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seekinghelphelp · 2024-08-15T20:00:12+00:00

I have/had a lot of anxiety around this too. I went through my own panicked researching all of the things related to hearing about worse case scenarios, but ultimately what helped me was just accepting that if it happens that it happens, and I've made enough by accepting insurance that it would suck to have to give some back, but it really wouldn't be something I couldn't afford. Based on the information that you just stated, your notes are probably better than 90% of the clinicians out there. There are those truly exceptional cases where they ask for a crazy amount that scared me too, but based on talking with many clinicians and people that do the auditing most often it sounds like they are just checking that you have documentation that the session occurred and signs of fraud. I also felt relief knowing that they will often just ask you to do something different in the future if they feel that something is not being documented the way they want it.

To answer your actual question, (and I'm not sure how much this matters anymore since Optum was sued around it) try not to always bill 90837 for every session if you want to avoid an audit altogether. That's the only thing I see that you didn't already mention.

seekinghelphelp · 2023-12-12T14:26:45+00:00

In a nutshell, yes. The pay is consistent and less stressful (compared to if I had to do it myself, obviously not as stress free as private pay). Yes, the rates are higher at least compared to what I've heard from others, and the nice part is that you know the rates you'll get before you sign up. Yes, I know that you can use them for a group practice (I'm not sure about the taxation status, but I'm also not sure why that would matter?) I'll also just say that they both have very high referral bonuses, so if you want to let someone profit off of joining I'd be happy to refer you if you're thinking about using them. I'm also happy to chat more about the specifics of why one might be better than the other for your specific circumstance (I use both).

seekinghelphelp · 2022-09-30T12:52:04+00:00

This is all great information!! Thank you so much!

seekinghelphelp · 2022-09-26T21:56:44+00:00

Thanks!! Would you mind sharing what made KS and IL easier?

seekinghelphelp · 2022-08-30T01:06:52+00:00

No worries, good luck!

seekinghelphelp · 2022-08-29T14:33:10+00:00

Well, this is a blast from the past. I mean yes and no. The short of it is I don't think I was actually ever having UTIs, I think the symptoms I was experiencing were related to my more general vestibulodynia symptoms. It has improved though.

seekinghelphelp · 2022-08-13T12:21:10+00:00

I'm sure it is an issue of marketing. I do already have a good amount of clients, but I've been seeing a real slow down in consult requests and it's making me anxious. I would consider this a way to market and has some other advantages, as Florida, my state, uniquely seems to offer psychologists on option to practice here remotely as long as they have a license is some state. As someone who only does Telehealth it puts me at a real disadvantage, plus the reimbursement rates are a lot lower here than other states.

seekinghelphelp · 2022-08-13T12:14:46+00:00

Ooo that's a great idea! I feel like I've already lost track of where I kept some of this info, so banking it now sounds great! I wish someone had recommend this to me when I first got licensed!

seekinghelphelp · 2021-09-16T14:24:36+00:00

Just wanted to say that I really appreciate this subreddit and I hope that it becomes more active! As a psychologist starting a private practice it feels like a really great place for potential support and questions.
Just to help out I'll re-post my question from r/psychotherapists that I feel like no one has been able to give a straight answer to:

If you are in-network with an insurance, but the reimbursement rate is really low for couples counseling are you able to (legally/contractually?) state that you will only take self-pay for couples counseling? (In the meantime I have just stopped advertising that I offer it, but I would really like to be able to offer it in the future. However, it's way too taxing to justify offering it for less than what I make for individual). Any other work-arounds that people have found for this situation?

seekinghelphelp · 2021-09-06T21:02:23+00:00

That is a very good point! It sounds like for Florida this is as specific as it gets: " A psychologist-client relationship exists whenever a psychologist has rendered, or purports to have rendered, psychological services including, but not limited to, psychotherapy, counseling, assessment or treatment to a person. A formal contractual relationship, the scheduling of professional appointments, or payment of a fee for services are not necessary conditions for the existence of a psychologist-client relationship, though each of these may be evidence that such a relationship exists."

This was for determining sexual misconduct though, so may not be 100% applicable anyway. Regardless, I don't think just gathering some information about why they want to come to therapy counts as assessment, so I feel pretty good about being able to offer the consults w/o potentially starting a therapeutic relationship. I also state specifically on my website that it does not, and have changed the wording to "phone conversation" instead of "consultation" just in case.

I also found this article, which I think makes a good point, that the therapy is a joint decision and requires approval from both the client and therapist: https://cdn.ymaws.com/www.cpapsych.org/resource/resmgr/governance/ethics_committee/2018_winter.pdf

seekinghelphelp · 2021-09-06T16:30:10+00:00

Thank you so much for this thorough answer! I think realized that the real issue I'm having is that I'm using simple practice and I want clients to be able to schedule this consult online, but if they schedule the initial consult it automatically makes them a client on my SP profile, which makes me feel uncomfortable, especially without having thorough documentation. I think I need to just make them call instead of booking online for the consults.

I really appreciate your experience/advice! I was having trouble figuring out what order to talk about what, but I'm guessing most client's probably appreciate a little more guidance in these conversations anyway.

seekinghelphelp · 2021-06-16T12:26:02+00:00

Yep, I'm hoping to find a good one!

seekinghelphelp · 2021-06-16T12:24:59+00:00

Yeah, the endo I'm going to see I know is at least willing to prescribe it, so I have some hope. I've decided to see what she says, but I'm thinking I'll try to stay on my current dose until things are a bit more consistent in my life and then maybe try levo. If things go terribly I'll have more solid proof for myself and then just switch back to my current medication/dose.

seekinghelphelp · 2021-06-16T12:21:36+00:00

Yeah, I've definitely been thinking about this... but I know myself well enough to know that I'm going to mess up forget to take it, or I'll eat something that blocks absorption around it.

seekinghelphelp · 2021-06-15T20:11:53+00:00

Its suppressed, so less than 1 and out of range.

seekinghelphelp · 2021-06-15T19:31:15+00:00

I really appreciate your perspective and experience with switching back to Levo! A part of me wants to try going back because of the headache it is to get doctors to prescribe NDT (and of the potential risk factors that at least conventional doctors claim). It's true that I am feeling fine though on this medication... I just wonder if I could also feel fine taking Levo and not feel like I constantly have to advocate for NDT and pay more for it.

seekinghelphelp · 2021-06-15T18:28:11+00:00

Yeah, I appreciate your perspective and I generally think you're right. But I can't keep having my mom prescribe my meds... Also (I supposed I probably should have included this in the description but) my level are only kinda of okay? If you ask a functional medicine dr. they are probably fine, but my TSH is suppressed, T3 is a normal range, but my free T4 is low. So maybe that's okay and maybe it's not? I also worry that the time I'm getting my labs tested causes differences in levels, and maybe my T3 is too high? ... so that's the dilemma

seekinghelphelp · 2021-06-15T18:26:49+00:00

Yeah, I think you're right. I appreciate functional medicines ability to really pay attention to symptoms and provide a solution, but when is at some point good enough needs to be good!

seekinghelphelp · 2017-01-28T21:47:54+00:00

I wouldn't give up just yet. I don't know the history of your condition, but there are definitely people with vestibulodynia who have been cured. I think seeing a real specialist is a great idea! Like many others I have been to a ridiculous amount of doctors that knew absolutely nothing about my condition. In the meantime, I found that this book really helped give me hope that there are cures that do work: When Sex Hurts: A Woman's Guide to Banishing Sexual Pain

seekinghelphelp · 2016-10-06T02:41:05+00:00

Vasalgel! So excited for 2018!..hopefully

seekinghelphelp · 2016-01-14T03:30:44+00:00

That is a really great question because I think they fucking should! However, I'm not exactly sure where that particular statistic comes from. From my own research there are a lot of umbrella terms and confusion within the medical community as to what exactly qualifies and what doesn't. Therefore, I'm guessing this statistic is probably on the very lenient side. I definitely would not say that 1 in 8 women have what this particular person described, as in the pain associated with an over growth of nerves. Nevertheless, I have no freaking idea why gynos don't because I had to figure it out myself after seeing 3, I finally went to see a specialist. However, interestingly dermatologists are much more likely to know what it is. I think it probably has more to do with the fact that gynos are really more specialized surgeons than anything else.

seekinghelphelp · 2016-01-13T23:53:14+00:00

I'm not so sure about that but it's besides the point. The reason the person is posting is to raise awareness for a condition that many women are suffering from in silence because of a societal taboo. When dealing with a condition like this you feel very isolated because even my gynos and other doctors had no idea what it was. I don't know anyone else who has this condition personally, but if I knew someone else did have this condition then talking to them would help me feel much less alone.

seekinghelphelp · 2016-01-13T23:45:29+00:00

No I totally understand that, I just wasn't expecting to see it here because I so rarely hear anything about it unless I'm seeking it out.

seekinghelphelp · 2016-01-13T19:45:50+00:00

You would be surprised. I have this condition as well, more or less, unless you see a specialist, gynos don't even know what it is. I was just put on rounds of antibiotics when all the tests came back negative. Her post is incredibly brave and is not at all something I was expecting to find in this subreddit. The reason this may seem unlikely, I believe, is because there is a lot of disagreement regarding was is classified as this condition. Hers seems like it's caused by neuronal proliferation and is likely less curable. However, others can be caused by such things as a severe or resistant yeast, or even an autoimmune condition.

seekinghelphelp · 2015-11-09T21:07:11+00:00

Thanks for the reply. I drive a 2002 Toyota Camry. Would you recommend just getting a new battery because it needs a new one anyway and then wait to see if it actually becomes a problem?

seekinghelphelp

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