WHAT EVERY THERAPIST SHOULD KNOW ABOUT INSURANCE
By Barbara Griswold, LMFT
Author, Navigating the Insurance Maze
April 25, 2023
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Hi everyone,
I hope by now you have heard that the federal COVID Public Health Emergency will end on May 11, 2023. If you missed my overview article about what this could mean for you and your clients, click here. [Spoiler alert: for most of us, the sky is NOT falling...] Today's newsletter has three articles that further address this topic, with a few important updates.
Do you have insurance questions, or could you use some feedback on your notes and treatment plans, or a little business or clinical coaching? Schedule your consultation now -- click here.
Take care,
Barbara
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MY NEXT LIVE WEBINAR!
"What Out of Network Therapists Should Know About Billing"
Saturday, May 13, 2023
2 HOURS: 11 - 1 pm PDT | 12 - 2 pm MDT | 1 - 3 pm CDT | 2 - 4 pm EDT
Can't make it live? Register and the recording will be sent to you
If you never join an insurance plan, you may feel you don't need to know how insurance works. But your lack of knowledge can hurt your clients -- and you. Your client's superbills may be denied due to your coding or billing errors. And if you haven't kept good notes, clients may not be reimbursed. Yes, even out-of-network therapists can have notes and treatment reviewed when a client seeks insurance reimbursement! In this webinar, we discuss what EVERY out-of-network therapist should know about billing, documentation, handling finances with private-pay clients, and ethical sliding scales. For more info, click here
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Want More Time to Get
HIPAA-Compliant? You've Got it
During the COVID Public Health Emergency (PHE), the government allowed therapists to use telehealth platforms like Facetime and the free versions of Skype and Zoom that are not compatible with the Health Insurance Portability and Accountability Act (HIPAA). Enforcement of penalties on providers for HIPAA-noncompliance was scheduled to resume on May 11th, at the end of the federal PHE.
Until then, the government will “continue to exercise its enforcement discretion and will not impose penalties on covered health care providers for noncompliance with the HIPAA Rules that occurs in connection with the good faith provision of telehealth.” But by August 9th, we all need to be using telehealth platforms that claim HIPAA-compliance and offer a Business Associate Agreement (BAA).
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Can a Client Waive the Need for HIPAA-Compatible Telehealth?
Question: “Dear Barbara, I have a client that wants to continue to use Facetime -- which is not HIPAA-compliant -- after the Public Health Emergency (PHE) transition period is over. Is this OK? My malpractice company says if the client signs a waiver stating that they are aware that the platform is not secure, it is OK to use these platforms. That is, if we have client consent, these video platforms are considered HIPAA-compliant. I was also told that phone sessions can be continued without any special waiver.”
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Practicing Across State Lines After the Public Health Emergency Ends
I really enjoy breaking down complex topics for you. But today I found a great article on the topic of practicing across state lines from the Telebehavioral Health Institute that really covered the most frequently asked questions.
Please keep in mind that even when seeing NON-INSURANCE clients in other states, you have to abide by the same rules.
Get answers to questions like:
- If my client lives in a state where I'm not licensed, is it OK to see them?
- What about my Medicare clients?
- What about private insurance clients?
- Will phone sessions across state lines be paid?
- What's happening with interstate compacts or "model acts" that allow interstate license portability?
To get the answers to these questions and others, read the full article from the Telebehavioral Health Institute -- click here
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WEBINAR: "WHAT'S MISSING FROM YOUR CHARTS: WRITING GREAT NOTES"
This recorded webinar is for all therapists, since we all can have charts reviewed by insurance, disability, licensing boards, and courts. Includes 8 note examples, 3 downloadable templates, and telehealth note requirements. For info, click here
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PRACTICE FORMS PACKET
Need forms for your practice? Get 20 essential forms including telehealth consent, couples consent, and Good Faith Estimates. Easy to customize. Designed to meet common legal, ethical, and insurance expectations. For info, click here
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WEBINAR: "THE FIRST SESSION: Juggling Clinical and Administrative Tasks"
This recorded webinar gives tips on juggling intake tasks -- to build rapport, take a history, while handling paperwork, payment and insurance issues. For more info, click here
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WEBINAR: "ARE YOU COMMITTING INSURANCE FRAUD?"
This recorded webinar answers all your questions about fraud and contract violations, including whether it is ethical to bill two insurance plans for a couples session, ethical sliding fees, waiving copayments, and how to avoid common types of fraud. For info, click here
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WEBINAR: "AUDITS AND RECORDS REQUESTS: WHAT EVERY THERAPIST SHOULD KNOW"
This recorded webinar is for all therapists, since even out-of-network therapists can have their notes requested by an insurance plan or other agency -- and can be asked to pay back monies already collected. Learn to prevent this. For info, click here
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WEBINAR: "HOW TO WRITE A 10-MINUTE TREATMENT PLAN"
This recorded webinar is for you if you hate writing treatment plans, worry about the ones you write, or don't write them at all. Learn how to write brief plans that satisfy legal, ethical, and insurance expectations, so you feel confident if you receive a records request, and won't have to pay money back if audited. For info, click here.
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WEBINAR: "WHAT EVERY THERAPIST SHOULD KNOW ABOUT INSURANCE"
This recorded webinar is for insurance novices, veterans, or even out-of-network clinicians. Topics include joining plans, billing, getting treatment approved, common mistakes. For info, click here
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WEBINAR: "COUPLES THERAPY:
BILLING AND ETHICAL DILEMMAS"
This recorded webinar covers thorny issues and common mistakes made when working with couples. It will challenge myths, clarify areas of confusion, and invite you to think about your policies. Find out more -- click here
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Audits and Records Requests -- FREE!
Sponsor: SimplePractice
May 3, 2023
12 - 1 pm PDT | 1 - 2 pm MDT
2 - 3 pm CDT | 3 - 4 pm EDT
Can't make it live? Recording sent to all registrants
What Out-of-Network Therapists Should Know About Billing
May 13, 2023
11 - 1 pm PDT | 12 - 2 pm MDT
1 - 3 pm CDT | 2 - 4 pm EDT
Can't make it live? Recording sent to all registrants
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Order the NEW NINTH edition of
Navigating the Insurance Maze: The Therapist's Complete Guide to Working With Insurance -- And Whether You Should
(buy from us directly -- Amazon keeps 55% of profits!)
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NEED INSURANCE ANSWERS?
- Considering whether taking insurance is right for you?
- Need help fighting a claim denial?
- Need help dealing with a records request?
- Want to build your practice, or discuss a case?
I CAN HELP. Schedule your consultation now-- click here
($150 for 50 min; $85 for 30 min.)
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DID YOU MISS THESE? Read these articles online:
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Barbara Griswold, LMFT
Author, Navigating the Insurance Maze: The Therapist's Complete Guide to Navigating Insurance -- And Whether You Should
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