Billing Basics
At the bottom of 'Billing Setting', all clients should have this feature turned on.
Auto-pay
The amount a client pays versus what their insurance covers.
Hint: Can change depending on the situation.
Copay
The tab in Therapy Notes that contains information regarding client's copays/coinsurance amounts, insurance payments, and claims submitted or future claims?
The 'Billing Settings' tab
Name one of the insurance plans clinicians can be in-network with at this practice.
Bonus Q: Due to red tape, LCATs can only take one insurance currently.
Aetna, United Healthcare, and Cigna
Bonus: Cigna
The sliding scale rate for out-of-pocket costs.
$150-$300
If a client doesn't use insurance, they would pay this.
An Out-of-pocket cost.
This happens if a card declines and will need to be turned back on.
Autopay gets turned off!
Where do you run the aging and batch statements?
This amount resets at the beginning of the year or can reset at the end of a contracted year and could change your copay.
Hint: insurance may not cover treatment or ask for a high copay until it is met.
Insurance Deductible!
The sliding scale rate for intakes.
$175-$350
Who do I reach out to if my client isn't responding to messages about paying a missed fee, or wants to set up a payment plan, or I have a billing question?
Your supervisor and Jess
jessika@greenpointpsychotherapy.com
Who do you contact first about a missed session fee or outstanding balance?
The client!
How often you should check your aging and batch statements.
Minimum of once a week
A document that contains everything that is needed for insurance companies to process claims for out-of-network benefits.
A Superbill
The amount a missed session fee costs.
$150
The range of minutes you must meet with a client for billing an individual 60-minute session.
53-57 minutes
The document in the Therapy Notes library you send to a client for them to put a card on file or a new card on file.
Payment Authorization Form
If you have reached out to a client on multiple occasions and tagged in billing, where does an outstanding balance go?
To Collections
What does OON stand for?
Hint: Short for services rendered by a provider who does not have a contract with a client's insurance.
Out of Network Benefits
What do you do when a client has two missed session fees that haven't been paid or has no-shows in a row?
Discuss temporary termination with the client.
What is the billing code for one 60-minute individual session?
90837
A client has an insurance card (HSA or otherwise) on file for payment. What else does a client need in case they miss a session?
A second card (credit or debit) on file!
What happens to unassigned credit if the balance for a client is at 0?
The balance can go towards paying for future sessions, or you can reach out to Jess to discuss a refund if necessary.
This is the profile that the practice manages for you once you create it, which allows you to be in-network as a provider.
A CAQH
How many missed sessions can a client have an unpaid fee for before you temporarily terminate until the fee is cleared or a plan is made?
2 ($300)