insurance company from doing a take-back down the road. A necessary but easy resolution to what could become a costly issue later.
Pro Tip: Always follow through on insurance requests, if a patient refuses to handle a problem do not continue and hope the issue resolves itself. Verify they have contacted the insurance company and resolved whatever the problem may be. Do not take their word for it, they will often say they called when they haven’t. Verify it.
Thinking of making the switch to electronic claim submissions?
The creation of electronic claims was not just a reaction to the rest of the world going digital — It was made to simplify the claims process and to make submissions quicker and more accurate.
While there are representatives you may speak to and unique circumstances that request submitting claims by mail, most insurance companies now allow for and actually encourage providers to submit claims electronically.
If you’re not using electronic claims, do you really know what you’re missing?
While there are dozens of benefits to adapting electronic claims, we’ve got three compelling reasons.
CMS 837 submission and 835 remittance standards.
CMS 837 submission and 835 remittance standards are basically a standardization to the forms a claims process for electronic claims.
Because of the confidential and sensitive patient information included in insurance claims, these standardizations were put in place to ensure the protection of patient information. The CMS has developed standards for both electronic claims submission and electronic payment retrieval. Anyone submitting claims electronically must meet these standards, making any claim created have a standard format. This is great because it puts everyone on the same page and leaves little room for interpretation when it comes to reading forms.
These forms also make the claims process much quicker. For many people managing claims, they simply submit these forms electronically and then await a check and EOB.
For the super-efficient, you can also reconcile your claims electronically. This is a little more difficult and not all insurance providers have the capability to send out payment information electronically, but if they do reconciling claims becomes a matter of minutes to do versus hours.
EFT eliminates delayed and lost checks.
Hooray direct deposit! Direct deposit means no more checks in the mail that can potentially get lost or be sent to a wrong address. Direct deposit also means that you get paid quicker and often funds are available immediately for use. Managing payments electronically also makes it easier to track checks and pull information if need be.
Cutting-edge and customizable software provides insurance payment information.
Most practice management software will provide you with detailed reports showing how a claim was processed. We use and share customized RCM software with all of our clients. RCM software acts as not only practice management software used for processing claims, it has also developed into a revenue cycle management program used in creating charges that we then use for claims processing. Additionally RCM software shows in detail how claims have been paid, displays a robust set of reporting and literally puts all of your claims information at your fingertips, not in stacks of paper.
Want to learn more about the benefits of electronic claims? Contact us today! 1-888-595-5101!Learn More
As we enter the last month of “summer vacation” we’re starting to see movement from the sleepy industry. We’re rolling-out our next major software update just in time for fall, so that our clients are armed and ready for the busy season. While many of us were enjoying the seasonal splendors of the years’ sunniest time-of-year, Congress was busy trying to repeal Obamacare.
Let’s dive into these changing times.
What Congress and the President did and didn’t do to the Affordable Care Act.
Inaction on the insurance healthcare front is a better alternative to countless uninsured patients if you are a healthcare provider. Maybe a bipartisan approach can produce improvements rather than the complete appeal and replace that we were facing.
For further reading on this topic, read this article in the Washington Post.
Exciting Improvements to Our Technology
On our RCM product, we will see additional improvements towards the standardized defaults to the system; with the ultimate goals always being to provide staff with time efficiency and error reductions. This month’s focus was on insurance default modifiers, the improvement to this has eliminated the need for us to add on claims.
Automating the addition of a standard modifier will allow for one less piece of information to be added to certain insurance claims. This is mainly required by certain Medicaid’s and CMO’s. Another improvement is standardizing the supervisor field for a patient, so that supervisor is on all claims. The financial dashboard will include the ability to see the number of new patients for the month and separate out revenue by locations. This additional information will allow for better visibility on which providers are getting the new patients, and if there is follow through with subsequent therapy. Seeing the location breakdown will also be a nice way to determine how each location is performing.
Common Billing Problems We’re Eliminating
Issues we run into that groups and facilities can relate to are the challenges in setting up electronic remittance for the variety of payers. Between this setup requirement and contracting with insurance we seem to spend almost as much time on the setups for our clients as we do on the claims process itself. There isn’t any standardization in the insurance industry, although CAQH and the two largest clearinghouses Availity and Emdeon (Change) do help with streamlining the setup process, it is still time consuming and disjointed.
Other issues we seem to come across constantly are the way providers organize themselves, both with the Internal Revenue Service (IRS) and the insurance companies. These problems arise from using social security numbers for some insurance, employee ID numbers (EIN) for others and then switching between using individual and group National Provider Identifier Standards (NPI).
We see the need to improve in the software area for obtaining the data we need accurately and efficiently as a requirement that demands a near-constant evaluation. We also value helping groups and providers establish and maintain themselves correctly with insurance so we can then process claims as efficiently as possible, the ultimate goal being paid claims and cash flow that allows the group to both pay its bill and be profitable.
Providers: Have you been hearing talk about peer-to-peer payments and how they can be used for patient payments?
Want to know if this is really a viable way to have patient’s make co-payments? Watch this week’s Tuesday Tip to learn everything you need to know!
Are you a provider who’s losing 40% of your potential revenue from simply not re-billing rejected claims?
According to the Centers for Medicaid and Medicare services 26% of all claims processed are rejected and 40% of those claims are never re-billed. That’s a pretty big revenue loss. Get the facts in this week’s Tuesday Tip!
Are you concerned that if you enforce your payment policy as you should, it will turn your patients away? This couldn’t be further from the truth! Learn why you should in today’s Tuesday Tip!
Did you know that medicare requires a deductible? Today’s Tuesday Tip covers what you might be missing.
EAP is a hassle, however it may be a necessary part of your practice due to the insurance you are contracted with. If you are trying to grow your patient/client base, EAP can also help with that too! Learn everything you need to know in this week’s Tuesday Tip!
Did you know if you enter the same CPT code on the same date of service you are more than likely doing something wrong?
Did you know that if you are using the same CPT code more than once for the same date of service you are more than likely doing something wrong? Watch this week’s Tuesday Tip for more!
By now you’ve probably heard of RCM software, here’s what it can really do for your healthcare business.
Want to simplify your workflow while making your business more profitable? By now you’ve probably heard of RCM software, here’s what it can really do for your healthcare business.
Enrolling in ERA / EFT for every insurer I am contracted with is very time consuming. Is there an easier way to do it?
By: Michelle Husted
In my last blog I introduced you to a little town in West Virginia across a tributary from Kentucky and the serious opioid epidemic that is decimating this already economically struggling town, not to mention the whole state of West Virginia; a state that needs help to curb the pharmaceutical profits that are feeding this disease, and needs federal resources to overcome and survive this pervasive plague that is spreading across the nation.
West Virginia is the state with the highest opioid deaths in the nation where over 10% die from addiction. I didn’t mention that 5% of the babies are born addicted as well. These little victims are born with neonatal abstinence syndrome. It is no fault of theirs that they came into the world this way, but oh do they suffer the consequences of the opioid epidemic. Malfunctioning nerves cause all their muscles to cramp and spasm, they are left with fluid in their lungs that doesn’t allow the little air sacs in their lungs to properly fill with oxygen, they suffer from vomiting, inability to eat properly, tremors, hypothermia, irritability, sensitivity to sound, light, and touch and suffer from withdrawal. These are just how they suffer as newborns, with treatment they can usually go home in 30 days under the watch of Health and Human Services, as long as the parents are able to care for them.
NAS babies can be born to mothers who are trying to get their lives back on track and are under treatment for their addiction. Methadone is a popular drug in the treatment to wean their addiction. With cuts to the federal budget, though this may not be a choice anymore for them or their babies who are also treated with methadone, avatan and clonidine.
In Huntington West Virginia there is a residential recovery home that is the first of its kind in the country, called Lily’s place, that was founded in 2014. It is the only one in the nation to date that houses mothers and their addicted infants. Babies are monitored through their recovery and withdrawal, by medical staff and Child and Protective Services. Lily’s place is a little less than an hour away from Kermit W.V. along the Ohio River, nestled in the crook of the Tri-State area of Ohio, Kentucky, and West Virginia. These are three of the four states with highest opioid deaths in the nation.
With the government’s desire to reduce the national deficit over the next 10 years, some of the proposed cuts that relate directly to the opioid epidemic are:
-States can opt out of basic Services (That the Affordable Care Act required)
Drug & Mental Health treatment
-Health & Human Services: 12% of Medicaid recipients suffer from opioid abuse
-Drug Control office funding cut by $364 million.
-Doing away with HIDTA, The High Intensity Drug Trafficking Areas (HIDTA) program,
Created by Congress with the Anti-Drug Abuse Act of 1988.
We don’t know what each of these babies will face down the road with health issues, learning disabilities (note education cuts), or the need for Health and Human Services to be involved in their developing lives. But we do know that to alleviate their suffering the question we need to ask is “Why?” Why are they born this way? Why didn’t something get done to stop the influx of pharmaceuticals? Why won’t they continue to fund the Federal Drug control office? Why will these be the tiniest victims of our proposed Federal Budget?Learn More
Should I set up my practice as a sole proprietorship or incorporate? What are the pros and cons?
As a provider you want to be as helpful to your patients as possible. However, when it comes to giving patients an exact quote for services, it can be tricky. Luckily, there are ways around the looming unknowns of coverage, and simple ways you can prepare your patients with decent estimates.
Have you just been told that your contract with an insurance provider has expired? Without any warning or notification?
Watch this week’s Tuesday Tip.
By: Michelle Husted
Kermit West Virginia, is a little town in the heart of the Appalachian Mountains and coal country. With 392 residents of most German and Irish descent, Kermit shares a border with Kentucky made up of a tributary off the Big Sandy River. A railroad bridge built to carry coal links them across the fork to the town of Warfield where they do most of their shopping. The town was named after Theodore Roosevelt’s son, Kermit Roosevelt. A peak area to live decades ago when the coal mines were alive. Now the area has a median household income of $31,000, and most struggle to make ends meet.Learn More
Are your applications being denied even though you have a CAQH profile? Make sure you’re checking-off these three important things when you’re trying to get an application approved.
By: Michelle Husted
Recently I decided to attend a local, one day healthcare technology conference. It was a day full of innovative upcoming and tried and true technologies. Some of the interesting topics were biometric integrated medicine along with teletherapy.
Just recently it was revealed that Apple is working with biometrics to monitor diabetes through the use of technology. Having this biometric reminder in the news reminded me of my day at that conference.Learn More
What is a clearinghouse and how can it be used in mental and behavioral health billing? This week’s Tuesday Tip explains…
Most providers know that by now they’re “supposed” to offer electronic payment options for patients, but did you know that not doing so can result in lost payments? This week’s Tuesday Tips video explains the importance of payment options…
By: Michelle Husted
First let me say that is not just you mental health providers, but all types of providers as well as hospitals. Would you walk out of Target without paying? No that would be shoplifting. So why do so many patients feel it is ok not to pay their deductible or copay when they visit their mental health provider?Learn More
When it comes to mental health billing, is there an “easiest” remedy to the claims process to increase first claim insurance payment? the solution is simpler than you may realize. Watch this week’s Tuesday Tip.
Just because a claim is denied, doesn’t mean it’s time to throw in the towel. Dozens of different fixable errors can cause a claim to fail to go through. But how long do you have to resubmit that claim? Check out this week’s Tuesday Tip to learn more.
Your CAQH profile is vital to claim accuracy and overall claim success: Learn why in today’s Tuesday Tip!
By: Michelle Husted
With the repeal of the Affordable Care Act and the planned implementation of the American Health Care Act (AHCA) looming, many are concerned about healthcare coverage changes. Some of the primary areas of change was Pre-existing conditions, and those young adults who are under age 26, the ability to get coverage under the umbrella of their parents health insurance while they are pursuing their education and/or starting their careers. After much back and forth the past few months it seems that those areas will be protected.Learn More
There’s a saying in the technology industry: Garbage in equals garbage out. See how it relates to claims processing and payments and what you could be doing to improve your flow in this week’s video!
Wonder what a COB is? Are you never able to resolve this issue? Here’s why.
There’s a quote that says: “People with goals succeed because they know where they’re going.” Goals are the cornerstones of success, and that includes the success of your practice. Do you know where you’re going with your billing company?
By: Michelle Husted
We have heard a lot this Presidents day weekend about healthcare, Trump spoke on it Saturday in Florida, Kasich spoke about it yesterday. People are nervous, some are happy. But no one knows many facts, many of the descriptions of what will be are vague, or are worded in a way that they seem to benefit the people, when they may, in fact, not.Learn More
Let’s face it, United probably won’t be changing anytime soon, so choosing to stay or go is a choice that depends on your end game as a provider.
Is your AR out of control? This week’s Tuesday Tip explains what is normal and when it’s time to get some help.
Most insurance plans are calendar based, meaning they start January first. Although, there are also many plans that are fiscal year based, meaning they can start any month of the year. When you are an in- network provider you are limited to the allowed amount in your contract per procedure code — so, collect that amount. This amount includes the co-pay and co-insurance.
One of the biggest things holding providers back from switching billers, is the uncertainty of the transition. There a couple things to look for in any legitimate billing company to ensure a smooth transition without any negative consequences. Check out our video for more!
By: Michelle Husted
A new year and many changes, one of these will be the exceptional growth of E-mental-health/Telepsychiatry. This was addressed in the Mental Health and Parity Act of 2008, and in the past nine years it has been slow to take shape due to differences in every state, every insurance and with Medicare and Medicaid. There are questions that have different answers for all of those groups, such as: Visit limits? Copays? And standards for privacy and confidentiality.Learn More
One huge perk with technology is the ability to communicate whenever, wherever! Between: facetime, social media, virtual meeting tools, Skype and the good old-fashioned telephone; you can choose contractors, employees and business partners based on what their experts in, not where they’re located.
Most insurance plans are calendar based, meaning they start January first. Although, there are also many plans that are fiscal year based, meaning they can start any month of the year. When you are an in- network provider you are limited to the allowed amount in your contract per procedure code — so, collect that amount. This amount includes the co-pay and co-insurance.
By: Michelle Husted
On January 20, a new president will be sworn into office. This past Friday Congress certified Trumps electoral victory.With him in office as our new president, this year we will see lots of changes. Though not all will be immediate, already with new representatives in office, we have seen some of those changes begin to take shape.Learn More
Why collecting outstanding deductible balances at each session is the surest way of being profitable
Collecting deductibles is a less than enjoyable task, that if you let get out of hand, can result in loss of revenue. Submitting claims quickly and electronically can guarantee that your business continues to grow!
We’re in a complex ever-changing industry, and if you’re not contracted with the right insurance providers, you can lose a lot of revenue. Don’t fall out-of-the-loop! Check out today’s Tuesday Tip, and contact us with any questions you have about billing and claims today!
What is the one common mistake that can lose you 3 to 6 months of claims reimbursements? A mistake that can cost you time and money? Not having your CAQH profile up-to-date! Check out this week’s Tuesday Tip for more! Our staff is very knowledgeable and experienced with the CAQH ProView Credentialing database. We offer clients the service of reviewing their current CAQH profile data to determine what the issues are and corrections required. Also, at the client’s request, we perform the updates to their CAQH profile!
By: Michelle Husted
It is that time of year again! Calendar year deductibles kick in on January 1. Some deductibles can be up to $10,000! When we submit your psychiatric billing claims we will be able to see right away if the deductible has not been met. We are able to check eligibility when we submit claims. So we are able to tell pretty quickly if there are issues with the insurance information your patient has given you.Learn More
Although at times it may be difficult, collecting copays is a vital part of running a successful practice! Take on the mindset of your regular physician, and never let copays slip through the cracks — As this can result in lost revenue. We are up-to-date on all technology available for practice management, our free software allows for immediate claims creation, submission and view of claims status!
By: Michelle Husted
Most insurance does not cover couples therapy. Couples are about are about a relationship and the people’s behavior in the relationship. The relationship is what needs therapy, therefore most insurance to not treat this as a medical necessity, and will deny it.Learn More
The new platform for our health and behavioral health coverage.
By: Michele Husted
Now that the election is over and our new president has been elected, one of the topics of worry and discussion is health care for our nation. Health care is obviously one of the primary areas our country needs to keep a priority, including mental health care.Learn More
With technology advancing so quickly over the past several years, it is easy to use our cell phones, Ipads or other devices while on the go to send patient information back and forth. Although simple and easy to use, it may not be HIPAA compliant. If you were audited, would you be?Learn More
On October 1, 2016 flexibility in ICD-10 Diagnostic Coding expired. Those of you using electronic remittance may have already seen some denials coming back. CMS’ one-year grace period to use unspecified codes is finished. Non-specific codes, like the codes used when converting ICD-9 to ICD-10, are no longer supported.
- CD-10-CM was developed by the Centers for Disease Control and Prevention for use in all United States of America health care treatment settings.
- ICD-10-PCS was developed by CMS for use in the U.S. for inpatient hospital settings ONLY.
Providers should be coding to reflect as much specificity as possible, New terminology aligns with the DSM-5, and also new Diagnosis that were added to Chapter 5 of ICD-10-CM 2017. The new updates require you to produce codes with more precision and specificity. ICD-10-CM Diagnoses Codes: 3–7 digits Digit 1 is alpha Digit 2 is numeric Digits 3–7 are alpha or numeric (alpha digits are not case sensitive)
For example if you code F43, ICD-10-CM F43 is a non-specific code, that is, there are codes below or above this code that have a greater level of detail. Here is an example of a new code that is specific: ICD-10-CM F42.9 is NEW 2017 ICD-10-CM code that became effective on October 1, 2016.
This code diagnosis is A disorder characterized by the presence of persistent and recurrent irrational thoughts (obsessions), resulting in marked anxiety and repetitive excessive behaviors (compulsions) as a way to try to decrease that anxiety.
Or you may want F43.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. This is stress related to Post trauma.
F43.0 is billable but below that you have the choices of F43.1, or F43.10, -F43.12 the more digits after the decimal the more detail you are giving about your approach and the symptoms.
Diagnostic coding can have up to 7 characters. The first character, in our case “F” is the section of the the manual (Mental Health) the second character a number 0-9 describes the specific disorder; for example orders with onset in childhood or adolescence will always start with F followed by a 9, anxiety disorders will always be an F followed by a 4 and so on. But these are not specific enough.
Lets use this example, substance abuse will always fall under F10-F19 the second character will always be “1” the third character then gets more specific with the type of substance such as F14 “4” signifies cocaine use. Then we have the decimal followed by even more description. F14.1 is cocaine abuse, but more specifics will show the symptom/ approach such as F14.1 cocaine use F14.10 is mild
→ mild F14.10
→ amphetamine, cocaine, or other stimulant intoxication F14.12
→ without perceptual disturbances F14.129
As you see each character after the decimal shows more and more specific information about the diagnosis and treatment of the patient.
There have also been disorders changed and added for social and eating disorders; Some disorders used to fall into a physical category but have since been regrouped as falling under a mental disorder after being recognized as the mental disorder being the primary diagnosis at the visit. Diagnosis such as Excoriation or PMS type mental disorders have changed to Mental Health categories. The following is a table of some of the new changes:
We follow up on all claims until they are paid, and if there are issues with coding we try to contact you to get more specific diagnosis before they are submitted thus lowering you chance of a denied claims. Michelle Husted. If you are in need of billing for maximum reimbursement contact us here at Denmaar Psychiatric Billing 1-888-595-5101Learn More
Some of you, once you become an independent provider may at one time decide to add to your staff to encompass a wider range of services and to provide for a growing practice. Do you at this time you have a growing client list and would like more practitioners to help with the services provided to your patients? Here at Denmaar Psychiatric Billing we have providers that we assist with their growing practices billing questions, including delegation of services. Delegation of services is allowing non-physician, therapists, LCSW’s, & LPC bill under Physician level NPI and provide therapeutic psychological services.
One advantage of delegation of services is that through Medicare, they are paid at 100% of the physician fee schedule, as opposed to to services provided by a non-physician, which is reimbursed at 85%. As long as you, the rendering provider share the same office suite and are on the building property at the time of treatment, you may allow delegation of services to a non-physician provider after the initial diagnostic treatment.
Different states have different requirements for their own definitions of independent and supervised providers. Delegation of Services is not to be confused with Licensure Supervision; which each state requires a certain number of supervised hours, after applying for a permit for supervised counselling, in order to graduate before applying for licensure by that state’s board. In the Case of delegation of Services, the non-physician provider has already completed all the hours, graduated and applied for and received their licensure from the state. “Even if you graduated from an approved education program, you cannot practice until the limited permit has been issued. If you practice before receiving a limited permit the experience will not qualify for licensure and you could be charged with illegal practice, a class E felony.”
In the case of delegation of services with Medicare the non-physician do not have to be enrolled separately in Medicare, which is a huge perk as, we see how long the credentialing process can take. The non-physician can bill under the Medicare providers NPI number.
The requirements for delegation is that the attending provider must see the patient first and oversee the care plan. They don’t have to see the patient regularly but must have brief interaction with the patient at regular intervals and review documentation. The provider must be one of the following: Doctorate or MA level Clinical Psychologist, Doctor or MA level Clinical Social Worker, Clinical Nurse Specialist & Nurse Practitioner.
The provider must provide Direct Supervision to the non-physician practitioner . By direct supervision it means that the claims are always filed with the physician providers NPI, the provider is in the building at the time of service, (doesn’t have to be in the same room) and must share the same office space (ie, business mailing address) The attending provider does not have to be the provider who initially saw the patient and oversees the care plan.
The provider may not delegate to someone whose qualifications exceed their own. But the non physician practitioner can bill under the physician’s CPT codes. For example an LCSW who has been delegated services by a Doctorate of MA Clinical Psychologist/Social Worker, Clinical Nurse Specialist or under a Nurse Practitioner can bill with the following CPT codes: 90785, 90832, 90833, 90834, 90936, 90837,90838, 90846, 90847, 90849, 90853 & 90899.
Here at Denmaar Psychiatric Billing we have experience with providers who delegate Services and can assist you with the billing for your non-physician staff, and help with the accepted CPT’s by the insurance carriers you are panelled with.Learn More
“It’s unwise to pay too much, but it’s worse to pay too little. When
You pay too much, you lose a little money – that’s all. When you pay
too little, you sometimes lose everything, because the thing you
bought was incapable of doing the thing it was bought to do. – John Ruskin
This past spring one of our clients decided to leave us. We didn’t like it one bit. The head of the group is a psychiatrist and in a couple of years, we had helped him grow from just himself to a bigger practice, even flying across the country to meet with him and did research for him to ensure proper coding for PA billing the current script laws in his state as well as overseeing therapists.
When we took him on, his credentialing was a mess. Blue Cross we had to go back and forth with for months and finally we got everything running smoothly, he added staff. We did more research to ensure he was in compliance with the methadone rules as well as prescription rules and we had his AR down to only 10% which was terrific considering the volume.
Well, as is always the case, someone comes by and whispers something in your ear, things you want to hear, that makes you think that the grass will be greener on the other side. You think you can do better, they are telling everything you want to hear-right. So you decide to leave- He left us. It hurt, we had put the time in, we fixed things, we made everything smooth.
Guess who is back after 5 months? Yes after that other billing company approached him and offered lower rates and what he thought he wanted. But guess what? Those little percentage points he thought he would save by going with them, ended up costing- A LOT. Tens of thousands of dollars in lost revenue, in only a four month period. His AR exploded to $240,000 from $60,000; with over 60 days at 50%.
So, yeah he called, he wanted us back, we took him back, and we are working on getting things to how they should be.That’s what we do here at Denmaar Psychiatric billing. We make sure that we are working and doing all we can to make sure your billing needs are being fulfilled~Michelle Husted- Give us a call:1-888-595-5101Learn More
There are no set standards of reimbursement rates across the board because each state has its own industry standards for for reimbursement based off of medicare, not only each state but also within each state reimbursement varies based on the provider’s level of education, location, and license as well as each each insurance carrier and the type of insurance each patient may have. For example because someone has United Healthcare Insurance doesn’t necessarily mean that they have mental health or substance treatment benefits, as these are optional to a medical policy.
Most carriers consider reimbursement based on “unit” billing. The reimbursement is To be billed with appropriate license-level modifier, as applicable to the service and time provided. CMS has a physician’s fee schedule on their website. You can also join the American Medical Association and go on their sight to understand how reimbursement units work. For example Anthem Blue Cross reimburses 90791 based on modifiers that are used in conjunction with it. (again based on license level AF,AM,U3,SA,AH,AJ,U8,HO,U4,U1,U2,HN,U5)
Here is an example: in Kentucky, for CMS 90791 Psychiatric diagnostic evaluation Physician (MD or DO) with Modifiers: AM, AF reimbursement is $94.84 APRN or Licensed Clinical Psychologist with Modifiers: SA, AH is $80.61, Licensed Masters-level (Supervisor) Modifiers: HO, AJ, U9, U6 the rate is again lower and reimbursement is at $75.87.You can download your own CMS fee schedule as well as looking up the fee schedule for your particular state to evaluate your own situation based on the services you are providing to get a better understanding of reimbursement rates across the board.
Some insurance companies pay poorly, but many pay quite well.. Usually the larger private insurance companies: Aetna, Blue Cross, Blue Shield, and United Behavioral Health Regardless of the reimbursement rate, it’s important to stick to the time limit provided in a service’s CPT code.
Without special permissions, the rule is normally one session, per patient, per day. However, if you call the insurance company, you may be able to receive authorization for more than one service per day. Special circumstance: if you have a psychiatrist on staff, it is completely acceptable for the psychiatrist to provide one service, and then you (the counselor) to perform one service, totaling two services.
Typically, with most insurance companies, a basic office visit, therapy session, even the initial session, do not need authorization;“United behavioral health denies claims without authorization for 90837 and refuses to give the authorization unless you use a particular type of treatment that they deem appropriate for only a few diagnoses. They also reduced their reimbursement for 90791
Some insurance companies like Blue Cross of Massachusetts allow up to 12 visits without authorization, and then providers are required to get an authorization for the next 12.
So lets review how you are reimbursed:
- The type of insurance the patient has is number one- call before seeing the patient to verify benefits
- What level of education do you have as a provider? The more educated you are, the higher your reimbursement
- Location, location, location- think of it as you would a meal per diem, you will be reimbursed higher if your practice is in Beverly Hills than you would in Brimfield Ohio.
- What is your licensure? Using appropriate modifiers will get you the most reimbursement based on if you are PA or a DO.
Here at Denmaar Psychiatric Billing we can make sure that you are getting the best reimbursement by using the appropriate CPT codes, modifiers and add ons.Learn More
Research the job market in Mubaii, Chennai, Vellore, or Delhi India and you will see thousands of job listings for call center, medical billing, “voice processing” & accounts receivables. It is not just your credit card or online ordering service that is offshored anymore.
These workers have to be available to work rotating shifts from day to night sometimes one shift following the other. They need no education, and are not familiar with American medical coding. Here is a sample of a current posting.
|Eligibility||Any Graduate – Any Specialization|
|Role||Associate/Senior Associate -(NonTechnical)|
|Salary||1,00,000 – 3,25,000 P.A|
Most medical billing companies in the U.S. have taken the lazy route, and decided it is just easier to offshore their follow up to claims to low wage workers overseas, and not do it themselves, or create local jobs to boost the local economy.
Companies such as Medphine, Avantha Billing Services, Athena Health, Bristol Healthcare services, Allzone Management Solutions, are just a handful of the scores of billing companies that are more concerned with industry “fools gold” sending the hard work to India rather keeping it in house where they can ensure customer satisfaction and a “under one roof” family team environment, that offers personable service and client satisfaction. Here is part of a current ad on Wisdom.com “XOL Med RCM Services Corporation, Arizona (US) based Medical Billing/RCM Company requires senior Medical Billing professionals for the position of TEAM LEADERS at their Chennai office.”
What is the big deal you may say, who cares? Well you will. Do you know that companies like Kareo still charge you 4-9% of overall collections? Do you know that they service over 35,000 providers? That they don’t focus on one type of billing? What kind of service do you think as a mental health care provider going to receive when you have questions about your claims with your billing company, when each time you call you will talk to a different associate who knows nothing about you or your practice, and may be a challenge in communicating with?
You may think that 4% sounds like a good deal, until you realize that is the starting rate, and everything is an add on. Patient statements are extra, data import is extra, and some places charge you a fee of $295 a month just for use of a cloud server. Our fees include everything. There is no extra for this or that. What you see is what you get.
“With a relatively narrow window during which the workdays of India and the United States overlap, it can be difficult getting the answers you need when you need them. When that happens, a question that can be answered in five minutes by a colleague in the next cubicle might take until the next day. In fact, a one-day turnaround might be optimistic. If your problem or question is not understood, the back and forth can result in days passing before a problem is resolved — a disastrous situation for a project-critical issue.”
Here at Denmaar we pride ourself on keeping our provider list manageable so we can offer personal assistance to our mental health care providers. We Keep our training and focus only on mental health care. We will never outsource and pride ourselves on creating jobs here in the U.S. especially for our family. Having a family business means we want to have high customer satisfaction. Not an assembly line of faceless providers. Give us a call- The owner of Denmaar will be happy to chat with you-Michelle Husted.Learn More
Are you advertising to target clients in need? This is a great time to take ads out in your local paper to focus on clients who would benefit from your specialty. This is the most stressful season of the year, back to school/ bridging facing the holidays. This is your best time to to get new clients in your office, or contact clients who were too busy over the summer to keep their visits with a friendly reminder call to book an appointment. If you are doing a google ad, you can change it to make the focus of “Back to school”. Here are some of the needs of the back to school crowd:
Parents: Back to school blues and more stress for parents. After being with the kids all summer their schedules free up somewhat to resume office visits, as well as address the stress of being an empty nester of a college student or having sent the baby off to kindergarten. New schedules and additional expenses can leave parents stressed and harried. Back to school spending has grown 42% over the last 10 years. Having more than one child and a long list of back to school supplies and uniforms/ clothes/ gym outfits can leave parents with sticker shock. .
Other stresses of parents along with schedule juggling are worries about their own childhood experiences. Worry may only increase your child’s anxiety and be a projection of your own experience. Research has shown that mothers of middle schoolers may face the most stress. This is a transitional time as children become tweens, going from elementary school to trying to be a teenager and continue to high school. Because of puberty and physical development, children can be very emotional and at times irrational during this period. Also the added stresses of making decisions of their “adult” future, needing particular classes to fulfil academic requirements for high school is an added stress at this time. There is more branching out into specific interests and new peer groups. A study done at Arizona State University found that Across the board, mothers of only middle-school-age children reported the highest levels of stress, loneliness and emptiness, and also the lowest levels of life satisfaction and fulfillment.
Children: May face adjustment disorders if they have had a move or are attending a new school. Stressors may affect a single child or adolescent, an entire family. Some stressors may accompany specific developmental events, like starting school the first time or failing Treatment may be needed as well for children with with ADHD helping them, their teachers as well as the parents find proper behavioral strategies that can help the child to become focused on learning as well if medication is needed. They may need coverage during school hours and beyond, to help her deal with homework, after-school activities, social relationships, Other patients may suffer from childhood emotional disorders such as conduct, developmental disorders such as autism or anxiety disorders. It may be found through testing that they suffer from dyslexia or speech disorders and while they may get therapy at school, it can cause added stress to be singled out and pulled out of class a few times a week to go to “Special Ed” It is good to form a network with pediatricians as well as family care practitioners, and primary care doctors to get referrals since children need back to school annual well checks, vaccinations and physicals- This is usually where the parent voices their concerns over the child’s issues and the doctor recommends an evaluation and gives the parent the name of a reputable psych/therapist.
College students: College students face many of the same challenges that they did when they were younger. Meeting new teachers, new peers and trying to do well. They face many many additional challenges as well as they struggle with learning to be independent adults. While most continue to be dependent on mom and dad there is so much that they suddenly must always be doing for themselves.Adapt to living with a stranger and their habits, cooking for themselves, doing their own laundry. as well as work and study and take care of their own transportation, shopping etc. Success in college is a huge undertaking.
The stress of college has its own mental health issues. Here are the top 5 as listed in Best Colleges. Depression, Anxiety, Suicide, Eating Disorders & Addiction. In January a student jumped to his death on the first day of the spring semester according to suicide.org. The second leading cause of death for college students is suicide, according to suicide.org. And the number one cause of suicide for college student is untreated depression.
College is very stressful and those stressors can also lead to addiction, whether it be abusing stimulants to try to juggle a demanding course load along with internships and jobs, or the peer pressure of the social scene. Some try new drugs out of curiosity and unfortunately become addicted to them.
Research conducted by the National Alliance on Mental Illness on mental health on college campuses shows that:
- One in four students have a diagnosable illness
- 40% do not seek help
- 80% feel overwhelmed by their responsibilities
- 50% have been so anxious they struggled in school
As a mental health care provider you can help any of these people reach their potential by reaching out and advertising in your local paper, higher learning institution, church newsletter, community bulletin board. As well as targeting these conditions on your google ad. Getting your name to local physicians for referrals can make all the difference in any of those facing their back to school issues.
Here at Denmaar Psychiatric Billing we can make sure that all your back to school diagnostic codes are correct for each insurance carrier’s specifications before they are submitted. Give us a call for questions about billing for your back to school patients. 1-888-595-5101 Michelle Husted.
Further reading:Learn More
Whether you are a psychiatrist, psychologist, social worker, mental health care nurse practitioner, or therapist….being on your own means growing your own practice. Are you doing all you can to be a successful behavioral health care provider?
Here are a few ideas at how you can be successful at growing your practice:
Get Listed – Get your URL listed on as many free directories as possible, especially the Psychology Today Find A Therapist directory. Social Psychology Network Directory , Directory of National Associations of Psychology, Healthgrades Find a Clinical Psychologist.
Networking & Referrals – Mail post-cards to specific family care/general practice/ or pediatricians (depending on your specialty) Or better yet take a handful and schedule an appointment to meet a few Drs. to establish a referral relationship. Many behavioral healthcare appointments are made through primary care referral.According to the law of reciprocity, when you give, you receive,” says Larina Kase, PsyD, MBA, a marketing psychologist and author of The New York Times best seller The Confident Speaker, among other titles. “When you provide true value for your referral partners, they do the same for you. The value you provide needs to be authentic and the giving needs to be from a place of inspiration—without necessarily the expectation of something in return right away.”
The Big Four-Get paneled. Are you panelled with Aetna, Blue Cross/ Blue Shield, Cigna and United? All these insurance carriers have provider directories that is another way for patients to find you. If you do your billing with Denmaar Psychiatric Billing we can assist you with all the tools you need to do so.
Get on Google – Google is the #1 search engine in the world. You need to be easily found on Google and Google Maps. When you are looking for something online what do you do first? You Google it!. If someone is looking for a special type of counseling or someone close to where they live they will google it too! Make sure you are on Google maps, as well as Google my Business .
Associations– Join Associations such as the American Psychological Association. Not only will you get great tools for your practice, you have the opportunity to join educational webinars, and understand the current tools for the trade. Not only that, but when a patient sees the additional memberships on your wall, they will feel more comfortable that you not only graduated but are a member of a reputable organization.
Keep your patients happy Engage in behavioral engagement strategies such as contingency management and motivational interviewing. Give them a warm welcoming environment. Call them: with a reminder phone call the day before, or a follow-up to a missed appointment.
Form one time workshops or support groups. This is a great way for you to break into meeting new potential clients. Place an ad in the local paper for a planned Tuesday night group meeting about a specific topic. Make it free. Plan it for a few months down the road. Have a sign in sheet to record the name and email, and follow up with an email a week later to the attendees. It can be on eating disorders, mindfulness, or for bipolar spouses, for example. Those who need tools to cope with living with a family member with mental health issue can benefit from therapy as well!
Webpage– Do you have one? People love to look over webpages as they make decisions and check out a potential provider. A good web page is not overly complicated. When people search for things like “marriage counseling” You want to have keywords most relevant to your specialty and the types of patients you serve. The more those words appear on your Web pages the higher up key words. As a mental health care provider they shouldn’t just relate to what type of care or clients you serve; you should specify zip code, city and region as well. Here at Denmaar Psychiatric Billing we can assist you.Learn More
S.524 – To authorize the Attorney General and Secretary of Health and Human Services to award grants to address the national epidemics of prescription opioid abuse and heroin use, and to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes.
On July 8, 2016, Democrats conceded and were no longer opposed to what is known as “The Opioid Abuse Bill” Now that it has passed through the House, it should get signed next week by President Obama. This bill contains 31 Different acts relating to drug use oversight, and implementing laws relating to opioids; those affected, prescription monitoring, disposal, help for veterans on pain killers and many other acts related to opioid use and trafficking.
Congress was originally split on this bill, because of questions how it could possibly be supported with funding. Original opposition to the bill was because of this lack of funding. There still some questions, but Democratic leaders like Nancy Pelosi “signaled that she would support the bill on the floor Friday. She said she hopes the bill “is just the first step” and that the GOP will commit more funding “in the very, very near future.” There is a proactive delve to provide emergency funding because of the detriment of this epidemic. Part of the funding includes $50 million to expand access to substance use treatment providers, which would help approximately 700 providers .
~28,000 Americans died from painkiller/heroin/ opioid overdoses in 2014
–six out of ten drug overdoses involve opioid misuse
~Each day, 44 people die in the United States from an overdose of prescription painkillers, according to the Centers for Disease Control and Prevention. Drug overdose is now the the leading cause of accidental death
~Between 2000 and 2014, fatal overdoses increased by 137%.
~In West Virginia, fatal overdoses increased by 473% between 2004 and 2014
~New Hampshire, which has the third worst fatal overdose rate, drug deaths increased by 670% between 2004 and 2014
Here are a few of the Thirty-one acts that recently passed related to this bill:
On May 16, 2016 The Transnational Drug Trafficking Act became Public Law S.32 No: 114-154
On July 7, 2016 Authorized the Attorney General and Secretary of Health and Human Services to award grants to address the national epidemics of prescription opioid abuse and heroin use, and to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes. S. 524 Rule H. Res 809
On April 27, 2016 The National All Schedules prescription Electronic Reporting Reauthorization Act Was placed on the Senate calendar and is a part of the Opioid Bill that passed this week. S.480
On July 7, 2016 H. R. 1818– Veterans Emergency Medical Technician Support Act of 2016, was included as part of the Opioid Bill
SAMHSA makes grant funds available through the Center for Substance Abuse Prevention, the Center for Substance Abuse Treatment, and the Center for Mental Health Services. Find funding opportunities that support programs for substance use disorders and mental illness, and learn about the grant application, review, and management process.-Michelle Husted
On July 5, 2016 a new docuseries The Fighting Season will air on the Audience network. This docuseries is first hand view of combat through the helmet cams of the soldiers. The series shows only a percentage of the combat situations, and daily stress levels the soldiers live with ( view fighting season trailer)
Not only the soldiers, but those that they have left behind, face a great deal of stress from being a an empty nester letting your baby go off to war, to a single parent taking care of all the home and family responsibilities by oneself, the wondering, the fear, and if their loved one will come back in one piece or at all.
All those involved have mental healthcare needs. TRICARE, formerly known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), is a health care program of the United States Department of Defense Military Health System. Tricare reimburses well and is worth considering getting panelled with for you to be able to aid in serving the soldiers and their families.
Below are some statistics of those returning in recent years with troubles of PTSD, suicide risk, & alcohol and drug abuse. Following those is the link for you to look at forms with TRICARE, and how you can become a TRICARE provider.
- As of September 2014, there are about 2.7 million American veterans of the Iraq and Afghanistan wars
- According to RAND, at least 20% of Iraq and Afghanistan veterans have PTSD and/or Depression.
- PTSD is the third most prevalent psychiatric diagnosis among veterans using the Veterans Affairs (VA) hospitals.”PTSD and comorbid AUD”, Subst Abuse Rehabil. 2014; 5: 25–36, Ralevski, et al.
- Over 260,000 veterans from OIF and OEF so far have been diagnosed with TBI. Traumatic brain injury is much more common in the general population than previously thought: according to the CDC, over 1,700,000 Americans have a traumatic brain injury each year; in Canada 20% of teens had TBI resulting in hospital admission or that involved over 5 minutes of unconsciousness (VA surgeon reporting in BBC News)
- Recent statistical studies show that rates of veteran suicide are much higher than previously thought, as much as five to eight thousand a year (22 a day, up from a low of 18-a-year in 2007, based on a 2012 VA Suicide Data Report). Contrary to the impression many media articles give, veteran suicide rates, although definitely higher, are not astronomically higher than civilian rates. See New York Times 2013 article, “As Suicides Rise in US, Veterans are Less of total,” by James Dao.
- PTSD distribution between services for OND, OIF, and OEF: Army 67% of cases, Air Force 9%, Navy 11%, and Marines 13%. (Congressional Research Service, Sept. 2010)
- Recent sample of 600 veterans from Iraq and Afghanistan found: 14% post-traumatic stress disorder; 39% alcohol abuse; 3% drug abuse. Major depression also a problem. “Mental and Physical Health Status and Alcohol and Drug Use Following Return From Deployment to Iraq or Afghanistan.” Susan V. Eisen, PhD
- More active duty personnel die by own hand than combat in 2012 (New York Times)
If you are interested in serving active military, their families, & veterans in crisis and with suicide prevention and the other issues that are a result of their duty click the link below.-Michelle HustedLearn More
2016 a proposal was presented on behalf of CMS to change the current physician payment schedule and replace it. The final rulings will be available November 1, 2016, with implementation taking place on January 1, of 2017.
Currently, behavioral health provider organizations can qualify for meaningful use incentive funds only through the current definition of eligible professionals, which includes physicians and some nurse practitioners that are affiliated with their facilities.
“Generally, the Privacy Rule applies uniformly to all protected health information, without regard to the type of information. One exception to this general rule is for psychotherapy notes, which receive special protections.” 1 “The Privacy Rule defines psychotherapy notes as notes recorded by a health care provider who is a mental health professional documenting or analyzing the contents of a conversation during a private counseling session or a group, joint, or family counseling session and that are separate from the rest of the patient’s medical record.”
According to the Department of Health and Human Services’ (HHS) documentation covering frequently asked questions related to the management of protected health information (PHI) and psychotherapy notes: If providers were required to extend extra protection to a patient’s mental health records, which are to be considered part of their general medical record, then HHS would have made a clear distinction between mental health records and the general health records. Instead, the definition was drawn between psychotherapy notes and the medical record. 1 HIPAA Privacy Rule Information Related to Mental Health
MIPS, or Merit-based Incentive Payment System is the proposed physician fee schedule that would repeal the Medicare sustainable growth rate. Being a merit based system would mean monitoring physician performance and increases or penalties would be based on this performance. Areas of performance measurement totaling to 100 are as follows; quality would be fifty percent, advancing care information twenty-five percent, clinical practice improvement activities fifteen percent and use of resources ten percent. One of the areas of performance is the integration of physical and mental health.
The performance score earned at the end of the year would adjust a provider’s payments from CMS for the second year following the performance measurement(2017 performance will influence 2019 payment year) either with an increase of up to four percent of Merit earned is 100, or with a penalty of -4% for if merit earned is zero, through payemet years 2019, increasing to +5%/-5% for 2020, +7%/-7%for 2021, and +9%/-9% for 2022. The merit score for each provider is also available to the public.-Michelle Husted.
(PQRS) was a voluntary program for reporting to CMS (Centers for Medicare and Medicaid). Starting in 2013, it’s mandatory, and penalties will now be imposed on non-reporting physicians, including psychologists. If you are enrolled in Medicare under the clinical psychologist designation, have an NPI number, participate in the PECOS program and are reimbursed by Medicare under the Physician Fee Schedule (PFS), you must begin reporting certain quality measures to CMS starting in 2013 or you will start to be penalized in 2015.
‘Behavioral health and primary care differ in their language, classifications, codes, data reporting requirements, and regulations’
Current standing of Helping Families in Mental Health Crisis Act of 2016
( Congress is on Vacation July 16 – September 6)
July 14, 2016
Read twice and referred to the Committee on Health, Education, Labor, and Pensions
|7/14/2016||Senate||Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Type of Action: Introduction and Referral
|07/07/2016||Senate||Received in the Senate.
Type of Action: Introduction and Referral
|07/06/2016-4:16pm||House||Motion to reconsider laid on the table Agreed to without objection.
Type of Action: Floor Consideration
|07/06/2016-4:16pm||House||On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 422 – 2 (Roll no. 355). (text: CR H4301-4318)
Type of Action: Floor Consideration
|07/06/2016-4:06pm||House||Considered as unfinished business. (consideration: CR H4333-4334)
Type of Action: Floor Consideration
|07/06/2016-2:45pm||House||At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.
Type of Action: Floor Consideration
|07/06/2016-1:51pm||House||DEBATE – The House proceeded with forty minutes of debate on H.R. 2646.
Type of Action: Floor Consideration
|07/06/2016-1:51pm||House||Considered under suspension of the rules. (consideration: CR H4301-4325)
Type of Action: Floor Consideration
|07/06/2016-1:51pm||House||Mr. Murphy (PA) moved to suspend the rules and pass the bill, as amended.
Type of Action: Floor Consideration
|07/06/2016||House||Placed on the Union Calendar, Calendar No. 517.
Type of Action: Calendars
|07/06/2016||House||Committee on Education and the Workforce discharged.
Type of Action: Committee Discharge
|07/06/2016||House||Committee on Ways and Means discharged.
Type of Action: Committee Discharge
|07/06/2016||House||Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 114-667, Part I.
Type of Action: Committee Consideration
Action By: House Energy and Commerce
A career as a mental health care provider is two-fold, you do it to help others and to earn a living. Unfortunately many providers will do the “help others” part, and not collect the money that is due to them. There are a variety of reasons that providers do not collect fees for services they render. A single provider may not have an office person to verify insurance and fail to collect copays and fees up front. A larger office may assume there have been no changes to a regular patient’s insurance, and not find out until a few weeks after the new year and the claims that were submitted are rejected.
The best way to to ensure payment is to collect up front. Specifically with new patients verification of benefits is your way to get paid for the services you render.
We all have gone to the doctor or taken our children to the dentist, or even been to the emergency room or had a hospital stay. When you go for any medical treatments, they will ask you for your copay up front. Even as you lay in a hospital bed a person from their financial department will visit you bedside while you have needles in your arm, are in pain, and hand you forms to sign for your financial responsibility for services you are receiving.
Here are areas that providers show their financial health:
–Point of Service Collections including co-pays and deductibles, especially after January first-this needs to be addressed. Some will go so far as to have a patient sign a loan for current and future service, so that you have a legal document to ensure patient responsibility for services they are receiving.
–Days in A/R
–Bad debt write-offs and the percentage of gross patient revenue
-Denial write-offs and the percentage of gross patient revenue
Here at Denmaar Psychiatric Billing we work with you to ensure high compensation for your work with you patients. We are trained and certified to ensure you have used correct codes based on treatment and the insurance carrier being billed. We take the team approach- while you work directly with the patient, we offer the following:
- MTD income, open AR, patient balance totals displayed.
- Authorization expiring soon chart gives instant information so a new authorization can be obtained.
- Insurance revenue for last 12 months shows each insurance company by revenue generated.
- Provider Revenue to date and Open AR by provider.
- Provider claims activity for past 6 months and average claim dollar.
CLAIM DENIAL MANAGEMENT
- Denmaar provides client with tools to assess and manage claim denials.
- Using our systems clients can easily identify and correct both front-end errors and back-end rejections, allowing for rapid reprocessing.
- Back end scrubbers identify errors. Billing process adjustments can be identified to reduce rejections.
- Utilizing denial management solutions, clients are able to prevent future denials, in turn accelerating reimbursements and improving A/R days.
Give us a call to let us help you perfect your Revenue Cycle Management-Michelle Husted
For further reading: 7-Strategies Revenue CycleLearn More
In January Business News Daily published an article on the benefits of hiring a medical billing service. They weighed the pros and the cons, and overwhelmingly there were many more pros than cons.
“Medical billing services can help alleviate that burden… for a percentage of your
collections or a a medical billing service can take over your revenue cycle
management and free up your staff to focus on other tasks. A good medical
billing service will increase your collection rate, reduce rejections and denials,
and even provide an analysis of your accounts receivable. You’ll typically be
able to generate on-demand reports and view your day-to-day finances through
the company’s software as well. At best, outsourcing your revenue cycle
management can result in more money for your practice without allocating
your own staff to complete the arduous tasks of coding and billing. But how
can you possibly know which billing service to trust with something as important
As your revenue cycle management?
We at Denmaar Psychiatric Billing would like to answer some of the questions expounded on in the article including; area of specialty, training, services, support, patient engagement, remote hosting & professionalism. If you are considering hiring a biller for your psychiatric/therapy needs we are an American company that does no outsourcing, all of our work is done in house.
Area of specialty:
We focus 100% on Behavioral Health billing and any associated fields including substance abuse, in or out-patient mental health services, neurological testing etc.This enables us to narrow our focus and stay up to date on changes in legislation as well as training specifically in the psychiatric field.
Our staff has been involved in claims & accounts management for over twenty years.
They have also stayed up to date with Credentialing, including
- ICD-10-CM Behavioral Health Specialty code set.
- Member American Association of Professional Coders
- Member Healthcare Information and Management Systems Society.
Online access to our practice management system is provided, with no additional costs incurred by clients. Providers see revenue increases.
- 24 hour electronic claims processing, electronic claim remittance and direct deposit of funds improves cash flow. Claims paid and funds deposited into client bank accounts in as little as the same week.
- Electronic insurance claims payment posting, patient statement generation, and unpaid claim resolution for therapy, E/M, medication management, psychological testing and substance abuse for both inpatient and outpatient settings.
- Secure online practice management accessible 24/7, allowing executive staff to view financial data in real time. Constant practice performance updates.
- Easy and accurate charge creation, point and click increases efficiency and reduces errors. Authorization controls, CPT code verification of insurance payment reduces denials.
We follow up on all claims. Claims may be missed by insurance carriers or set aside if there are problems such as incorrect date of birth, lapses in insurance or other issues. We stay on top, and are in constant contact with insurance carriers to ensure proper handling of claims.
We also provide readily available analytical data and reporting that provides a view into the daily operations of your practice. With dashboard style reports you can quickly access your provider revenue and AR to date.
We email financial statements, invoices and allow for easy payment of patient balances with debit/credit cards through a merchant account at no additional fee.
Remote Hosting & Costs
We take care of all software and hardware that is needed and manage all system updates at no extra charge, thus eliminating your additional costs for a server. All clearinghouse fees and portal access are included in the costs of our services.
With all your needs met through us we look forward to any questions you may have after reading this article. Click the link below for the full article-Michelle Husted.
A mental health care provider asked us recently how she could get more patients. She has been in practice for decades. She was in practice before modern technology edged its way into the business world- before cell phones and before even pagers. To see what she was doing to reach potential patients, I did some searches for her online- todays yellow pages.
The first thing I did was look for her in Psychology Today since they push lot of articles on Facebook, targeting users to whatever their current life issues may be. I looked in her zip code on their “Find a therapist/psychologist” search tool. She wasn’t listed. So she wasn’t getting her name out there even with that.
But what the real shocker was that just in that zip code alone there were over 200 mental health care providers- and these were only the ones listed with that particular publication- meaning there are probably at least 50% more out there who, like her aren’t even listing themselves where a reader can come across her practice.
Then I searched for her online- nothing. Not even a Healthgrades page, and that is with me searching for her by name. We know her name, and could look specifically for her. A future patient does not, and only looks for what they are specifically looking for, for example “troubled teen, Toms River” this is how people look for the help they need, unless they are getting a specific referral from a pediatrician or Family care provider, and that’s even if those mental health providers are even taking new patients. (Which is another topic on it’s own, some providers have such a full load they can’t even take anymore because they have made sure they have gotten referrals, networked and gotten their name out there-as opposed to this particular situation).
When I searched for “Psychologist, Toms River New Jersey”. The first thing that pops up on the top of the page is a Google Map with the pin locations. People are visual and so the map catches their eye first. So this is what they will look at first before even going down the listings below. Do you know there were only 3 major ones pinned on google maps?! Of these three, only one, ONE had a website.
Are you invisible on the internet or are you one of the three that easily stand out? “First of all, say the experts, stop stereotyping yourself. Obviously, with background and experience…it’s important to realize that others have had similar experiences, But that’s just a starting point for building…” You really have to show that you are different from the other 300 mental healthcare providers in your area.
We here at Denmaar have all the tools to help you get your name out there from web page design to helping you with Google Small Business tips. Because you want local patients you will advertise differently than a company that does more than local business. You don’t need to advertise for people searching in China. You goal is to keep your advertising in your perimeter so those future patients can find you. We at Denmaar Psychiatric Billing are family operated. We have professionals with experience in Media online content, customer service, and years and years of insurance billing experience. Our family wants to help you Stand out and put your best foot forward.