Using insurance when you need it feels great and you rarely hear arguments about it, unless it’s about the lack of coverage under a particular insurance plan. However, being an insurance provider seems to make many counselor entrepreneurs cautious and a bit concerned.
There are a variety of concerns associated with accepting insurance, but today I am answering a question about insurance, documentation, and reimbursement from the insurance companies. Does documentation increase? Do you have to capture the clients words? If you don’t will they withhold your reimbursement?
It’s time for Tuesday Q&A…
Do you have a similar or different experience with insurance?
Share your views with us.
I am also using an EHR format for my case notes now. There are checklists with dropdown lists where I just click on a box but I also have a place for narration of symptoms and treatment planning. It’s HIPAA compliant. I am using CONSOL.COM right now but there are others. I used to type out DAP notes. Here’s a good example of that format: http://www.purdue.edu/hhs/hdfs/engagement/documents/MFT_forms/Student/Resources/Casenote.PDF
Great Q&A Camille!
Great resource Linda! Thank you for sharing this. EHR makes it so nice and easy but thorough.
If you work with the military and try to get reimburse. Does it matter how the documentation is written? How long does it take to get reimbursement for your services.
Good Morning Annmarie! It is always good to keep organized and thorough documentation because any insurance company has the right to audit the files of those clients who are using their insurance. There are many formats that I think work great. You have your standard BIRP, DAP, and SOAP formats. You also have the option of creating a checklist that captures symptoms, behaviors (like a short mental status exam), med changes, suicidal thoughts, and more. Then, you can leave room in the note to discuss intervention used, client reaction, and future goals.
Reimbursement from insurance depends on whether you submit claims electronically or paperwork format. Paper format is slower by a few weeks. Electronically, can be approximately a week, depending on insurance company and assuming claim is not questioned.
Do you think you might want to accept insurance when you get your practice started?
Absolutely I would like to accept insurance. What are the acronyms? For instance, I know what SOAP is but the others I am not sure?
I also prefer the electronic method of billing. I am currently using the EHR. What format are available and does it depends on the type of insurance?
There are many different billing options available. Many insurance companies allow you to submit claims through their own system. However, clinicians who are on more than one insurance panel, prefer to use a system that allows you to bill many different insurance companies under one clearinghouse. I use Office Ally’s Practice Mate. However, there are so many out there.
Oh sorry about that! This is a good question though. For anyone else needing to know about this, I have explanations of the different types of notes and examples of how to use them in my book http://thecounselorentrepreneur.com/pocket-mentor/
BIRP:
Behavior (client)
Intervention used
Response (client)
Plan
SOAP
Subjective (what the client reports to you)
Objective (What you, the counselor, observe. Client’s appearance, behavior, smells, body lanuage, or affect.)
Assessment (Clinical diagnosis and/or clinical impressions based on the subjective and objective sections.)
Plan
DAP (Data, Assessment, and Plan):
These notes are quite similar to a SOAP note.
Data: Subjective and Objective information about the client
Assessment: Clinical diagnosis and/or clinical impressions based on the subjective and objective sections. If sufficient data is collected in the subjective and objective section, it will support the clinical impressions or diagnosis given in the assessment section.
Plan: Interventions used, future plans for treatment, homework given, and referrals made.