“One of these things is not like the other” Much has been written about the current high demand for mental health services and (supposed) clinician shortages.* Some (not all) private insurers have begun reimbursing supervisory billing, which was unheard-of outside
Buried within all insurance/government payers is an unknown department most clinicians have never heard of, let alone interacted with: Payment Integrity. Payment Integrity is a department you never want to hear from! They have a lot of power: audits and
If you’ve never heard about “value-based care,” it’s time to catch up, and fast! This July, Medicare will be premiering a 10-year pilot model called ACCESS: Advancing Chronic Care with Effective, Scalable Solutions. While Medicare certainly has had other value-based
Battling insurance probably never was anyone’s idea of fun. But these days, we’re all exhausted from constant systemic accountability failures: insurance payers not taking responsibility for their mistakes. The national companies are organizational monoliths grown from a sequence of mergers
Clients are soon going to report New Year’s insurance changes, and you may suddenly be out of network. But, they might be entitled to “Continuity of Care” extensions of in-network coverage for a period of time. The reason for the
In mental health private practice, reimbursement rate mysteries plague us all: What if you could discover what insurance pays everyone in your market for the same CPT code? You can! A law passed at the end of 2020, called the
Yes, it’s true. Insurance companies are investors in Alma, Headway, Rula, etc. Worse, following the tech platform money trail back to its origins, we uncover the same economic dynamics in behavioral health that now control all of American healthcare. It’s
Of all the 1,000 cuts I’ll be featuring in this blog series, Electronic Data Interchange / EDI enrollment is the least publicly discussed and the most poorly understood. Because it seems so onerous and difficult to struggle through, and can
I admit it! With my biller’s perspective, I mentally cringe when someone says they have a “biller” or “credentialing service” but then cites Alma, Grow, Headway, Rula, Sondermind, Talkiatry, Talkspace, etc. That’s like saying a life coach is a psychotherapist.
Join the Western Oregon Mental Health Alliance (WOMHA) on Friday, October 30, 2026, 9am–12pm PT for a live 3-hour CE webinar with the amazing Susan Frager, PsychBilling Coach, to tackle the tricky insurance, billing, and Medicare dilemmas therapists face every day, plus how to handle the ones with no perfect answer.
