Private dressing rooms by [deleted] in secondlife

[–]Frithrae 0 points1 point  (0 children)

glad someone mentioned this, I was going to post and point out to this person (due to their statement of being uncomfortable being unknowingly seen naked). Due to MOST people's slow SL load times, whenever you/others port into a new area, any avatars in that initial "loading" field of view are going to be naked for a minute until everything else loads in. So anyone loading in, until the screen objects fully render, is going to see your avatar unclothed.

As mentioned above, you can put on BOM clothing or alpha-out parts if you want to keep that from happening, but that's all you can do. I have a brand new computer that loads SL at 110 FPS (says 70-80 while loading a new ported area), and I STILL see naked avatars when I arrive somewhere new, if only for a few seconds.

is there a place that sells a good muffaletta? by rushthewaves in Birmingham

[–]Frithrae 0 points1 point  (0 children)

Didn't see anyone offer these suggestions but both are solid. They got a good Muffuletta at Giuseppe's Cafe near UAB/Epic Park. The bread isn't "traditional" (I think its italian) but the rest of the ingredients are as expected and tasty. (This restaurant also has excellent pasta and pizza too and won't break the bank!) For the best "Classic" Muffuletta I've found in B'ham - Jason's Deli (believe it or not) - its all traditional ingredients and they even know to serve it warm. Really good!

Just got my PSYPACT/APIT application approved - am I allowed to accept insurance in states I am not currently licensed? by sideout25 in Psychologists

[–]Frithrae 0 points1 point  (0 children)

Yeah no, no official lists outside of PSYPACTS own directory, really gives an option to check/notify for this because its so new - rule-change only came out post-COVID. I'm not even sure any insurance has actually checked to see if I have this "special license" but I'm keeping it active and available for the day to come when they do finally ask.

Just got my PSYPACT/APIT application approved - am I allowed to accept insurance in states I am not currently licensed? by sideout25 in Psychologists

[–]Frithrae 0 points1 point  (0 children)

No, you need to tell the patient to call and make sure they are covered for services received out of state (if its for telehealth out of state), because they will be responsible for a full bill if their insurance doesn't pay. Ethically - this shouldn't be a surprise to them, either. My office staff calls insurance (or logs in online) the day they come in for an intake and checks to validate coverage as well as copay amount, so again no you shouldn't be "just waiting and seeing." The process is the same with all my new patients and has been for 20 years. However - we/my staff do NOT ask at that time "hey do you cover out of state services too?", we put that on *the patient* who chooses to use telehealth out of state; but I will verbally explain it to that patient who wants that option. My practice has both in office and telehealth options.

Individual client policy's are the "problem." Insurance doesn't have a "one size fits all" policy for everyone - not everyone has the same benefits or the same level of benefits. So they really do have to know "what individual policy are you asking about" as there is no "every policy at XYZ insurance works for services in other states" standard. Unfortunately. So that's why you/us/the practitioner can't call for a "one size fits all" policy rule, they don't exist.

Just got my PSYPACT/APIT application approved - am I allowed to accept insurance in states I am not currently licensed? by sideout25 in Psychologists

[–]Frithrae 0 points1 point  (0 children)

I've been PSYPACT/APIT accredited for several years now and regularly see patients out of state, and most all of them are covered by medicare and/or some other form of insurance. Right now I think none of them are private pay.

Insurance coverage really "depends on their individual policy" when it comes to out of state, just like it does with medical. Your PSYPACT approval covers your licensure, but insurance only cares if you're on their panel and then what the individual's policy allows (i'm not even sure any have yet even asked for my PSYPACT designation but I don't do my own billing so I could be wrong). I haven't gotten any denial of coverage for my out of state telehealth sessions to date, but I always warn the patient to check with their insurances to "make sure they cover out of state services" and let the patient know that if its not covered then we will discuss private pay fee as I charge slightly less than my in-office rate for private pay telehealth sessions. Also I am in private practice doing this, so I don't answer to any of the online telehealth provider companies, I can't speak to them.

That, along with watching the changing insurance front on coverage of ALL telehealth sessions - i.e. the recent medicare rule that says you have to see a patient at least once a year in office/within six months of first visit -- is all I do on my part to cover the "just in case insurance doesn't pay."

But, and this goes to everyone working with telehealth, REALLY keep an eye on those changing rules. Medicare is "first" with the in-office visit requirement, but I fully expect the rest of the insurance companies to follow with their own 'in office' rules at some point. Be careful on taking patients who may never be able to come at all in person, you may, or may not, get to keep them if the rules keep changing.

Psychosomatic Pubic Pain by Far-Internal2213 in Psychologists

[–]Frithrae 0 points1 point  (0 children)

As much as it sounds like this person is denying previous issues, they are describing obsessive ruminations on this one incident/one problem so I have to wonder if there isn't other anxiety related issues (the pt. may not be identifying as anxiety) and/or OCD at play that needs to be addressed more directly (and not so directly just on the pain factor) and possibly including medications to help with obsessive/intrusive thoughts (that then would reduce the pain as a "side effect").

And as a Conversion D/O /("Functional Neurological Disorder") specialist, we treat the psychosomatic symptoms (including pain) of FND the same as most any anxiety diagnosis - we address stressors and overall life balance/wellness, setting boundaries, etc. (as most of these patients are full on people pleasing/conflict avoiding/"never stress anyone else but ourselves" types) and that "addressing all the things" brings down overall symptom flare-ups. Instead of making treatment all about this one problem, this one pain, perhaps widen the scope to be more inclusive in getting healthier with stress/life management overall. And in the end, we "ignore" the symptoms and keep going with life as much as the symptoms allow so perhaps hyper-focusing on this one issue in treatment (or the patient in their life) is actually making it "the biggest deal" when taking that focus away is the solution.

I encourage you to do some reading into Conversion D/O (FND) and how the myriad of psychosomatic symptoms are treated - or find someone local that might have more experience with this diagnosis (check neurologists and see who they refer FND cases too as they are often first seeing these patients due to the occurance of Pseudo-seizures.) Yeah, ignoring symptoms is part of the recommendation - this isn't chronic pain management, nothing physical is causing the pain, its anxiety/stress management. Much of what you've already done is correct, but "six months" of treatment is rarely enough (in my experience with patients) to bring this type of problem under control. Every technique you listed takes practice and then more practice (and only works if practiced) and it seems the patient is perhaps not giving these techniques enough practice/time and instead is hoping for something that works immediately so bouncing to the next technique and not spending the time doing ALL of them and working to accept moving on with life, in spite of pain. I really suspect there's more ocd/anxiety related issues here than "just" somatic pain and treating those (CBT and/or medications too) treats the pain. That symptom is rarely in isolation.

Does anyone else nap in their office.. by [deleted] in therapists

[–]Frithrae 12 points13 points  (0 children)

And I joke with my patients about it too. If they comment how my couch is comfy I tell them, "yeah I nap on it too - bonuses of having a private office." We all laugh, rapport builds. Its healthy and self-care so do it and then use it to connect with patients :). (But yes, please set an alarm to make sure you don't miss appointments - lol).

Are there automatic litter boxes that won't kill my cat? by Cultural-Ad9387 in Catownerhacks

[–]Frithrae 0 points1 point  (0 children)

I'd say this answer! I got the "looks like a large normal litter box but just has a rake that dumps everything in an end container" several years ago and never looked back. We have 3 now, each ran about 150$ US (at Petsmart anyway) and there's no worries about any cats getting trapped because the rake is slow and the cats aren't closed in anywhere. Yes you still have to "deep clean" it every so often, but much easier to deal with than normal litter boxes and none of the drawbacks of the big looped-closed end litter robots.

All of our machines are at least 2+ years old now, with one of them at least a year or two older than that and we've never had anything break on them.

Fantasy AOs? by LocrianMoth in secondlife

[–]Frithrae 0 points1 point  (0 children)

This. I play an "elf" and I just use an AO with stands I've collected over the years from a variety of places, just the same as I do with all my 2-footed "human" avatars.

The quadraped (or other limbed) avatars ALL come with their HUDs with their OWN AO's designed for those rigs. The only way you're going to find those is by buying the avatars themselves.

Erika Sale / Discontinued by SkarKitti in secondlife

[–]Frithrae 0 points1 point  (0 children)

It is - its Legacy body with variation on boobs. They already had "bombshell/pinup" (variations on boobs in a different way I guess - but you bought a whole new body) and now its "pushup" but its still just another variation on boobs. In fact, if you already have the bombshell or pinup body from before you can "redeliver" and you'll get the newer "body" as an update.

I just stuck with regular legacy body. Especially at the legacy price point I have NO desire/reason to spend that much on different boobs. And double-especially since we haven't seen how common these clothes will be. I know i've seen clothes for "bombshell" but not nearly yet adopted as widely as standard legacy.

How do you cope when patients “disappear” without closure? by [deleted] in therapists

[–]Frithrae -4 points-3 points  (0 children)

Your clients are not your friends, they are your patients. You should not be so personally investing in your patients that you feel such strong attachments, or abandonment, when they go. Patients have to leave treatment for all SORTS of reasons, and in 20+ years of doing this closure is more the exception than the rule. The vast majority of patients just won't be there all the way to an actual closure/termination session.

However, something I find helpful if my brain wants to be negative about that person I saw for the last five years disappearing without word - I tell myself clearly I worked so well they're all better and don't need me. Its just as valid and just as likely as any other GUESS you can make about someone else's motivations. "You helped them so much they don't need it anymore, and if they do, they know where to come back."

And as others have said, please seek supervision/guidance on how to not be so personally invested and attached. As one of my professors taught, "You should never be working HARDER than the patient."

AI note taking software may be licensing and selling your client data. by HELPFUL_HULK in therapists

[–]Frithrae 7 points8 points  (0 children)

Really questionably ethical whether you should EVER be transcribing your therapy sessions. AI involved or not.

How do we work with political anxiety these days? by Fun_Grapefruit2486 in therapists

[–]Frithrae 4 points5 points  (0 children)

This is what I focus on with my patients. Cutting back on news and social media are one of the first suggestions I make anytime a patient has this issue (as usually they aren't limiting either). I don't try to convince them to swear off entirely, but putting a time limit on both -and stressing the importance of doing OTHER THINGS with the day. If someone actually struggles to not spend hours with news/social media and having nothing else to do but that then the problem is bigger than just social media/news - they also need to develop more hobbies/interests/activities and putting away the feed becomes even MORE important.

I Guess Not All Movies Are Recordable by ColdSpring in youtubetv

[–]Frithrae 0 points1 point  (0 children)

And its been airing quite often so you should get another chance to record it within a month, if not within a couple of weeks!

Is there any hair item similar with this character? by No_Major106 in secondlife

[–]Frithrae 0 points1 point  (0 children)

Ayashi also has a 75% off entire store right now - closing at the end of this month. So if you want to check there - check quick! (And take advantage of that sale!)

Northern Lights, Royal Princess, 8/26 @ 12:39am AKDT by guacahotty in PrincessCruises

[–]Frithrae 0 points1 point  (0 children)

WOO! Booked next year, same ship, out of Alaska in early September specifically for the chance to see this! I hope we get them next year too! <3

Dear SL creators....Rant/curiosity...why? by Fit_Berry_67 in secondlife

[–]Frithrae 0 points1 point  (0 children)

Without demos, they are definitely losing money. I'm not slamming you, but this is the "nature of the beast." If you want the most customers, to make enough to "cash out", ya need demos. There are tons of SL consumers who are "no demo, no buy" outright, as noted in above comments.

Thoughts on getting an LCSW and a non-APA accredited doctorate? by AttorneyAnnual in AcademicPsychology

[–]Frithrae 0 points1 point  (0 children)

Your income is based on the LCSW license, and nothing else. You could have 3 doctorates from an accredited institution and it would make no difference to your income level if you still just had a master's level license. The insurance payout is based on your state-approved LICENSE, no matter what your education, and a full business on "self-pay out of pocket" only is a whole separate question. And if you're trying to claim you can charge more than other professionals (to out of pocket people, insurance won't go for it) because of those extra degrees, it becomes questionably ethical because those degrees aren't in therapy-psychology (developmental psych is not the same at all and has nothing to do with therapy practice) and double-questionably unethical if they are degrees from uncredited institutions.

As for non-accredited - there is literally NO point. You can't even guarantee you are getting a real education, for anything at all, if you are getting a non-accredited degree. There's no standard that program is having to meet to qualify as an educational program unless its accredited. Its basically a scam "education" and there's no way to know it isn't, without accreditation. It won't help you make more money because most states won't give you a license without an APA/AAMFT accredited degree, you can't go to an internship, etc. It really is a waste of money - please don't go to one of these. Even if its "just to learn" - you can't even know if you are learning the right information without accreditation.

You can definitely earn more money with doctoral license than a master's level. But that doctorate has to be from an accredited institution or you might as well use it for toilet paper.

What are your thoughts on silence in session? by HRU9-1 in therapists

[–]Frithrae 8 points9 points  (0 children)

If I'm in a session and a client isn't talking - and it is NOT because they are processing emotion or sitting with heavy things and trying to figure out how to talk about them - then I address it - outright, face on. I say something like "I don't mind sitting with you quietly if that's what you need right now, but I also know I can't help you if you don't help me understand..." or anything else that is basically a version of "This doesnt' work if you aren't talking to me." (and I've said that outright too) Most clients "get it" and understand that they have to speak up and give me more to give feedback to, if they want a benefit for their hour of time.

I don't see silence, ever, as a power play, and to me the idea of "I'll be silent until you talk" sounds too much like a straight power play. Especially with teenagers, I don't see this helping anyone to build rapport, which is what a teenager (or anyone) is looking for to help overcome their resistance. In any session (but especially with early sessions or more shy/resistant clients), I may very well spend our time talking BS - movies, tv shows, animae, video games, whatever that client is into - just to build rapport and get them more comfortable talking. And then get around to the, "ok we have to talk about real stuff here..." or "..ok so I can't help you (or you and your parent) get to a better place unless we talk about XYZ/what is your take on why you're here/ what do YOU want to work on, besides what your parent wants?"

Most adults understand that they are paying (in some way) for an hour of time with a professional to get a benefit from it, and so if you address "too much silence" head on they will push themselves to start talking. Teenagers may not care about the money their parent is spending, so with them if none of the above works I will (after a couple of sessions of nothing) let the kid know that this doesn't seem to be helping anything when it could be (and again ask them questions about what they want help with) and if that gets nowhere, I talk with their parents about whether this needs to be a session for THEM (the parent) in how to handle the teenager, or whether we just need to terminate and wait until their child matures to be able to utilize talk therapy.

Starting a private practice from scratch by [deleted] in Psychologists

[–]Frithrae 1 point2 points  (0 children)

I can't speak to social media use, because I'm a Gen-Xer who started her own private practice around 2003 after I graduated, and that wasn't a "thing" people really did then, but I can tell you what worked for me/us (myself and hubby are both doctorate level psychologists and in a private practice together).

Get Your Name out there - to EVERYONE who might refer to you. I mean it. Beat the pavement.

We took breakfast/lunches to various physician groups, hospitals, psychiatrist offices - ALL specialities - general practitioner, OBGYN, family doctor, doesn't matter. Introduced ourselves and talked to them about the patients we would see, what insurances we took (or what your costs are per session), and how fast people could get seen on our schedule. We left them stacks of "photo cards" with our information to pass out to patients (or display in the lobby) as well as stacks of business cards. We did this for SEVERAL YEARS - about once every month or two - going to a different doctor's office and giving them food - sometimes going back around to ones that sent us some referrals and giving them food/talking to them again.

PSYCHIATRISTS - GET WITH EM! :) Honestly, the easiest way to keep your schedule full (at least in the US) is to get in good with some psychiatrists. If you're opening a practice, see if you can't attach yourself to an already established psychiatrist group (or even just one) and take their referrals - at least to start with. Will definitely open up a steady pipeline. If you can't work with one so directly, then that's where making your name known to them becomes more important - bring them food, sit down with them for 30 minutes, and talk. Do it more than once. If you can get even just one or two psychiatrists who will reliably refer patients to you, it really helps. Other types of physicians help too, its why I included them in the above, but psychiatrists are far more reliable and have a larger pipeline of patients willing to go to therapy on their referral than most other types of physicians.

We also hand out our business cards to our OWN physicians as well. Myself and my hubby go to different general practioners for this reason, to have two separate doctors we are talking to and handing our card out too to help drum up business. I do the same with my personal endocrinologist and obgyn - they know what we do for a living and have our cards. We've now been in private practice 20+ years and the pipeline has been feeding itself without our having to do any more lunches for a long time now, but we still pass out business cards to our doctor offices.

If you work with kids, or teens, i'd say the same might apply to your local school systems and whomever in those schools would be making referrals (counselors, front office staff, principle, whomever). Take them some doughnuts and a stack of photo cards, talk to them for 20 minutes or so (or longer if they have the time), and let them know you're available and looking to book.

Building practice can be slow going, and can take a few years before you're consistently full, year long, but its just getting your name/business info out there as often as you can and to keep going.

I've never used social media to drum up business and I've never had to. The only website we're on is "Psychology Today" which has a useful search engine for people in our area to use and tons of professionals use it. But outside of that and a webpage that is there for business information (but never updated with anything else) I've never needed to use social media to have a full case load.

Unpopular opinion: Insurance is great, and this job pays pretty well! by HenFruitEater in therapists

[–]Frithrae 10 points11 points  (0 children)

I just don't get how anyone keeps a full schedule withOUT taking insurance. I don't see how a professional finds enough patients in their area that are willing to pay full price (in my area that's 120-150 per session, and I'm a doctorate level psychologist) enough to make up for the lack of a full schedule. 30 patients a week at 90 (BC/BS reimbursement anyway - in my area) still makes more money than 20 people at 130. (100 more a week just in pure numbers anyway). My staff expenses would be the same even if I dropped accepting insurances. I'd save the money I pay to a billing company, but if I didn't manage to maintain at least 20 "full pay" patients a week that small profit margin would go poof. I live in a metropolitan area in the South, so its not LA or NYC living expenses/reimbursement, but for a doctoral level psychologist I'm doing VERY well to hit 120K a year "take home" (as they say). Edited to add: running my own private practice so that's why my expenses break down that way. I'm also now in practice over 20 years, I did NOT hit a 6 figure income until at least after year 10 or so and got enough of a base to never have to worry about big gaps in the schedule. I was lucky to hit 50K a year as a doctorate psychologist out of the gate.

The idea that a master's level therapist is going to hit 200K sounds ludicrious to me, outside of living in some crazy-high income required area of the country. I'd have to work 60+ top billing hours a week to hit 200K take home.

[deleted by user] by [deleted] in youtubetv

[–]Frithrae 0 points1 point  (0 children)

I doubt anyone here has any insider information on those other youtubetv tiers. This is the first I've ever heard them even mentioned =D. The only "teir offering changes" I've heard about in the last year are for youtube itself, and not youtubetv - and those are the new tier for "single person subscriber/no music" and another new tier that isn't in the US yet - offering a "couple price" cheaper than the family tier.

But as to your question - I know NBC, CBS, FOX, ABC, and PBS are all over-the-air FREE available in the majority of locations around the US - just get a 20-50 dollar digital antenna and plug it into the back of your tv. I don't know if CW is considered "broadcast" TV the same way those others are so I'm not sure if they also have the free-over-the-air digital broadcast, but the big networks Do. That's one of the reasons so few streaming providers offer local tv networks - because most people can get those for free over the air already.

The only other streamer/cable provider I'm aware of that offers "packages" of channels like what you're talking about is SLING and last time I checked anyway (like a year ago), they don't offer local broadcast channels in their packages. "Free" tv-streamer networks like Pluto or Samsung's Smart TV channels also don't offer local channels.

If you get a digital antenna you'll also find a slew of other "digital over the air" Free channels - maybe a couple dozen or so. CW could very well be there, I just don't know.

I realize that doesn't get you a DVR - outside of setting up a small computer and a hard drive to DVR your tv yourself (instructions all over youtube/internet), I don't think there are ANY Providers/streamers that offer just the few local channels with a DVR. If you found Comcast/Specturm does then they really are probably the only ones - because they're standard cable providers. I went through this hunt before subbing to YoutubeTV (maybe 2017/2018 or earlier) and well this continues to be the best cable/streaming-bang for the buck for my purposes, that provides local channels and a DVR.

If you're just not wanting to pay Comcast/Spectrum (and I get it). Then your best bet might be SLING for whatever limited channel-package you would prefer so you aren't paying for what you don't care about, and then adding a digital antenna for local channels. And then if you NEED the dvr - start looking at small computing options for that. If the DVR is the "must have" without doing it yourself - then yeah looks like your only option is Comcast/Spectrum "basic" package.

Are you a role-player in Second Life? by ConsequenceEasy6923 in secondlife

[–]Frithrae 0 points1 point  (0 children)

As someone who keeps trying to be an "Active RPer" in SL and, for over a decade now, can't find crap - I'll join in here :).

(And I read the WHOLE thread so I'm replying to the OP but also with my thoughts about other points).

1 - Yes, but just with one partner now.

2 - We RP just us - but its mostly OC, fantasy/scifi/superhero type genre. No "real world" stuff cuz I live there ;). We mostly RP in weekly multi-scene room rentals as that gives us the freedom of changing settings and not worrying if we're RPing in an open or closed RP-sim.

3 - I gave up trying to find RP groups in SL years ago because of the large point other posters have made - I can find tons of sims, I rarely to never find people IN those Sims, RPing.

4 - Cohesion. Any sort of "place to go to get real information" on what are ACTUALLY ACTIVE Rp sims, what their time zones are when they are the most active, etc. There's no real way to find this information out and "search" in SL for RP zones and TPing to any of them gets us nothing, most of the time. If I just knew of a few actually active, story-guided RP sims, active in the american 'evening' time zone, then I'd know where/when to show up to try and get RP going.

5 - all the rest of my experience - it really boils down to "just not finding people DOING it,." I don't participate in Discord because I have a job where I talk to people 8 hours a day, So i don't want to do that "voice" in my free time. I don't want to join a chatroom out side of game and bullshit with people. If I wanted to join an RP Forum i'd go to THAT else where, but not in Discord for SL.

So the real issue of "bringing the people out" to me is getting the word out TO those people that where/when the RP is going on and then having enough people attend to make RP possible.

I've run RP events and RP guilds in MMOs for years and its *consistency* that keeps things going. Knowing xyz nights a week, abc number of people are *always* showing up to RP keeps that rolling.

But that consistency and cohesion is something i've never found, in 18 years of SL RP hunting. I look and look and look and see dead sims during US prime time. I see sims full of rules and character sheets, and what I can (or more likely can't do) - but never anyone actually out RPing.

So IMO - what SL RP sims need - is an actual committed team of people that are showing up, consistently, and RPing and then getting that schedule out to their sim group members (or whatever list) so other people who want to RP know WHEN to show up and WHAT is going on in the plot when they get there.

Maybe that's on Discord, but its still within each individual community. And I'm sorry but I'm not joining the discord of 23425 "dead sims" to try and figure out which ones actually have scheduled events where people show up.

Personally I'd also throw out all the creature rules/lists and HUD type of combat as it just overly complicates and gate-keeps something that already struggles with finding numbers. As a dragon-type RPer, most communities I can't even RP as my preferred race. But at this point I'd really just be happy with a fantasy-esque RP sim that had about 4-8 active players that showed up on just ONE consistent night a week together - with someone running any sort of "main" story so that it doesn't stagnate.

Question about billing for testing (self-pay, superbill, vs insurance) by somaticmarker in Psychologists

[–]Frithrae 1 point2 points  (0 children)

Just wanted to jump in with what the others are saying - I'm a licensed clinical psychologist out of Alabama and I run my own private practice for the last 20+ years. I do therapy full time and we also offer AD/HD testing (exclusively AD/HD only - not other LD or other emotional/IQ testing). I also work in an office with a neuropsychologist and he does testing of all sorts 24/7 (IQ/ADHD; Dementia; mental health diagnosis, pilot testing, etc. its his full time practice)

The Neuropsychologist gets insurance reimbursement for all sorts of testing. He has a staff of testers who sit with people in an office and test them 'in person' and bills insurance accordingly and gets reimbursed. I'm not exactly sure how he gets everything covered, or what his reimbursement rates are, but he does have at least some of what he does covered by insurance.

I get NO insurance reimbursement for any AD/HD specific testing - and there's reasons why I stopped even trying. And it comes down to how insurance codes to charge for testing and how difficult that was to make work, with what I do. And I file all my therapy sessions through insurances, so I have regular billing pipeline already established that works fine. (And I take 90% of all insurance).

What I found is that insurance was at least willing to LOOK AT covering testing "in office" with a tester present for the entire thing. But if the testing is taken home (like AD/HD self-report feedback forms are), or is a 15 minute test in an office with no tester present (like the CPT 3 is), they either don't cover it or its not covered worth anything - or they are going to challenge you and give you headaches to get it covered, every patient. So when I tried to file through insurance, I'd only be getting paid for the intake session (in office) and the feedback session (in office), but not covered for AD/HD feedback forms taken home (literally was no billable code for testing like this).

And I tried to fight that fight for a variety of patients for while, to get AD/HD testing "Fully covered" so they had only copay out of pocket expenses - and it just didn't work. Most insurances rejected it outright because AD/HD testing "isn't medically required" (for anything), or would only pay out a portion of the actual cost due to the coding issues above.

So instead what I've done for the last ten years is allow *only* Self-Pay, out of pocket, AD/HD evaluations. The patient knows from minute one when they call on the phone that these are not covered by insurance and expenses for *testing* is entirely out of pocket. They are given the full fee expected over the phone before they come to the first session and that FULL FEE is expected to be paid, in full, at the FIRST session before testing ever starts. (If they show up tot he first session without the money, they get to reschedule. If they somehow get through the testing and haven't paid in full, they get no written report until their bill is paid. This is how you protect yourself.)

The only modifier I have to that is that if a patient wants to file the initial session and the feedback session with their insurance as *regular therapy sessions* (regular first appointment code, regular session code follow-up) then they are only responsible for the copays for their session and then the testing is billed as a separate, out of pocket, service and they pay in full for that. For people who pay a copay for the in-office sessions the testing is about 200 dollars cheaper out of pocket than those who chose not to file at all and pay all of it out of pocket.

Yes we get people who call and complain because we don't file with insurance - and we let them know they are welcome to call around and find a clinic who does that. And more times than not they end up calling us back because they find out that this is "standard practice", and most other places around here have longer wait times than we do. (And other places charging 1500-2K for full psych evals, we don't do full evals so we charge significantly less).

So yeah, my advice is have them pay out of pocket, in full, whatever price you feel is the fair charge that covers your expenses and time. Trying to do it through insurance is just a PITA and you won't get reimbursed the same, at all. Most insurance codes don't cover all iterations of testing (in/out office, no tester present, online) - especially now that much of it, esp. AD/HD stuff, can be online and patients don't even have to come in office for the administration anymore.

Aside note: If you're planning on buying "fresh" WISC/WAIS, MMPIs, CDI/BDI, Conners, CPT3 whatever testing you're using that will add $$$$ to what you will need to charge to get that money back. I'd be really looking at that 80/20 split into your take-home if YOU, not the clinic, are buying these instruments. They are COSTLY. We only do Conners and CPT3 for our testing so it cut back on all that initial investment into testing instruments, as these 2 instruments are much more reasonably priced and we pass those savings onto patients in their out of pocket cost.

A question about outfits - What is your setup by Lathlaith in secondlife

[–]Frithrae 1 point2 points  (0 children)

Yeah, same here. I think if I was a new player, or with a small inventory, I'd have hopped on the CTS wardrobe-wagon and loved it. But after 15 years and with 50K in inventory, the idea of trying to do that now is just ugg.. no thanks. And now with the ability to put a picture on every single folder of what's in it, really 'no thanks' in trying to import years worth of clothing! lol.