Did you receive an audit requesting records recently? If they’re calling it “Risk Adjustment,” watch out: it could be a legal excuse for data mining. You’ll get these letters if you saw Medicare Advantage, Medicaid managed care, or clients with
1980’s Biller Humor: Because I gotta laugh in order not to cry. I want my ERA! Look at Change Healthcare, that’s the way to do it You took away the MFA That ain’t workin’ that’s the way Change do it
Like them or loathe them, no one disputes that large venture capital-funded mega-groups have irrevocably altered the business of private mental health practice. But I have an uncomfortable question, one I’m not sure has yet been asked publicly: What happens
The Center for Connected Health Policy reported that Medicare issued a “Change Request” earlier this month, amending the Medicare billing manual. On page 18 of the 21-page amendment, Medicare just happened to mention a 180-degree telehealth coding flip-flop in the policy as
Opting out of Medicare is causing therapists to be disenrolled from commercial payer panels. It’s illogical, and has all the makings of a perfect storm. Why would a therapist’s decision about Medicare affect clients without Medicare in any way? I’ve
Have you ever moved offices and changed your address with the insurance payers – and then mail reverted to your old address? Chances are, the NPI was responsible. And you didn’t even know about it. Here’s why! And there’s something
“One of these things is not like the other” Much has been written about the current high demand for mental health services and clinician shortages. In response, some (not all) private insurers have done what was once unthinkable. They now
The categories of Medicare participation or opting out for behavioral health clinicians. (Originally published 2/17/23)
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