Private, vetted email list for mental health professionals: https://www.clinicians-exchange.org
Open LEMMY instance for all mental health workers: https://lem.clinicians-exchange.org
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If you ever wonder why psychotherapists sometimes stop taking insurance
in the United States, there are lots of reasons. Low pay is the typical
one.
Hassle is another.
I'm trying to catch-up on billing this fine Sunday afternoon. The last
thing I need is a billing rabbit hole to get stuck in...
Today's rabbit hole -- trying to figure out why one of my insurance
panels keeps paying significantly different rates on the same CPT 90837
billing code (the code for a roughly one hour session). A LARGE
difference in fact.
Took a long time... drum roll...
I'm paid LESS for POS 02 (place of service telehealth AWAY from home)
versus POS 10 (place of service telehealth AT home).
Cause, yeah -- that makes sense.
So, yes, I'm required to code whether or not a client is at home for
telehealth. Why? No idea. (I suppose I do need to know the address
in case I need to send an ambulance or something.)
This all was made especially fun by:
a) The insurance company does not publish a rate schedule. No way to
know if I'd get a check or a claw-back if I inquire about the discrepancy.
b) The client has co-insurance. So the co-insurance rate varies by
place of service (POS) too. Client pays a percentage (%) of the total
amount I'm due.
It's crazy-making. And "crazy" is a term I usually avoid. Except when
discussing the American health system.