RESOURCES
This Resources page will come in handy when you are trying to find out specific information about a topic or just as general knowledge.
Medicare Documentation Guidelines for Amended Medical Records
"Corrections to the medical record legally amended prior to claims submission and/or medical review will be considered in determining the validity of services billed. If these changes appear in the record following payment determination based on medical review, only the original record will bere viewed in determining payment of services billed to Medicare.Appeal of claims denied on the basis of an incomplete record may result in a reversal of the original denial if the information supplied includes pages or components that were part of the original medical record, but were not submitted on the initial review".
Psychotherapy in Crisis Code Documentation
Psychotherapy for crisis should only be used for urgent assessment when
a patient is in a state of crisis.
These codes (90839 and 90840) are billed based on time and may only be used when the
provider documents that the patient is currently in crisis. The provider
must document the total time spent. If less than 30 minutes is spent
then report either code 90832 or 90833 as long as 16 minutes is
documented.
The provider must devote his/her full attention to the patient during this
time and cannot see other patients.
The codes are to be used by providers during the time when
they are trying to diffuse a crisis and restore safety.
REGISTRATION DENIAL EXAMPLES
Front Desk Registration is one of the most important steps in the revenue cycle.
Here are some denial examples:
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15 The authorization number is missing, invalid, or does not apply to the billed services or provider.
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19 This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.
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20 This injury/illness is covered by the liability carrier.
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28 Coverage not in effect at the time the service was provided.
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31 Patient cannot be identified as our insured.
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38 Services not provided or authorized by designated (network/primary
care) providers. -
257 The disposition of the claim/service is undetermined during the
premium payment grace period, per Health Insurance Exchange requirements.
doing telehalth in
a different state
Here are answers to the most commonly asked questions about practicing telehealth across state lines.
By APA’s Office of Legal and State Advocacy and the California Psychological Association
A patient who lives in another state wants to initiate treatment with me via telehealth. Can I provide treatment to that patient? What if I have special expertise that they cannot access in their area?
Most states do not have a specific requirement that care must be initiated in person or must be initiated in the same state where their psychologist is located. Your expertise may be an important clinical reason for initiating treatment with a patient in another state. However, practitioners should consider the patient’s best interests. If appropriate services are available, a patient may benefit from working with a local psychologist who would be able to provide in-person care.
My patient will be temporarily visiting another state (e.g., for vacation, business, or a family visit). Can I provide services to that patient via telehealth while they are out of state?
You should be licensed or legally permitted to practice in the states where you and your patient are physically located when services are provided. If your patient is temporarily in another state, you may be legally permitted to practice there under temporary practice laws. Temporary practice laws allow psychologists licensed in one state to practice for a limited amount of time in another state (e.g., 20 days per year) and may specify additional requirements such as obtaining a temporary permit or license. However, not all states allow for temporary practice. For information about another state’s temporary practice laws, please contact the state’s board of psychology.
In addition, you may be able to engage in interstate practice through the Psychology Interjurisdictional Compact (PSYPACT) (see questions nine and 10).