Theinsurancemaze.com

10 Tips for Responding to a Record Request: Risk Adjustment

WEB1) Confirm it is a Risk Adjustment Audit. Carefully search the letter you received for the words “risk adjustment.”. It’s usually mentioned on the page from the …

Actived: 4 days ago

URL: https://theinsurancemaze.com/recordrequests/

Choosing, Changing, and Adding Diagnoses

WEBDiagnoses are expected to reflect your best understanding at the time you assign them. As more information is gathered, it is expected that your diagnosis might change. Also, the …

Category: Health Go Health

10 Telehealth Billing Myths

WEB7. “Since the health plan covers video, phone sessions will be covered.”. During the pandemic it does seem that most insurance plans are covering phone sessions, but …

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The DSM-5 and ICD-10

WEBYes, but here’s some good news: For each diagnosis in the DSM-5 you will see listed both ICD-9 CM codes for immediate use as well as the ICD-10-CM (in gray …

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Update Extended Sessions billing

WEBOne Washington biller reported “the insurance companies who paid for 2 units 98034 were CIGNA, Premera Blue Cross of Washington, and Lifewise HealthPlan of Washington. …

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When Your Client Has Medicare AND Another Policy

WEBWhen Your Client Has Medicare AND Another Policy. By Barbara Griswold, LMFT. (Updated August 16, 2022) When a client is covered by two insurance policies, …

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by Barbara Griswold, LMFT

WEBPROGRESS NOTES: “Progress notes” — as defined by the Health Information Portability and Accountability Act (HIPAA) — are a REQUIRED part of the client’s medical record …

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What is a Treatment Plan

WEBPossible Plan for Queen with OCD. Goal 1: Decrease in frequency of intrusive/unwanted thoughts/images. Obj 1: Ct. will be be able to practice thought-stopping when …

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Billing for Couples and Family Therapy

WEBPut the name of your IP on your statement/invoice if you are out of network, or if using the CMS-1500 form put it in Box 2 under “Patient’s Name” (the name of the …

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Data isight Multiplan article

WEBFor months, the health plan allowed $200 per session. However, without warning, claims for three clients were paid with an allowed amount of $104 — almost …

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Blue Cross Reviewing Adjustment Disorders

WEBBy Barbara Griswold, LMFT (May 16, 2022) Many Blue Cross network therapists around the country have received a curious correspondence from the Blue Cross Provider …

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clawbacks: What a plan wants their money back

WEBClawbacks: When a Plan Wants Their Money Back. (By Barbara Griswold, LMFT January 3, 2023) While there are many types of records requests and audits you …

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Billing for Extended Sessions

WEBA New Billing Possibility. Another billing possibility for extended therapy sessions emerged in 2016 when the AMA allowed add-on codes for Prolonged Services, …

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Ending of the PHE

WEBThe use of the phone (audio-only) to provide mental health services has been approved permanently. During the pandemic, Medicare telehealth visits have been …

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Blue Shield of California and Magellan: A Deceptive Arrangement

WEBIn our example, as of January 1, 2012, 1.9 million of Blue Shield’s mental health services and EAP services were carved out to Magellan. But here’s the part that …

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CIGNA is Evernorth

WEBCIGNA Is Now Evernorth By Barbara Griswold, LMFT (July 27, 2021) CIGNA Behavioral Health, the fourth largest major medical insurance company in the United States by …

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Speaking the Language of Insurance Plans: Surviving Treatment …

WEBAuthor: Barbara Griswold, LMFT · 4010 Moorpark Avenue, Suite 118, San Jose, CA 95117 · 408.985.0846 · [email protected]

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Are Raises Possible

WEBYou’ve got nothing to lose. Steps for Requesting a Raise. Write a letter to the health plan requesting a reimbursement rate increase. In your letter, include. if you are …

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Another Way to Bill for Extended Sessions: Prolonged Service …

WEB2 Will insurance reimburse for Prolonged Service codes? Some therapists who have used these codes have reported they were reimbursed the 99354 and 99355, yet others only …

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