Is this a normal way to do session management and billing for 52 vs 53 minute sessions? It's stressing me out like crazy and not great for my finances.
I'm an associate clinical mental health counselor in a group practice. We're simultaneously encouraged to do 53+ minute sessions as the norm (which most of mine end up being even without trying) since reimbursement rates are higher, while cautioned not to do it "too often" because insurance might flag it as a sign to audit and claw back. In our notes, we record session times to the exact minute so it's clear the session really WAS 53 minutes. But we're also encouraged to "include some 52 minute sessions" for every client on purpose so we can show insurance we're accurately representing session length and billing for what is actually being done, and not just billing 53 minutes as the standard.
Except, I get paid less for 52 minute sessions versus 53 minute sessions (my contractual pay rate of $45 per session is only for 53+ minute sessions; I get $15 less per client hour if it's 52 minutes). I can't really afford to take a $15-a-session pay cut several times a week/month by purposely cutting sessions short in order to convince insurance we're being honest so they'll pay us the higher 53+ rate without audits/claw-backs. Sure, if the session is legit shorter, so be it, it is what it is (which is still stressful on my budget, but whatever). I've been feeling a lot of financial stress lately due to this, and stress in sessions because it's a lot to try to manage session length down to the minute for each client and keep track of which ones are supposed to have "their turn" for a 52 minute session while also balancing it so it isn't tanking my pay for that particular pay period. It's been even more stressful with the Aetna news recently.
I'm still not far out of grad school and have never worked anywhere else, so I have no basis for comparison. Is this normal and I just need to deal with it, or is it a red flag?