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1/13/2021 @ 2:32:00 PM
Post 1 of 9
Contributor: bcaswell@munfordvillefmc.com
We an Independent RHC in Kentucky looking into partnering with a company to provide mental health services using a Psychiatric Nurse Practitioner for the medication management and Limited Clinical Social Worker for counseling. Please chime in on any issues anyone may see with this proposal.
Thank you Brenda Caswell, CPC, CPB | Business Office Manager (Insurance and Patient Collections Dept) cid:image003.png@01CFF2E6.0C750830 Phone: (270) 524-7231 Ext. 231 Fax: (270) 524-7415 1/13/2021 @ 2:51:00 PM
Post 2 of 9
Contributor: Charles James, North American Healthcare Management Services
Your only caution is that this provider's services don't exceed 49% of your total clinic provider hours. I assume you mean Licensed Clinical Social Worker? A "limited' CSW will not be able to bill Medicare, but I think that was maybe an autocorrect misfire? Other than that - I love to hear about this. This is our mission: expand healthcare services to underserved areas. I would LOVE to hear about you all having taken advantage of Psychiatric Coordination of Care G0512.
Charles A. James, Jr. President and CEO North American Healthcare Management Services 9245 Watson Industrial Park * St. Louis, Missouri 63126 888.968.0076 Office 314.560.0098 Cell www.northamericanhms.com 'Proper preparation prevents poor performance." Lt. Col. Tom Warner - paraphrased (USAF- Deceased) See our Stopwatch challenge! http://www.aprima.com/aprima-stopwatch-challenge [cid:image001.jpg@01D6E9B2.DE25AD70] This transmission contains privileged, confidential, and proprietary information and is only for the use of the individuals listed above, and may not be copied, distributed, or disseminated without express written consent. If you receive this transmission in error, please immediately destroy it. 1/13/2021 @ 6:02:00 PM
Post 3 of 9
Contributor: bcaswell@munfordvillefmc.com
Thank you for responding. The "Limited" was supposed to be "Licensed" and I will let auto correct take the blame! A concern was that for behavioral health services to be paid in the RHC ,the services HAD to be provided by a clinical psychologist where we want to use a Psychiatric Nurse Practitioner. You don't see a problem with that scenario? ---------- Original Comments ---------- Last Post By: Charles James, North American Healthcare Management Services Your only caution is that this provider's services don't exceed 49% of your total clinic provider hours. I assume you mean Licensed Clinical Social Worker? A "limited' CSW will not be able to bill Medicare, but I think that was maybe an autocorrect misfire? Other than that - I love to hear about this. This is our mission: expand healthcare services to underserved areas. I would LOVE to hear about you all having taken advantage of Psychiatric Coordination of Care G0512. 1/13/2021 @ 11:40:00 PM
Post 4 of 9
Contributor: Charles James, North American Healthcare Management Services
None at all. The "primarily engaged in primary care" limitation remains regarding behavioral health vs primary care. This is a statutory limitation not changing any time soon. For billing purposes, however, Nurse Practitioners are approved RHC providers. Full stop. Your Psych NP will practice within their scope in the RHC. The services they provide would be billed using 0521 or 0900 according to the QVL. In exactly the same manner that any MD or DO, regardless of specialty, is an approved RHC provider.
There are other flexibilities with the Psych NP. They could easily be the Behavioral Care Manager required for the Care Management Team under G0512 service requirements. Care management is the future - imho. Please let us know how it turns out. Thanks - Charles 1/14/2021 @ 8:30:00 AM
Post 5 of 9
Contributor: Joyce Harper, MDH Family Medicine
Can anyone tell me for Medicaid Advantage plans for Flu and Pneumo are you billing for them and getting paid. Are you billing the Rural Health on 1500 or the UB for the Medicare Advantage claims? We are a new Rural Health and are having problems
Thanks Joyce Harper MDH Physician Billing 1/14/2021 @ 9:00:00 AM
Post 6 of 9
Contributor: Jan Oberlin, Dickinson County Healthcare System RHCs
We bill flu and pneumo vaccines on 1500 form to Medicare Advantage plans. Medicare Advantage plans pay for the part B vaccines.
Jan Oberlin, CCS-P, CPMA, CRHCP Provider Coding Compliance Coordinator Dickinson County Healthcare System P 715.528.4775 ext 3016 Jeanette.oberlin@dchs.org 1/14/2021 @ 10:19:00 AM
Post 7 of 9
Contributor: Peggy Gautreau, Total Family Medical
Brenda, we use a Psychiatric NP and it works very well in our practice. We
also have an LCSW that provides counseling services etc. This combination has worked best for us as medication alone does not always do it for a variety of diagnosis such as depression/anxiety. We STRONGLY encourage our patients to see the MHNP for dx and med management and our LCSW for the "work" part of the tx, therapy etc. The LCSW obviously has a longer time slot to see her pts, the only issue we have had is the high no show for these appts because its hard work sometimes to get to the root of the problem and bring about change. However, those that have been willing to put in the time, have seen great benefit. Our primary care crew LOVES that our practice offers both services. They have expressed that treating depression/anxiety properly is sometimes out of the comfort zone and for the mental health crew to be able to collaborate with the primary care crew and vice versa has been a win win win for ALL. Especially the patients. We offer primary care 6 days a week (9-1) on Saturdays and we offer mental health services 2 days a week. For us that was our safety net to make sure we stayed compliant with the regs, we did not want to have to count how many patients each week/month were seeing what team,so this method works for us. Peggy Gautreau, RN, BSN, CNM Administrator, Total Family Medical 985-542-2466 (office) 504-236-5311 (cell) On Wed, Jan 13, 2021 at 5:06 PM NARHC News wrote: > 1/14/2021 @ 10:34:00 AM
Post 8 of 9
Contributor: Tara LaFollette, Henry County Health Department RHC
We are working towards rural health status and our Administrator wants to add a MHNP. What is the rural health reimbursement for a MHNP? Thanks for helping this newbie out! 1/14/2021 @ 11:11:00 AM
Post 9 of 9
Contributor: Charles James, North American Healthcare Management Services
The RHC Reimbursement for MHNP is the RHC AIR. There is no differential with other NPs.
Thank you! Charles |