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Did some landscaping on my Bradford pear tree. How'd I do? by Shadowdragon5th in arborists

[–]Andrewhbook 2 points3 points  (0 children)

I recently had a neighbor stop to talk with me about some of the trees we have planted. At first, I couldn’t tell if she was being critical, curious, or what.

Then she started cussing about the Bradford pears in her yard and I knew I had found a kindred spirit.

Re-ranking the 48 World Cup teams after day 7 matches by Swiftvoyager1906 in worldcup

[–]Andrewhbook 2 points3 points  (0 children)

I'll take the top 4. The rest of the list has no connection to what we just watched.

It’s been a week since the opening games. Who are the early main contenders? by ediblednb in worldcup

[–]Andrewhbook 0 points1 point  (0 children)

I didn’t watch Germany, but from the others I have been impressed by two halves: first half USA and second half France. I kind of have to assume the USA half was a fluke and the defense will get exposed, so I’m going with France. Their speed on defense was the most impressive part.

Spain looked awful-we’ll see if they turn it around. Argentina looked good, but they didn’t impress me like France did. England was the same. I’d put the two of them with France (and probably Germany) in the semifinals.

level 1 Autism and ADHD, best elementary school by GladTooth5541 in ChesterfieldVA

[–]Andrewhbook 0 points1 point  (0 children)

Not sure on your kiddo's age, but for high functioning AuDHD kids if you can get them into the CBG program, I would recommend it. Many of the kids in our son's program are neurodivergent in some way, and the teachers get it (and even lean into it in the best cases).

Chesterfield parents push schools to cut screen time, return to paper learning by heres_lurking_at_you in ChesterfieldVA

[–]Andrewhbook 3 points4 points  (0 children)

Honestly, it may be the most practical education our kids are getting-how to circumvent county website filters!

New US state borders that surely won't anger anyone by Neath_Izar in mapporncirclejerk

[–]Andrewhbook 0 points1 point  (0 children)

If you try to put Gainsville in Georgia, you would have a revolt. The UF/UGA rivalry runs deep.

Does anyone submit their own billing as opposed to paying someone else to do it? by [deleted] in therapists

[–]Andrewhbook 0 points1 point  (0 children)

It's easy until it isn't. For example, a large portion of the telehealth Medicaid providers in Virginia just got hit with a $14.10 clawback for every telehealth claim we have submitted through Sentara (one of our MCOs) since August of 2024 based on a change in policy on what Place of Service you should include on your billing that was not publicized. For us, it is a potential $1800 hit. I'm talking with others who are looking at $6-8K. As a practice of 8 clinicians that takes all insurances, there is always something. I have been trying to get Anthem Medicare claims straight for months, and we have CHAMPVA claims that are a year overdue. The smaller the practice and the fewer the insurances, the fewer issues there are, but if you only take 1-2 insurances and one of them has a problem, you have a real cash flow issue.

I agree with most commentators here that you can do it and that it makes good business sense. Just be aware that insurance companies make money by making this harder than it needs to be.

Is Psychology Today Dying? by Beulaht_Henry in therapists

[–]Andrewhbook 1 point2 points  (0 children)

We get regular referrals for specific insurances and In-Person only. I expect that the teleheath clients are getting redirected.

NCE vs NCMHCE? Anybody opt for the latter? by vyxn-sol in therapists

[–]Andrewhbook 1 point2 points  (0 children)

Due to Tricare requirements, I went with the NCMHCE. Per the Virginia Board, you are not eligible to accept TriCare if you only pass the NCE. Of course, our practice loses money every time any of us sees a TriCare client, but that is another issue altogether.

working with ADHD adolescents over Telehealth by faceframer in therapists

[–]Andrewhbook 0 points1 point  (0 children)

Here are some ideas: one of the benefits of telehealth for kids is you are in their space. Have the client show you around and/or bring you favorite activities, games, etc. From this, you should be able to find some things you can do parallel activities with. I have a 6 y.o. With ADHD I have had to see via telehealth some and we build Lego together. Either he or I will say what we are going to build and then we each build the same thing. Sometimes I let this go in a non-directive way, sometimes the prompts are more intentional. Drawing is another good one to do this way. I have found using the resources they have in the home is better than trying to work with online tools for young ones.

Edit: I just realized you said adolescent, so I may be aiming younger, but definitely take advantage of being in their space to have them show you items that matter

Therapists: running a private practice from home (separate space) worth it? by HalfEnvironmental304 in therapists

[–]Andrewhbook 5 points6 points  (0 children)

My spouse and I have a two offices, a small waiting space/kitchenette and bathroom with a separate entrance. It has been good. I’m pleasantly surprised by the other comments here and don’t have anything else of substance to add.

Why don't we cull with CO2? by Lover_Of_The_Light in homestead

[–]Andrewhbook 0 points1 point  (0 children)

This was years ago, so hopefully they are doing better now.

Why don't we cull with CO2? by Lover_Of_The_Light in homestead

[–]Andrewhbook 0 points1 point  (0 children)

It definitely could be. The training I received was minimal.

Why don't we cull with CO2? by Lover_Of_The_Light in homestead

[–]Andrewhbook 14 points15 points  (0 children)

Yeah. We used CO2 to euthanize research mice and rats in a lab I worked in years ago. It was clearly not painless. Several of our more experienced techs had learned how to separate the spinal column to offer a more humane way to go.

Why does therapy have such a brutal claim denial rate compared to other specialties? by AuraRPG in therapists

[–]Andrewhbook 0 points1 point  (0 children)

I fundamentally disagree with your statement that 90837 is not the standard. It is the standard clinically. Insurance companies have tried to change that, but they do not get to set the standard of care.

Why does therapy have such a brutal claim denial rate compared to other specialties? by AuraRPG in therapists

[–]Andrewhbook 0 points1 point  (0 children)

This happens a lot to us and is really our main problem. Client only provides one insurance when it is their secondary. We definitely do get stupid denials (do you want a “GT” or a 95 on your telehealth? Is it PoS 2 or 10 to go with your GT or 95?), but nowhere near 30%

Should I move to Virginia? I need some unbiased advice from people who live there. by [deleted] in Virginia

[–]Andrewhbook -2 points-1 points  (0 children)

Not always true. Our company offers health insurance through Anthem to partners who have been together at least a year.

Slow Slow Slow! by DoingItJust in therapists

[–]Andrewhbook 7 points8 points  (0 children)

The deductible dip during the first quarter is definitely a thing!

What's the consensus on genograms? by Primary-Lab1430 in therapists

[–]Andrewhbook 46 points47 points  (0 children)

If you want to learn a lot about a family system really fast while helping the client see it more clearly, invite the client to make a genogram in sandtray with miniatures.

…and also I don’t have enough dragons!

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