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NARHC-News
Psychiatric Nurse Practitioner
Page 1 of 1
1/13/2021 @ 2:32:00 PM
Post 1 of 9

Contributor: Brenda Caswell, Family Medical Center of Hart County

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

www.MunfordvilleFMC.com





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: Brenda Caswell, Family Medical Center of Hart County

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.

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 @ 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


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