r/TherapistsInPractice

I’m new to this, fumbling my way through DO NOT CONTACT ME WITH YOUR SERVICES. But what do people do? Do use EHR and submit your claims from there, set up your payers and jump thru all the hoops of electronic payments or submit claims through portals and get checks sent? I am soo frustrated and also want to avoid all the fees that are charged too!!

If there is one thing I have learnt about dealing with insurance cos., it is just just do the Paperwork properly.

Clawbacks, audits, non-payments, etc have nothing to do your skills. Trust me. You might be following the best plan but if your notes do not explain why the plan is needed, you are more likely to fail audits than pass them. You codes should in place, no clerical errors, ec etc.

To be honest, its very simple from the way I see it - payer companies have rules and you just need to make sure you follow them for a good practice which includes proper documentation, accurate billing structures, etc etc.

One thing I used to do very sincerely was reading the provider manuals by insurance companies. Nowadays, you can just use chatgpt but I would suggest you to read it atleast once. Chatgpt might be great for answering questions but not for an overall plan (I have tried it).

Once you understand that, then all you need do is to make sure all your paperwork align with contract language.

Hope it helps someone!

Happened with a friend but I am very frustrated. So apparently, she (my friend) did the sessions for a long term client. Insurance client.

The sessions were frequent. and payments were also on time. Now, in some audit for last year, insurance company found out that the client was not really covered as their policy had ended for a brief time in the middle. Now, they are charging back the money from my friend. How does this make sense?

She would have discontinued the sessions or something if she had known before. In general also, this is completely insurance cos. fault.

What are her options in this case? It's not a very big amount but it's not a small amount either. But, I feel this is unfair to her and to all of us in general.

I was talking to a colleague today and he mentioned that 3 out of 10 claims in mental health are denied by insurance cos. Which sounded kind of unreal to me because I dont remember the last time I had a denial. So, I am just curious - what are the reasons for such denial? Admin issue like wrong entries dont count.