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Do Insurance Companies Cover Teletherapy?

The internet has had a huge impact on how patients seek health and medical care. These days, a growing number of people are accessing mental health professionals via teletherapy. This allows patients to meet with their doctors using a live communication service.


Teletherapy is convenient and flexible, and it provides access to mental health care for those patients who live in areas where there is a shortage of practices.


The problem is that most insurance companies have yet to catch up with this new form of providing care. This means that for psychologists, psychiatrists, and therapists, it’s a toss-up as to whether or not insurance companies will reimburse the cost of teletherapy sessions. Despite the growing popularity of teletherapy, there are still many insurance providers that will potentially deny claims that are submitted for these services.


In some instances, a patient can choose to submit their own claim, which means that they have to pay for services out of pocket. To make matters worse, there have been recent changes in CPT billing codes, which makes it harder for patients to correctly submit claims to be reimbursed for teletherapy services.


For more than a decade, telehealth services have been reimbursed by Medicaid and Medicare. The good news is that the Affordable Care Act has accelerated telehealth parity, which means that a growing number of health plans are following suit. This is in part of the ACA making healthcare more affordable and accessible for patients.


Mental Health Billing Service


Coverage Is On a State-by-State Basis

At the same time, even though coverage is becoming more widespread, blanket coverage isn’t available. It’s important to note that most plans will only reimburse teletherapy in certain situations. For example, a patient may need to be located in a rural area where there is no mental health care provider within a certain number of miles. This means that an insurance company may offer teletherapy coverage in one state but not in another.


What Mental Health Professionals Need to Know

In the event that the patient’s insurance company does not cover the cost of teletherapy, they may be willing to pay out of pocket. Many patients are willing to pay for the flexibility and convenience that telehealth services offer, especially when it comes to mental health. People often feel safer speaking about their mental health from the comfort of their own home.


But before you decide to offer HIPAA-compliant teletherapy, there are many things you’ll need to do in order to protect yourself and your patients. Some of the steps to take include:


  • Checking with insurance companies that you work with to see if they offer reimbursements
  • Confirming with your billing service to determine billing codes
  • Confirming the rates in which you would be paid


The most important thing to do is to ensure that your teletherapy sessions are HIPAA compliant. There are more than fifty teleconferencing and video services that have been determined to be HIPAA compliant. Choose a platform that is easy to use so that you can get started offering mental health care for patients.


Need assistance filing claims, resolving rejections, or claims processing? If so, contact Psychiatric Billing Associates at 800-650-6334, extension 947.

Benefits of Using Psychiatric Billing Services


Whether you are starting your own practice or have been in practice for years, there are several benefits of outsourcing your psychiatric billing to a qualified billing service  like Psychiatric Billing Associates. In recent years, there have been changes to cpt diagnostic codes, billing processes, billing forms, and the complexity required when submitting claims. In addition, further reforms and changes are expected in the future.


Psychiatric Billing

  1. Access to expertise and specialized mental health billing skills. Billing services that specialize in only mental health billing ensure claims are completed accurately and correctly the first time. They understand correct coding, and are familiar with the third party and managed care companies that handle mental health reimbursement. Billing expertise is especially important when filing claims for neuropsych, academic testing, ECT, EAP and Hospital based services.
  2. A reduction to your practice’s operating costs. You do not have to waste precious time recruiting, hiring, and training staff to perform billing operations, nor investing in the latest billing software applications. An experienced billing service takes care of recruiting the best employees and software, resulting in paying less in the long run for collecting your payments for services rendered.
  3. Fewer headaches and more control over your practice. By outsourcing your billing, you do not have to deal with the red tape, rejections, complications, and other stressful aspects of billing procedures. Rather, you are freed up to concentrate on the needs of your patients, providing them higher quality of care.
  4. Eliminates having to learn the complexities of medical billing. Even if you do not perform your own billing directly, you do not have to worry about whether your staff is spending sufficient time staying on top of the latest updates and changes.
  5. Always know what medical billing codes are relevant for your services and treatments. Medical billing codes are constantly being updated, changed, and even deleted. Your billing service will keep you informed of these changes and help you determine which codes are the most appropriate to use for your practice to reduce the number of rejected claims.
  6. Quicker reimbursement times. Mental health billing services submit claims on a timely basis, deal with resolving rejected claims quickly, and other such issues, so you can get paid faster and improve cash flow. They will also submit as many claims electronically to providers, who accept electronic claim submissions, thereby decreasing claims processing times.
  7. Affordable rates. Qualified billing services will only charge a percentage of the amount of money they actually collect, not the total amount billed. As a result, they work harder to help increase your collections rate. Not only does this mean they will earn more, but also helps increase your revenues and cash flowing into your practice. With the increase in revenues and decrease in overall operational costs, most practices can easily justify the billing service fees.

To discover how Psychiatric Billing Associates can help your mental health practice, contact us today by calling 800-650-6334, extension 24. We offer customizable solutions and provide the assistance you need with claims, processing, collections, and more.


Psychiatric Billing Services

Stalled Mental Health Bill Finally Passed by the House


In 2012, United States Representative, Tim Murphy (R-Pennsylvania), who is also a clinical psychologist, introduced Helping Families In Mental Health Crisis Act (House Bill H.R. 2646) to reform the mental health system and increase the amount of federal funding for various mental health programs. While Murphy’s efforts have been ongoing, the bill has been delayed on several occasions for various reasons along the way.


House Bill H.R. 2646

However, with the recent string of shootings by individuals in major cities, including those that recently took place in Orlando and Dallas, the House finally decided to move ahead with its first steps in reforming federally funded mental health programs. It is worth noting the reforms have not occurred for several decades.


House Bill H.R. 2646 was co-sponsored by U.S. Representative, Bradley Byrne (R-Alabama). Byrne’s support of the bills was largely related to his grandfather being killed by a person suffering from mental illness. The bill was modified in efforts to initial changes to the system and passed the House with a majority vote of 422 to 2 on July 6, 2016. The objective of the bill is to help ensure those with severe mental illnesses such as schizophrenia, bipolar disorder, and major depression to have access to treatments and services in efforts to avert future tragedies.


In order to gain support for the bill, it had to be separated from gun control reforms. Even still, the bill ensures money will get to the patients who need it most, through federally funded mental health programs, and not get tied up in bureaucracy, according to Byrne.


The legislation addresses the treatment and care of patients with severe mental illness in several ways:   empowering families to work with doctors and mental health professionals to be part of the front-line care delivery team; fixing shortages of inpatient beds providing more psychiatric hospital beds, instead of expensive emergency rooms, for those experiencing a mental health crisis and in need of immediate inpatient care.  The new law would reach underserved and rural populations with tele-psychiatry to link pediatricians and primary care doctors with psychiatrists and psychologists in areas where patients don’t have access to mental health professionals.


One of the more beneficial changes is the focus on providing alternatives to institutionalization to those with serious mental illness to get into treatment, especially when they are unable to understand the gravity of their condition and cannot voluntarily seek out care. This would reduce the rate of imprisonment, homelessness, substance abuse, and costly ER visits.  The government would expand crisis intervention team training for law enforcement, so patients are treated in the healthcare system and not warehoused in the criminal justice system.


With the new law, there is an increase in requirements for private insurance companies to cover mental health treatments and care, just like they currently do for physical health treatments and care. In addition, for people with Medicaid coverage, the bill now allows for –same day billing for mental health and primary care of the same patient.  This helps primary care doctors on the front lines to coordinate more closely -and quickly- with behavioral health providers.


Next, the bill must pass the Senate in order to move forward, but with this being an election year, and the fact July 15th was the end of the current Senate session, there is going to be a tight timeline if the bill is to be passed this year. The Senate meets again in September, but only for one month, and then does not meet again until after the elections in November.


In the meantime, while we wait to see if the bill passes the Senate, you can get help with your mental health medical billing and related services by calling Psychiatric Billing Associates at 800-650-6334, extension 947. We offer assistance with collections, claims processing, and more.


Mental Health Medical Billing


How to Negotiate Fee Increases with Insurance Companies

Physicians are often unaware they can consider negotiating reimbursement rates with insurance companies. After all, health care providers and their networks play an important role in the insurance business. There may be times reviewing your existing contract helps, such as when there are changes or updates to CPT, diagnostic, and behavioral health billing codes.


Behavioral Health Medical Billing

In doing so, you could find opportunities to renegotiate a contract with an insurance provider. Depending on the practice, the reimbursement rates may differ, even for similar types of treatments and services. This can result in being reimbursed less than other practices, which negotiated their original contract differently. A thorough review can also reveal outdated codes that are no longer accepted and which should be updated.


If you’re not satisfied with your insurance provider’s reimbursement fees, these tips for negotiating rates with insurance companies can help:


Understand Your Role in the Network

The more you understand how your practice fits in, the more negotiating power you may have. You’ll also need to prove you’re an asset to the network. Cost savings is one way you can stand out. Be prepared to bring numbers and figures to the negotiating table. Desirable factors include providing specialties scarce in your area, having favorable clinical outcomes, and employing a nurse practitioner who provides less acute care at lower rates.


Gather Your Data

To negotiate a better reimbursement rate, first you need data to back up your reasoning. First, list your most common CPT codes and their frequency; this reveals how often you provide a particular service over a specified period of time. Billing software can generate reports automatically to avoid time-consuming manual processes.


Next, identify your top payers, reimbursement for each code, and fees for each one. Then organize all the data into a chart or spreadsheet for analysis. Codes with higher volumes and dollar values will yield the most return, so focus your efforts here first. Another negotiating point can target health plans with lower rates or codes that are paid at a much lower percentage of Medicare than others.


Negotiate Individual Fees

Psychology Billing

Your data analyses can reveal individual services you can try to negotiate fees for. Payers generally don’t grant fee increases across the board, but you can deliver your argument targeting specific services to the health plan’s provider relations representative, who can forward it to a network manager or contracting manager. For a new procedure or one that’s not well-defined, a medical director can support a payment increase request for its respective code (although they’re typically not responsible for negotiating rates).


Whenever any contract changes or proposals are made, read the plan and its addendums or attachments carefully before signing it. The changes shouldn’t, for example, conflict with malpractice coverage. If anything is unclear, have a legal consultant review the contract.


Psychiatric Billing Associates can help if you need assistance with claims processing, collections, patient billing, or financial reporting for your mental health practice. To learn more about how we can help, call us at 800-650-6334 extension 947 today.