Our practice code is AFFILIATESINCOUNSELING
We will put the more common instructions below, but know there are always exceptions to the rules, and multiple ways to accomplish the same task, so if you are thinking 'how should I bill for...' please don't guess, - call, email, or text Sandy or Shelly
--Change the top field to say "Therapy Intake" instead of the default "Therapy Session"
--This enables the 90791 service code.
--Check the box at the bottom if you want to set up a recurring session using your preferred service code for ongoing sessions.
--After saving the initial session, a new box will open for you to schedule your recurring appointment.
--Go that patient's billing settings tab
--Scroll down to the bottom field "patient cash rates" tab
--On right side, click 'add rate info' choose a service code, and the fee to charge.
--Repeat 'add rate info' for all possible service codes you may use with a client (if you do a short or family session down the road, you won't remember to add the sliding scale fee, so please enter all the service codes from the start.)
--When you save this info, your new fee will be set. No need to email the office (but feel free to ask us to check your work until you're confident.)
--Consider, will your rate be lower for a 90832 (30 min session)? if so, rate it accordingly.
--Start by looking at the schedule tab, click the appt you wish to cancel, click either 'cancel appt' or 'appt missed'.
--In the yellow bar that appears at the top of that box, click 'charge fee'
--When new box opens, click the box by "Charge a Fee for this Missed Appointment"
--When new box opens, enter the intended fee, and save changes.
-DO NOT check the box that says "write off"
--Missed sessions with a charge should always include a short note - click back into that appt from your schedule, and click the note tab to 'create a missed appt note'.
FOR IN NETWORK CLIENTS ONLY:
If you have scheduled an hour session, but the client only presents for half of the session, you can only bill insurance for ACTUAL time spent (ie your planned 90837 53+ min has just become a 90832, 16-37 min session or perhaps a 90834, 38-52 min session.)
--In this case it is necessary to bill insurance for only the 90832 or 90834.
--You can then charge the client directly for the other portion of that session as a missed session at a prorated fee.
--Mark the completed session as a 90832 and complete your note as normal.
--Then create a new session in your schedule for the other portion of time, and mark it as a missed appointment using instructions above.
--(If a client is out of network, and being billed your full rate for the session, you must still use the accurate service code for the actual time spent in session, but you can charge your full fee for this out of network client, and so there is no need to create a separate session for/note for the missed portion - you haven't 'lost' any compensation from them being late)
• “Practice referral” = any link back to AiC (clinician, client, office, reached out to 3 people on our website) = 50%
---This client has a family member at AiC, or as a past client, or was told go see 'someone/anyone' at AiC, or tried to see someone else at AiC who was full.
• "Self referral" = Only “purely independent” clients (another client recomends you, a professional contact outside AiC, school) = your self referral rate.
---This client would not have known about AiC if your reputation/name had not led them here.
• If in doubt, confirm with the office.
--Add new client % in the ACCOUNT NUMBER field in the client info tab. This should be done when entering their name, email, and DOB, no later than after first appointment.
-- Just add the percent number (no symbols or letters) Shelly and Sandy will format (With name etc) it when we verify the percentage.
-- If this is a referral that came DIRECTLY from the Perinatal (PN) or Executive Functioning (EF) program, please ALSO add those two letters to the percentage, so 50PN, etc
--If a percentage is already there and you disagree, please DO NOT just change it back, if a number has been entered, SOMEONE thinks that's the correct number, so please contact Sandy before making any changes to percentages.
These definitions are for our general purposes, and definitely will have exceptions. Feel free to use your judgement, or check in with Sandy if you're unsure how to bill/record for anything.
--CONTACT-- (generally no fee for this)
if you have a short phone call, email, other communication, with a third party to exchange or share info this can be documented as a CONTACT note, by going to the patient's document tab, then the blue "create note" drop down on the top right, and choosing "Create contact note."
--Generally, these would be non-billed, information sharing communications (report from school social worker or physician, contact with a lawyer, a parent checking in on their child, recurring rescheduling from a client, ) Generally these would not be billed to the client (if it comes up that there is a significant contact, ask Sandy how to bill on a case by case basis.) I am not implying you must document every call/email received, but this is your opportunity to document anything necessary without creating an appointment.
--This is also an opportunity for Supervisors to log important contact regarding their supervisee's communication - you can create a contact note to log your "recommendation that clinician call DCFS, or request a welfare check,etc" Although this does live in the patient's document tab, these notes are visible to the clinician and supervisor only, never the client.
--CONSULT-- (includes entering a fee)
A CONSULT will generally be used for a billable meeting that does not qualify as 'therapy' or for other reasons can not be sent to insurance. (ie School IEP meetings, a phone call with a parent that is not really considered providing therapy, extended sessions, a longer/scheduled meeting with other therapist/lawyers, admission/discharge coordination)
It is important that anything you plan to bill for as 'not therapy', or otherwise not going to be sent to insurance, that the fees and out of pocket expectation be clarified to the responsible billing party BEFORE the consult whenever possible.
"I'd be happy to schedule a phone call with the social worker, but we can not send that to insurance, and so will bill you prorated to each 15 minutes" (half hour etc)
"Insurance will not pay for two sessions on the same day, so I can definitely make time to speak with you and your spouse today, but it will be billed directly to you at my normal rate of $xx."
Again, there is room for discretion and exceptions to this, but your justification of fees should be consistent across your caseload. We also know that not every phone call or communication is billable and that some 'outside of session' communication is part of the job. This CONSULT is here to protect you from the parent who 'just needs to check in' multiple times a week. Always feel free to discuss with Sandy 'what other people have done' in certain situations, and remember that your notes should always support your billing and fees.
--When entering a CONSULT, there is an extra step to entering your fee.
After you enter CONSULT as your appointment type and your service code and save the appt, You must go back to your schedule, click the appointment, and on the pop up screen choose the BILLING tab.
--Change the first drop down menu "Method" to "DIRECT" (Consults can not be sent to insurance, so it doesn't matter what insurance they have, change it to DIRECT")
--Then enter your rate, ensuring the 'write off ' box is NOT checked.
--You should also complete a note documenting this CONSULT
--Enter an appointment into your schedule using:
--Appointment Type: CONSULTATION
--Service Code: RECORDS: Records request
--you should likely complete a short note, which in this case is just a 'free write' box to indicate what/to whom the records were requested.
--you can also upload the document to the client's file for future reference (only you have access, the client does not).
--When entering a CONSULTATION/RECORDS, there is an extra step to entering your fee.
After you enter CONSULT as your appointment type, enter RECORDS as your service code, and save the appt, You must go back to your schedule, click the appointment, and on the pop up screen choose the BILLING tab.
--Change the first drop down menu "Method" to "DIRECT" (Consults can not be sent to insurance, so it doesn't matter what insurance they have, change it to DIRECT")
--Then enter your rate, ensuring you DO NOT check the 'write off ' box.
--You should also complete a note documenting this CONSULT, describing what records or letter was prepared.
If you want to include the letter in the patient's file (for your viewing, not theirs)
--Go to that patient's document tab
--At the top right click, 'Upload Patient File'
--Upload the given document from your computer, and name it appropriately.
--This will store it with the rest of your notes.
--Go to the client named 'Supervision Account'
--Session Type: CONSULT
--Choose the correct Service Code: SUPER (implies providing supervision to one whom you are required to sign notes for, they do not have full licensure) or
CONSULT (implies a continuing relationship if/when they are fully licensed and if/when you decide to continue meeting for clinical consultation without implication of responsibility for the notes)
--you should also complete a note, even if it just says 'Supervision with SUPERVISEE NAME' so *if* we ever needed to provide documentation, we have a time stamped record of the meeting.
If you are going away for a few days, you should cancel all appointments on your schedule so that your clients do not get confusing appointment reminders. T
--Go to your schedule and click on the first day you are 'away.'
--Use Appointment Type: Unavailable
--Enter the dates your are unavailable
--Check the box that says "Cancel the ## appointments scheduled during this unavailable period."
Note: TN only allows this option for about a week at a time. If you enter your dates and the checkbox to cancel multiple appts does not appear, just enter a smaller time period, then repeat for the next week (or more) until your entire vacay is covered and cancelled.
Other note: Even if you are away, after canceling your appts, you can still add back in an appt if you happen to have any during that "unavailable" time.
To save a new credit card or insurance
--log on to the portal
--click "Documents" at the top right
--Scroll down to the documents list under "Always Available"
--Update credit card or insurance info
***NOTE If a client makes a payment on the portal, this DOES NOT save the card for future use. Only filling out the form saves a new card.
--If a client wishes to have multiple cards on file, have them call the office to clarify.
To get a receipt from the past 90 days;
--log on to the portal
--click "Billing" at the top right
--Find the relevant receipt
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