1) Locate an office site so you can start the process of applying for insurance panels. Whether you use your home or pay rent for space, all health insurance providers need your address to start the ball rolling. If you just want to do private pay, you still need an office location to start your marketing plan and networking with others.
2) In Massachusetts, mental health professionals have to register for the CAQH-Council Accreditation for Qualty Healthcare-for insurance panels to get their information on their credentials. The CAQH is a two hour process to fill out the information required for panels to access your information. The CAQH is designed as s “one shop stopping place” for professionals to document their credentialing information so all insurance panels can get the same information.
3) Pick and choose insurance panels you want to apply to. Some are open to new providers, others are not. One insurance panel is closed to all new mental health providers in my area although there are less providers in this panel to service the mental health needs of their clients. It is important to be a “Nag” in calling these panels to verify that you received your information and checking up when you will be approved.
4) If you are interested, you may want to apply to Employee Assistance Program panels to get referrals. You can get a list of such providers by googling “EAPs” or going through your local telephone book or through word of mouth. There are national EAPs as well as local ones in your area. Each EAP have their own pay scale on how much providers get paid for their service. On a side note, it took me five years to get on one EAP panel after management replaced all its workers this year. Apparently, someone at this company did not want me to serve as an EAP provider due to not wanting to upset their colleague who counsels ADHD clients like I do.
5) Check out local office supplies and websites for getting business cards and other office items. I find that www.vistaprint.com is one of the best websites to order business cards. Once you get on their email list, they send you daily different offers to attract your business. Some providers also use Staples or Office Depot to order their business cards as well.
6) There are also businesses and websites that offer low costs for building your website. I found that having a website did not bring me any business. It is an individual decision to decide if investing in a website is worth your time and money.
7) Networking with Primary Care Offices is a wonderful way to attract business. I found that after getting one client from a PCP’s office resulted in me being put on their list for clients to refer to for mental health referrals.
If you want to earn money for your business, do workshops for a reasonable fee on topics relevant to their employees. For example, I will be conducting a few trainings for a local healthcare provider in the fall for their staff. My goal is be on their permanent list as a trainer for their staffing needs. In the past, I have done a few workshops where I have been invited back on a yearly basis to conduct future trainings.
9) Another way to attract private pay clients is to take their co-pays while you want to approved by their insurance panels. Some providers are doing this as a way to attract new business to their practice. You can also offer a sliding scale fee as well.
10) Blogging for free for local newspaper sites is a great way to get your name out. I blog for one local newspaper for free since the beginning of summer. However, I don’t use my credentials due to liability purposes. I do have folks in my town reading my blogs as the word is getting out.
It is up to you to put the time and effort in to start your private practice. Some colleagues are hiring others to do their “footwork” for them in getting on insurance panels. I heard mixed reports from a few who hired others to help them and were not happy the results. It is up to you.
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Robbin Miller is a counselor who specializes in mindfulness meditation; Positive Psychology; and Cognitive-Behavioral Therapies; and is also a volunteer cable access producer and co-host of her show, “Miller Chat” in Massachusetts.
Thursday, August 11, 2011
Monday, May 2, 2011
Tidbits to the Graduating Class of 2011:
Congratulations to the graduate students from the Social Work and Mental Health programs across the program. Your hard work and dedication will pay off as you enter the “real world.” Here is the top ten list from a seasoned professional of fourteen years in the trenches:
10. Know who your supervisor will be in your first job after graduate school. One thing I learned is that having a unprofessional boss who exhibits unethical behaviors and is simply “rude” and “unkind” to you is not worth staying on the job. Know your rights when you have been taken advantage of and don’t be afraid to stand up for yourself.
9. Select a new job where the commute is reasonable and feasible. Why take a job that can wear and tear on your car and is far away from your home. If you do home visits as well, pick a job closer to home. Car repairs are very expensive.
8. Be aware of the parameters when taking a salary job as opposed to a fee for service job. If you don’t make productivity, you are in danger of losing your salary and benefits and being stuck as a fee for service clinician. Choose carefully and wisely.
7. To add to number 8, if you are in job that requires reaching unfair productivity quotas, be ethical in your billing practices. There are too many clinicians who bill for hourly sessions when they saw their client for a half hour if they double booked them that way.
6. Provide support for your colleagues by being non-competitive and being a good listener. Select an employer where the work environment can be a “second family” to you. I have been blessed twice over the years to have worked in this type of environment. It helped to decrease my stress levels very much.
5. Be nice to the administrative staff that does your billing and filing. Even though you are educated, it does not mean you are better than them. Treat them with compassion and kindness.
4. It sometimes pays to be choosey in deciding what clients you want to counsel. It is not ethically appropriate to see a client where their issues may push your buttons or is out of your league. If a client is not a good fit, please remember to not take it personally. If you wish to grow and expand your horizons in working with different clients, that is OK too. Just remember to know your limits and not use your “ego” to reach productivity standards that are beyond your control.
3. Customer Service applies when seeing your clients. If you offend them by accident, say you are sorry and be humble. Thank them for coming in to see you. Don’t forget to smile as well.
2. Keep up on the latest trends and knowledge in your profession. Go to conferences; attend workshops; read books and magazines; and stretch yourself to read books outside of your profession. I read books from the business sector to get ideas on how to perfect my customer service skills and to market my work to others.
1. Take care of yourself. If you need to speak to a counselor, go and do it. It does not help you and your client if you are not able to counsel them objectively and fairly. Choose at least three interest/pleasurable activities to engage in to get grounded and balanced.
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Robbin Miller is a counselor who specializes in mindfulness meditation; Positive Psychology; and Cognitive-Behavioral Therapies; and is also a volunteer cable access producer and co-host of her show, “Miller Chat” in Massachusetts.
10. Know who your supervisor will be in your first job after graduate school. One thing I learned is that having a unprofessional boss who exhibits unethical behaviors and is simply “rude” and “unkind” to you is not worth staying on the job. Know your rights when you have been taken advantage of and don’t be afraid to stand up for yourself.
9. Select a new job where the commute is reasonable and feasible. Why take a job that can wear and tear on your car and is far away from your home. If you do home visits as well, pick a job closer to home. Car repairs are very expensive.
8. Be aware of the parameters when taking a salary job as opposed to a fee for service job. If you don’t make productivity, you are in danger of losing your salary and benefits and being stuck as a fee for service clinician. Choose carefully and wisely.
7. To add to number 8, if you are in job that requires reaching unfair productivity quotas, be ethical in your billing practices. There are too many clinicians who bill for hourly sessions when they saw their client for a half hour if they double booked them that way.
6. Provide support for your colleagues by being non-competitive and being a good listener. Select an employer where the work environment can be a “second family” to you. I have been blessed twice over the years to have worked in this type of environment. It helped to decrease my stress levels very much.
5. Be nice to the administrative staff that does your billing and filing. Even though you are educated, it does not mean you are better than them. Treat them with compassion and kindness.
4. It sometimes pays to be choosey in deciding what clients you want to counsel. It is not ethically appropriate to see a client where their issues may push your buttons or is out of your league. If a client is not a good fit, please remember to not take it personally. If you wish to grow and expand your horizons in working with different clients, that is OK too. Just remember to know your limits and not use your “ego” to reach productivity standards that are beyond your control.
3. Customer Service applies when seeing your clients. If you offend them by accident, say you are sorry and be humble. Thank them for coming in to see you. Don’t forget to smile as well.
2. Keep up on the latest trends and knowledge in your profession. Go to conferences; attend workshops; read books and magazines; and stretch yourself to read books outside of your profession. I read books from the business sector to get ideas on how to perfect my customer service skills and to market my work to others.
1. Take care of yourself. If you need to speak to a counselor, go and do it. It does not help you and your client if you are not able to counsel them objectively and fairly. Choose at least three interest/pleasurable activities to engage in to get grounded and balanced.
--------------------------------------------------------------------------------
Robbin Miller is a counselor who specializes in mindfulness meditation; Positive Psychology; and Cognitive-Behavioral Therapies; and is also a volunteer cable access producer and co-host of her show, “Miller Chat” in Massachusetts.
Sunday, April 3, 2011
Odds and Ends as Spring Arrives....
I love when Spring arrives in New England. "It comes in like a lion and goes out like a lamb" as the saying goes. I have good news to report in my neck of the words. I wrote in the past about the inequities in the mental health system for children on commercial health insurances who need intensive services and can't access them. I am glad to hear that there is proposed legislation in Massachusetts to mandate that commercial insurance cover children who need intensive care coordiation for their mental health needs. What this acutally means is that counselors and social workers would get paid for doing collateral services such as going to school meetings and calling primary care doctors on behalf of their clients. At the present time, providers are unreimbursed for their time if they conduct these extra services outside of the counseling parameter for their clients. Over one thirty five organizations co-sponsor this legislation. The state chapter of the National Social Work Association is one the organizations co-sponsoring this bill. However, I don't know if the state chapter for Mental Health Counselors Association is co-sponsoring this bill as there is no information on their website (www.mamhca.org) that says they do. If anyone who belongs to this organization knows, please email me privately. If the bill passes, all children and not just those on Mass Health (medicaid) will receive due diligence for their mental health needs.
I am so glad to hear that the ACA is forming an Ethics Revision Task Force. I would like this Task Force to implement regulations on ethical billing practices. For example, there is some professionals who bill for an hour when they see their clients for only thirty minutes. The rationale is twofold: 1) They have productivity requirements to meet or lose their benefits and salaries if they don't meet their monthly quotas and; 2) Some agencies/practitioners operate on the principle if your client wishes to end thirty minutes early or comes late, you have the right to bill for an hour. I look forward to debate on this controversial issue. Another area to look at is Section F.11.c.Multicultural/
Diversity Competence. This area needs to include what cultural competencies are required to be taught to graduate students. Right now, some counseling programs across the country are not teaching their students to be disability sensitive when counseling those with physical and psychiatric disabilities. I speak from professional experiences working with graduate interns and fellow colleagues who have clients with disabilities. I welcome again your feedback on this topic area. The Task Force needs to look at how social networking mediums such as Facebook; Twitter; and Linkedin can affect the counselor-client relationshp. It is obvious that counselor should not "friend" their clients on Facebook. However, if you counsel a fellow colleague who wants to be in your linkedin group, what do you say? Can counselors/agencies twitter their clients on announcements? What do you think?
I wish everyone a Happy Easter and Passover in April.
I am so glad to hear that the ACA is forming an Ethics Revision Task Force. I would like this Task Force to implement regulations on ethical billing practices. For example, there is some professionals who bill for an hour when they see their clients for only thirty minutes. The rationale is twofold: 1) They have productivity requirements to meet or lose their benefits and salaries if they don't meet their monthly quotas and; 2) Some agencies/practitioners operate on the principle if your client wishes to end thirty minutes early or comes late, you have the right to bill for an hour. I look forward to debate on this controversial issue. Another area to look at is Section F.11.c.Multicultural/
Diversity Competence. This area needs to include what cultural competencies are required to be taught to graduate students. Right now, some counseling programs across the country are not teaching their students to be disability sensitive when counseling those with physical and psychiatric disabilities. I speak from professional experiences working with graduate interns and fellow colleagues who have clients with disabilities. I welcome again your feedback on this topic area. The Task Force needs to look at how social networking mediums such as Facebook; Twitter; and Linkedin can affect the counselor-client relationshp. It is obvious that counselor should not "friend" their clients on Facebook. However, if you counsel a fellow colleague who wants to be in your linkedin group, what do you say? Can counselors/agencies twitter their clients on announcements? What do you think?
I wish everyone a Happy Easter and Passover in April.
Saturday, December 4, 2010
The Mental Health's Big White Elephant
Bravo to the physicians for speaking against the upcoming cuts in Medicare reimbursements and the threat of refusal of accepting more patients in their medical practices. How come mental health professionals can’t follow this same pursuit?
Our profession has a big white elephant in our presence for refusing to speak out against cuts in payments for providing mental health services to our clients.
I will give you an example on what I am talking about. Two years, one big powerful health insurance company in Central Massachusetts cut reimbursements from $ 55.00 to $ 50.00 for providing mental health services to their clients. There are two things wrong: 1) Why on earth are mental health professionals taking their clients for low pay? 2) Where is the threat from the profession to stop taking their clients when the rate dropped to $ 50.00?
I have more pet peeve with this provider. Last Spring, they implemented a new conversion of billing claims with their contracted provider to pay mental health professionals. It has been a nightmare in getting paid on time. From June to November, I called the contact in provider relations to complain that I was not being paid for my services. Due to my constant telephone calling on a weekly basis, I was paid for one claim in October after I saw the client in April. In November, I was paid for two claims (after being overpaid twice) after I saw the client in June. As I write this blogpost, I am still have not been paid for ten claims since September to October due to their billing company losing the claims and my bookkeeper having to fax the claims to their supervisor.
Isn’t this ridiculous and insult to injury to fellow counselors?
Regarding low reimbursement rates, this health insurance company does not value the work that we do in our state. I am very disappointed with the leadership from both the mental health counselor and social work association for not speaking out on these two issues.
Regarding this horrible billing system, many complaints have been noted on their annual feedback form that the health insurance emailed to use to fill out this year.
You may ask why we continue to take their clients. There are two reasons: 1) In my area, many companies have switched from Blue Cross to this provider who have cheaper rates. 2) Getting private pay clients is not happening. In fact, many working families are now on the state medicaid system due to not being able to purchase an affordable health insurance commercial program.
What can we do about these issues?
1) The state social work and mental health counselor association need to speak out against this insulting low reimbursement rates.
2) They also need to meet with this provider to negotiate a high reimbursement rate to accept their clients.
3) If the above two tactics don’t work, then I advocate that the two associations call for a statewide boycott of accepting more clients from this provider.
I don’t know if the velvet glove approach will. I welcome your comments.
Our profession has a big white elephant in our presence for refusing to speak out against cuts in payments for providing mental health services to our clients.
I will give you an example on what I am talking about. Two years, one big powerful health insurance company in Central Massachusetts cut reimbursements from $ 55.00 to $ 50.00 for providing mental health services to their clients. There are two things wrong: 1) Why on earth are mental health professionals taking their clients for low pay? 2) Where is the threat from the profession to stop taking their clients when the rate dropped to $ 50.00?
I have more pet peeve with this provider. Last Spring, they implemented a new conversion of billing claims with their contracted provider to pay mental health professionals. It has been a nightmare in getting paid on time. From June to November, I called the contact in provider relations to complain that I was not being paid for my services. Due to my constant telephone calling on a weekly basis, I was paid for one claim in October after I saw the client in April. In November, I was paid for two claims (after being overpaid twice) after I saw the client in June. As I write this blogpost, I am still have not been paid for ten claims since September to October due to their billing company losing the claims and my bookkeeper having to fax the claims to their supervisor.
Isn’t this ridiculous and insult to injury to fellow counselors?
Regarding low reimbursement rates, this health insurance company does not value the work that we do in our state. I am very disappointed with the leadership from both the mental health counselor and social work association for not speaking out on these two issues.
Regarding this horrible billing system, many complaints have been noted on their annual feedback form that the health insurance emailed to use to fill out this year.
You may ask why we continue to take their clients. There are two reasons: 1) In my area, many companies have switched from Blue Cross to this provider who have cheaper rates. 2) Getting private pay clients is not happening. In fact, many working families are now on the state medicaid system due to not being able to purchase an affordable health insurance commercial program.
What can we do about these issues?
1) The state social work and mental health counselor association need to speak out against this insulting low reimbursement rates.
2) They also need to meet with this provider to negotiate a high reimbursement rate to accept their clients.
3) If the above two tactics don’t work, then I advocate that the two associations call for a statewide boycott of accepting more clients from this provider.
I don’t know if the velvet glove approach will. I welcome your comments.
Saturday, October 23, 2010
Is Blood Thicker Than Water?
I heard about a very sad event that an adoptive single parent endured this past week. She had to relinquish her 17 month old preadoptive son from the state foster care system to his biological father. Apparently, the birth mother told the state who the father was after a year in which she refused to identify him at birth. The birth mother held back the information due to her belief she would get custody back of her baby after she cleaned up her act in a drug rehabilitation facility. When the birth mother found out her parental rights were terminated this year, she decided to identify the birth father so she can still see her son in his custody. What a tragedy for this parent and for this baby.
How did this happen? In Massachusetts, the foster care/adoption system runs a little differently as opposed to doing a domestic adoption from a licensed agency. For the former, there is no system in place to post announcements in public newspapers that call birth fathers to identify themselves during the adoption hearings. For the latter, this system is in place. If the birth father does not show up during an adoption hearing, his rights are terminated.
As a counselor, I believe that the foster system for preadoptions is broken. I have heard of other similar cases where children were going to be adopted by their foster parents and liberal judges painfully tore them away and placed them with biological relatives who came out of no where. This dysfunctional process hurts the attachment bonds between the children and preadoptive parents. The slogan, “ Blood is Thicker than Water, “ is bogus and harmful to preadoptive families.
In 2005, I taught a class to non-traditional students entitled, “Functional Families,” which defines families as a group of individuals living together and establishing healthy bonds regardless how they were formed. This definition needs to be taught to judges and lawyers who create outdated laws that hurt adoption options for families who want to be parents.
What can the counseling profession do about it? We need to be vocal in educating lawmakers about antiquated laws that say a family is made by DNA only. We also need to promote equal laws and processes for both the foster care and domestic adoption systems in your state.
Counselors can educate legislators about the broken attachment bonds that can develop between a child and adoptive parents when their adoption is “interrupted” and a child is forced back with their biological parents. Massachusetts promotes unhealthy families when they reunite children with their biological parents who are not capable of parenting them. This policy goes against the mission that both the social work and counseling professions hold in promoting healthy development and growth and the fullest potential in individuals and in families.
We can do something as a collective to make positive changes.
I welcome your feedback.
Robbin Miller
Moderator
How did this happen? In Massachusetts, the foster care/adoption system runs a little differently as opposed to doing a domestic adoption from a licensed agency. For the former, there is no system in place to post announcements in public newspapers that call birth fathers to identify themselves during the adoption hearings. For the latter, this system is in place. If the birth father does not show up during an adoption hearing, his rights are terminated.
As a counselor, I believe that the foster system for preadoptions is broken. I have heard of other similar cases where children were going to be adopted by their foster parents and liberal judges painfully tore them away and placed them with biological relatives who came out of no where. This dysfunctional process hurts the attachment bonds between the children and preadoptive parents. The slogan, “ Blood is Thicker than Water, “ is bogus and harmful to preadoptive families.
In 2005, I taught a class to non-traditional students entitled, “Functional Families,” which defines families as a group of individuals living together and establishing healthy bonds regardless how they were formed. This definition needs to be taught to judges and lawyers who create outdated laws that hurt adoption options for families who want to be parents.
What can the counseling profession do about it? We need to be vocal in educating lawmakers about antiquated laws that say a family is made by DNA only. We also need to promote equal laws and processes for both the foster care and domestic adoption systems in your state.
Counselors can educate legislators about the broken attachment bonds that can develop between a child and adoptive parents when their adoption is “interrupted” and a child is forced back with their biological parents. Massachusetts promotes unhealthy families when they reunite children with their biological parents who are not capable of parenting them. This policy goes against the mission that both the social work and counseling professions hold in promoting healthy development and growth and the fullest potential in individuals and in families.
We can do something as a collective to make positive changes.
I welcome your feedback.
Robbin Miller
Moderator
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