Inland Empire Chapter of CAMFT

Healthcare Reform and Insurance:  What Every Therapist Needs to Know

This entertaining presentation addressed what EVERY therapist should know about insurance, especially in light of the sweeping changes going on right now with healthcare reform, recent parity laws, a new claim form, and changing diagnosis codes. Even if you never sign a plan contract, what you don't know can hurt you and your clients, so it is important to be informed in this ever-changing arena.

In this economy, clients need therapists who accept their insurance, and insurance clients can fill your empty therapy slots. But must working with insurance mean fee discounts, limited sessions, mountainous paperwork, and compromising confidentiality?

From this workshop, we learned:

• An overview of the Affordable Care Act and what it means for clients – and you

• How to turn first-time callers into new clients – even if you aren’t on their health plan.

• The 12 Crucial Questions to ask when checking coverage to avoid denials

• The tricks for writing successful treatment requests (Medical Necessity Criteria)

• The pros and cons as well as the myths and realities of participation

• How to join insurance plans, and how to get on even if they are “full”

TOPICS COVERED IN Workshop

• How the Economy and Healthcare Reform is changing therapy and referral sources

• HMOs and EPOs, PPOs, and POSs – What’s the Difference, and Why You Should Care

• How to Get on Plans, and What They Are Looking For

• What it means to be an In- or out-of-network provider

• Our Biggest Fears about Managed Care: Myth or Reality?

• New Parity Laws and CPT Codes – What Every Provider Should Know

• Starting Treatment and Checking Coverage : 11 Essential Questions (Worksheet given out)

• The Biggest Mistakes Providers Make that Lead to Denials

• What You Need to Know When Talking to Insurance Plans

• Some Benefits to Accepting Insurance

• Complete claim form instructions (a sample completed claim form would be given to all attendees)

• Discussion of common billing practices that are actually insurance fraud

• Confidentiality issues