The AMA’s 2013 CPT procedural code book just arrived in the Vālant offices, after a summer’s worth of anticipation around the hints and murmurs of the coding changes on the way for behavioral healthcare providers. You have probably been thinking “What 2013 CPT code changes apply to my psychiatric practice?” It’s not uncommon for hundreds of coding deletions and new additions to appear from year to year in the official CPT guide; however, when your historic pool of coding options has been represented by a few dozen codes, any changes to the coding guidelines for your specialty of care are a big deal and require your careful review and consideration. For mental health practitioners, 2013 is the year.
Last week it was announced that CMS, the governing body for the new HIPAA version 5010 transaction standards, has extended the compliance deadline to March 31, 2012. The Centers for Medicare & Medicaid Services' Office of E-Health Standards and Services (OESS) is delaying enforcing compliance in order to allow more offices the opportunity to implement this new billing coding standard, without incurring penalties. The 90-day delay does not affect the implementation date for the coding systems, which remains January 1, 2012 (January 1, 2013 for small health plans). Industry feedback played a major role in the decision to push back the compliance date. It was found that many covered entities are still awaiting software updates and were unable to meet the short deadline.
Fee agreements for your behavioral health care practice are critical because it helps manage client expectations, gives protection for providers, and saves time in the long run.
Customers will often ask me, “Why can’t I just use Quickbooks for tracking patient balances?” Well, the answer to that question highlights the key distinction any practice should understand between Quickbooks and a Practice Management Solution (an EMR or EHR):Quickbooks is an application that will give you the tools to better understand your practice at a Macro Level, and an EMR or EHR will provide you with tools to better understand your practice at a Micro Level.
There are some obvious thoughts about what it means to stay on top of your practice’s accounts receivable. At a very high level, this means having an understanding of revenue cycle management. The question is, how can you apply that concept to the effective administration of a psychiatric or behavioral healthcare practice?
As an undergraduate, I volunteered at a mental health clinic to gain experience in the realm of psychology. In that setting, I quickly became immersed into the world of insurance and mental health benefits. Every day, as the clinic collected copies of insurance cards, I needed to call and check on patient benefits to make sure they had coverage for behavioral health services. I would call various insurance companies and verify their outpatient mental health benefits. What I learned from calling the insurance companies and about insurance billing was that you need to ask some pretty specific questions in order to make sure that patient encounters are accurately and efficiently processed.
So you’re in charge of your own psychiatric clinic and have purchased a brand new practice management system to help run the day to day. You’ve decided to handle of the billing yourself because hey, how hard could it be? Anyone can bill insurance; it can’t be that hard, right?
In our overview of best billing practices for mental health providers, we mentioned that obtaining outpatient mental health benefit information prior to your patient’s first visit is one step you can take to make sure your office is operating as efficiently as possible – in this follow-up, I’m going to make the case that this is actually one of the most important steps you can take in promoting maximum efficiency in your office administration.
The decision of how to manage your practice's medical billing is a significant one, with many factors to consider. This helpful article, published by Software Advice, discusses the pros and cons of outsourcing a practice's medical billing versus keeping it in-house. The article compares the costs of both approaches, as well as the qualitative factors of each.
If you are a mental health provider practicing in Wisconsin and you are contracted with BlueCross BlueShield (BCBS), what do you do when and a patient walks into your office with their BCBS of Texas insurance card? Are you considered “in-network,” “contracted,” “participating,” or any other term that means the patient has chosen a doctor their insurance will recognize? If you bill their insurance, do you have to accept the allowed amount? Can you still send your insurance claims to the same BCBS office in Wisconsin that you always use?