Did you know that some insurance companies require a note to be completed, sealed, and signed within 24 hours? If this doesn’t make you anxious - you are rocking it and kudos to you for getting your note practice down! Seriously, this deserves a celebration.
If this made you a little nervous to full blown panic - listen up! I want to make sure you aren’t making this mistake with notes, insurance, and billing that could leave you vulnerable to letting your hard earned money go out the window or be vulnerable to a clawback.
I wanted to share one common mistake with you that I have seen practices do a 10/10 job training staff, contractors, and employees on how to avoid, and some practices that literally had no idea this was a thing aka - they were unintentionally making this mistake on the regular. And this mistake? It’s all about timeline. Let me backup. When I started my private practice and contracted with my biller, one of the first conversations we had (beyond my overflowing gratitude for her helping me to navigate and demystify contracting and credentialing) was when she would bill out for my sessions. Specifically was there a time of day or week that all the sessions completed would be billed out? So first things first, different med records have different settings. Some you need to manually enter in the billing code you used and confirm the session, and others will default to the code you entered when you made the appointment. For the med records where you need to manually enter the billing code and confirm the session there is a little more protection for this error than the ones that have a default code. How often do you have a client down for a 45 minute session only for it to turn into a family session with client present? OR you were planning a full 60 minute session but the client was running 15 minutes late so now it is a 45 minute session? OR the client no-shows but you don’t have time to check it as a no-show until the end of the day. Changes happen in the way we bill all the time. Now, where this mistake comes in is that the insurance companies are not just paying for the session. They are paying for the package. Let me break this down. Insurance companies are paying for you to provide mental health therapy treatment (in accordance with the diagnosis in your diagnostic assessment and goals in your treatment plan) along with a note that clearly documents exactly what happened in session. The package is both the note and the session. If your session is billed out before your note is complete (in the words of one of my good friends who is one of the managers at a giant nonprofit agency) it is considered insurance fraud because the “package” isn’t complete. Yes, you provided the service but if you haven’t documented it (according to the insurance company, and probably your licensure board) - it didn’t happen. Therefore you are not (yet) eligible for compensation. And in cases where the amount of minutes in a session changes, the type of session changes (individual to family), etc. we need to be sure what we are billing for is an accurate representation of what occurred in the session. So the biggest takeaways? Make sure that your note is complete with an accurate billing code before it is billed out. My biller will bill in the morning for the previous day. For example, all my Tuesday appointments get billed early Wednesday morning. If there is a session that shouldn’t be billed it is my responsibility to communicate to my biller to not process this claim and again when documentation is ready. But this? It’s few and far between due to my proven practices of getting my notes done between sessions. AND with my electronic medical records coding it is easy to see if I missed any notes for the day! If you need more note support to get notes does fast and easy check out The 5 Minute Note! This is the program that will help you complete your notes, between sessions, within 5 minutes or less!! Loading...
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Hi, there!I'm Ann Meehan, an LPCC, Loading... Archives
January 2025
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