What is the No Surprises Act?
The No Surprises Act (NSA) is part of the federal Consolidated Appropriations Act (CAA) signed into law in 2020. The NSA includes patient billing protections effective January 1, 2022. There has been a lot of discussion around the No Surprises Act and how it will impact behavioral health facilities and medical practitioners. The goal of this post is to explain the No Surprises Act in an easily digestible fashion which will help you, the provider, understand its overall impact on your facility and your daily life.
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Topics:
Behavioral Health Billing,
Behavioral Health,
Insurance Billing,
US Government,
Behavioral Health Facility,
Documentation,
Healthcare,
No Surprises Act
As we enter a new year and a new decade, keeping up with insurance policy changes is no longer just best practice, but essential to your business. Sadly, with each new year, insurance requirements continue to increase, and guidelines become more and more strict. To help you stay on top of the changes, we have compiled a list of the current exclusions and requirements we have seen increasing as we head into 2020. Also, at the end of this blog post you'll find a FREE PDF cheat sheet--a simplified list of these bullet points that you can refer to anytime!
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Topics:
Behavioral Health Billing,
Behavioral Health,
Insurance Billing,
Mental Health,
Community Mental Health,
Behavioral Health Professional,
Elevated Billing,
Community Substance Abuse Treatment
Lisa M. Gingerich
Michael Best
The Wit v. United Behavioral Health decision (issued by Judge Joseph Spero of the United States District Court in the Northern District of California on March 6, 2019) will impact how managed care coverage decisions are made. The case addressed claims by several United Health Group members whom UBH denied coverage for behavioral health care. The lawsuit was based on UBH’s alleged breach of fiduciary duties to its members, under the Employee Retirement Income Security Act (ERISA), when UBH (i) applied coverage guidelines that are far more restrictive than those that are generally accepted (by CMS, American Society of Addiction Medicine and evidence-based medical guidelines) and (ii) prioritized cost savings over members’ interests.
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Obtaining authorizations for your patients is just one step toward insurance compensation. This can provide funding up front, but if documentation and charting is not kept up outside of utilization reviews and assessments, this could lead to considerable take-backs and force a facility to refund all or part of the reimbursement back to the insurance. Charting often appears excessive and often time consuming for the therapists treating the patients.
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Are POC's Even Billable Anymore?
Having trouble getting POC’s to pay? Stuck in an audit with insurance companies for this service? Follow these guidelines to ensure you get the most out of POC billing without jeopardizing another and/or future audit.
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Topics:
Insurance Billing,
Behavioral Health Facility,
Elevated Billing,
Community Substance Abuse Treatment,
Chemical Dependency,
Documentation
Joanna Conti, Founder & CEO
Vista Research Group, Inc.
The number of addiction treatment centers now monitoring their patients during treatment and
following up with them post-treatment has reached a critical mass. Commercial programs who continue
to hold off on quantifying their outcomes are risking being left behind. Tracking your outcomes is becoming invaluable for a number of reasons:
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Topics:
Behavioral Health,
Mental Health,
Community Mental Health,
Behavioral Health Professional,
Behavioral Health Facility,
Elevated Billing,
Community Substance Abuse Treatment,
webinar
By Joanna Conti
CEO, Vista Research Group, Inc.
In this time of tremendous industry upheaval, your ability to convince key payers of the unique value your addiction treatment center provides is crucial to your ability to stay in business.
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Topics:
Behavioral Health,
Mental Health,
Community Mental Health,
Behavioral Health Professional,
Behavioral Health Facility,
Elevated Billing,
Community Substance Abuse Treatment,
Chemical Dependency,
webinar
The value-based payment (VBP) model is indeed a real thing, and it is quickly becoming the standard for quality health care. In 2019 many payers are emphasizing VBP, and behavioral health providers will eventually be expected to make the transition as well.
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Topics:
Behavioral Health Billing,
Behavioral Health,
Insurance Billing,
Medicaid,
Mental Health,
US Government,
Community Mental Health,
Behavioral Health Professional,
Behavioral Health Facility,
Elevated Billing,
Community Substance Abuse Treatment,
Chemical Dependency,
Co-Occurring Disorders
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Topics:
Behavioral Health Billing,
Behavioral Health,
Insurance Billing,
Medicaid,
Mental Health,
Community Mental Health,
Behavioral Health Professional,
Behavioral Health Facility,
Elevated Billing,
Community Substance Abuse Treatment,
Chemical Dependency,
Co-Occurring Disorders
