Goals. Reflection. The 3 Ps: Marcus Lemonis. Private Practice Management: From Intake to Billing 9/1/15
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1 Private Practice Management: From Intake to Billing Christian J. Dean, Ph.D., LPC-S, LMFT, NCC And Sola Kippers, Ph.D., LPC-S, LMFT, CRC, CCTP Goals O Have an understanding of overall practice components (brief overview) O Explore the day to day management of a private practice. O Focus on the business 3 P s: People, Process, and the Product. Reflection O What do you see as your greatest strengths to help you be successful in private practice? O What do you see a your greatest areas of growth to help you be successful in private practice? The 3 Ps: Marcus Lemonis O D0q7GtNZ44 O People: the counselor; any administrative staff; and the client population. O Process: the intake process, paperwork, billing process, administrative, and therapeutic process. O Product: the counseling and the effectiveness of counseling. 1
2 Practice Foundation: What You Have Established O LLC or Incorporation. O NPI, Tax ID, and Occupational License. O Business cards, website, listed on some online directories (e.g., Psychologytoday.com, Good Therapy, etc.) O Intake paperwork and appraisal instruments. O Fees or Rates. Practice Fees, Scheduling & Billing O Out of pocket fee rates O Scheduling and billing software O EAPs Referral Sources O Insurance companies O Psychiatrists O Medical Psychologists O Nurse Practitioners O Other Therapists O Online therapist directories O Word of mouth Private Pay, EAPs and Insurance Companies O Private Pay O Credentialing O EAPs O Insurance Companies 2
3 Record Keeping/Admin O Therapeutic Chart O Billing Chart O HIPAA Compliance O Receipts O Quarterly Taxes O 1099 (insurance company) O Scheduling time for administrative work A Client Calls- What Now? Gathering information about client O Purpose of counseling O Individual, couple of family O Demographics for billing, tracking, etc. O Obtaining client s insurance information O Schedule appointment Sometimes EAPs, Hospital or doctors office may call Insurance Companies: Eligibility & Benefits O Example Scenario: Deductible O Example Scenario: Copay O Example Scenario: Coinsurance Insurance Companies: Eligibility & Benefits O Deductible: A pre-arranged amount of money that a client has to pay out of pocket prior to the insurance copay or coinsurance kicking in. The per-session rate is based on the contracted rate with the particular managed care company. O Copay: A pre-arranged set amount that a client will pay during every session. The insurance company will then pay for the difference between the copay and the contracted rate. O Coinsurance: A pre-arranged set percentage of the contracted rate (often 20%) that a client will pay during every session. The insurance company will then pay for the difference between the coinsurance and the contracted rate (often 80% of the contracted rate). 3
4 Before Client s First Session O Verifying Eligibility and Benefits O Contacting Insurance or EAP company O Information to Have Available for Representative O Information to Ask Representative O Options Prior to First Session O Intake paperwork Clients Appears for Session O People O Establishing business relationship O Establishing framework for counseling process and office protocol O Engaging in client observation O Offer refreshments O Process O Review intake paperwork O Review office policies O Answer client s questions O Appraisal Appraisal Instruments O DSM-5 related assessments O practice/dsm/dsm-5/online-assessmentmeasures Clients Appears for Session O Product O Gained overview of client s concerns O Acquired completed intake paperwork O Acquired additional client information and assessment O Therapeutic approaches/interventions 4
5 At End of Session O Scheduling next appointment O Collecting either full fee, deductible, copay and/or coinsurance After Session Follow Up O Following up with insurance companies O Inputting/tracking Explanation of Benefits (EOB) O Letters in the mail O Electronic tracking O Letters to physicians or other medical providers (depending on need, diagnosis, and medication) The 3 Ps Questions? Comments? O How are these all connected? O What do see as your greatest strengths in relation to the 3 Ps in private practice? O What do you see as your greatest areas of growth in relation to the 3 Ps in private practice? 5
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