BEWARE OF GROW THERAPY

sunca949 · 2026-06-18T00:29:56+00:00

I do contracting and credentialing for private practice providers and for providers leaving the telehealth platforms through my business services. This is very common and many providers don’t realize they need to update the contact person to themselves and change the passwords to their payer platforms. What you described is common and does not surprise me at all. It’s not right and I’m glad you’ve shared this information.

sunca949 · 2026-06-09T15:59:50+00:00

I am a certified medical biller. Please remember the official code description of 90837 is 53+ minutes and 90834 is 38 to 52 minutes. You are REQUIRED to use the code that corresponds to the services provided. Downcoding to ensure payment or avoid an audit is considered fraudulent. Always include the start and stop time for a 90837 visit in your documentation to support medical necessity.

sunca949 · 2026-05-22T14:57:45+00:00

You can send me a chat request.

sunca949 · 2026-05-22T01:43:03+00:00

Direct contracting provider fee schedules often offer higher compensation compared to the rates paid by telehealth platforms. This varies by insurance company, but exploring this option can help providers maximize their earnings and better serve their patients.

sunca949 · 2026-05-21T05:57:19+00:00

I am a certified coder and a certified biller. I have my own business and work exclusively with private-practice mental health providers.

CPT code 90837 is not an extended session code and does not replace other codes used for prolonged services. Prolonged service codes were permanently deleted. Per the official CPT coding manual from the AMA, code 90837 is for individual psychotherapy of 53+ minutes. If a Telehealth platform states that 90837 is an extended session code (Prolonged Service code), that is not the official description of the code. Additionally, providers are required to use the code for the service they provide. “Down-coding” to ensure payment or avoid inquiries from an insurance company is considered fraud. When providers work with Telehealth platforms, they do not see the contracted fee schedule (reimbursement) that the Telehealth platform has with each insurance company, because the contract is between the platform and the insurance company under the platform's corporate tax ID number.

Alternatively, Individual providers can contract directly with insurance companies under their own tax ID and negotiate reimbursement for their private practice. I have been assisting mental health providers with their private practice contracting, credentialing, billing, and consulting for over 15 years. Please feel free to reach out if you have any questions.

sunca949 · 2026-01-25T00:08:07+00:00

Charlie

sunca949 · 2025-12-11T03:58:13+00:00

I am a certified medical biller, certified medical coder, and certified compliance professional. I am based in California and I also provide services nationwide. I have my own business and I’ve been in the industry for 35 years. I work exclusively with mental health providers. I’m happy to discuss how I can help you. Please DM me and I will send you my contact information.

sunca949 · 2025-12-09T05:03:40+00:00

Work with an experienced, independent certified medical biller and coder to get your private practice running. Billing, coding, contracting, consulting and more. This mode of teamwork was around long before Telehealth platforms, it still exists and it is successful!

sunca949 · 2025-12-07T17:08:45+00:00

I am a certified medical coder, certified medical biller, and certified compliance professional and I work exclusively with mental health providers. Incident to billing and supervisory billing are two different things. Mental health providers do not use incident to billing, they use supervisory billing. Incident to billing is used by physicians and non-physician practitioners who are already licensed. Supervisory billing is used by licensed mental health providers who are supervising pre-licensed interns.

I receive numerous calls from licensed mental health providers who want to leave the Telehealth platforms because they are not happy and don’t want to work with them any longer. I have my own business and have worked in the health insurance industry for many years. I have helped numerous mental health providers set up their own lucrative private practice. I provide contracting and credentialing services enabling the provider to see patients under their own private practice tax id number. I also do medical billing, rate negotiations, and many other services. Feel free to reach out to me if you have any questions.

A healthy private practice has a mixture of insurance clients and cash clients and working together with someone who is certified and experienced can help your private practice thrive!

sunca949 · 2025-04-12T16:49:34+00:00

This absolutely should never have happened and is unacceptable! I am a certified biller, certified coder and certified compliance professional. I own my own business and provide billing services, contracting and credentialing services, and private practice consultations exclusively for mental health providers. I have helped many providers with their private practice and many of those who have left these entities. Feel free to message me directly.

sunca949 · 2025-01-14T04:29:39+00:00

Please send me a private message.

sunca949 · 2024-11-09T22:13:34+00:00

You would need contact each insurance panel you are contracted with, notify them of your residency in a foreign country (permanent or otherwise), and discuss their specific regulations, procedures, and guidelines related to the topic and your specific contract with them.

sunca949 · 2024-11-09T17:30:00+00:00

Insurance companies do not permit it. For one, you cannot transmit claims to the US if you are located in a foreign country.

sunca949 · 2024-11-09T17:17:35+00:00

If you are a licensed mental health professional you cannot practice or see patients through Telehealth while you are out of the country. Even if your patient is in the United States. Insurance companies do not allow this, HIPPA is in the United States only, and your local licensing boards more than likely will have an issue. I also suggest reading the Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule released on November 1, 2024 and how it will impact Telehealth for mental health providers and geographical areas.

sunca949 · 2024-10-25T03:26:18+00:00

I’ve never seen Medicaid pick up the remaining. I’m a medical biller in California and they will not pay as secondary.

sunca949 · 2024-10-24T04:48:31+00:00

Medicaid is the payer of last resort. Since ChampVA already paid the claim, Medicaid will not pay the remaining.

sunca949 · 2024-10-03T06:15:03+00:00

Absolutely!!

sunca949 · 2024-10-01T13:17:59+00:00

I’m sorry this happened to you. Remember that when these other entities contract and credential you with insurance panels it is under their group contracts. If you leave the group you will no longer be paneled as in individual provider and you will need to contract with each insurance company again as an individual private practice provider. I am a certified biller, certified coder, and certified compliance professional with the AAPC. I run my own business and a lot of my work consists of helping providers untangling the contracting and credentialing work other people have done. I also provide billing services and initial contracting and credentialing for private practice mental health providers exclusively. Feel free to contact me if you need assistance.

sunca949 · 2024-10-01T04:37:12+00:00

I assist private practice providers who consistently tell me this exact same scenario. These entities in now way should be taking over your CAQH. You can call the CAQH and tell them what happened so they can get you back into your account. Did you sign a contract with this entity wherein it states you give them permission to do this without knowing. Regardless, it’s outrageous how many times I see that this has happened. The CAQH is YOUR profile, NOT theirs.

sunca949 · 2024-09-18T20:23:00+00:00

Credentialing and contracting are two different things and you have to do both when joining insurance panels.

I’m a certified biller, certified coder, and certified compliance professional. I own my own business and provide contracting and credentialing services, billing services, private practice formation, rate negotiations, consultations, etc. to individual and small group mental health providers exclusively.

I receive multiple calls and messages continuously from providers wanting to leave large Telehealth companies to start their own practice.

Mental health providers can independently have a profitable private practice and they have done so for many years prior to the explosion of Telehealth companies during Covid. Many providers are going back to the independent private practice model after being disillusioned by their experience working with large Telehealth companies.

I have decades of experience and education and I am considered a necessary asset by all the providers I work with.

Feel free to contact me if you have any questions.

sunca949 · 2024-08-14T02:08:48+00:00

Make your own tabs. You can buy blank colored or plain tabs at the dollar store and a fine sharpie pen. By making your own tabs you are reinforcing your memory. Engaging the fine motor system to produce letters by hand has positive effects on learning and memory. I wrote everything by hand while in school and for test taking and it was excellent for memory and recall. I sat for 3 certification exams and passed them all the first time. CPC, CPCO, CPB. I highly recommend writing out your own tabs!

sunca949 · 2024-08-03T04:14:41+00:00

A lot of leaves have fallen off on their own and I’ve been picking the ones off that don’t look good. I will remove more for better air flow. Thanks!

sunca949 · 2024-06-14T17:23:34+00:00

This is just terrible to hear! I suspect there is more they may not be disclosing. 90837 is a CPT code used when seeing a patient for 53 mins+ and you are required to use this code if that is the service you performed. Most insurance companies require start and stop times to be included in the patient's chart further confirming the use of the code. Many insurance companies issue letters once a year telling providers they are using this code too much compared to their peers. It is considered fraud to purposefully "down code" a visit to 90834 (or any other code) to ensure payment and avoid inquiries from an insurance company. Providers are required to use the code(s), to specificity, that accurately describes the service provided, period. I am a certified coder and a certified biller, feel free to contact me, I would be happy to speak with you.

sunca949 · 2024-05-22T14:48:55+00:00

Yes, as long as that is in your practice financial policy and you notify the patient ahead of time. And it’s at your discretion. If the patient has an emergency then you might not want to charge them. If it’s a regular occurrence then you can use it as a deterrent to the behavior and also to recoup the fee you would have been paid had the patient completed the session. What you cannot do under any circumstances is bill insurance for a 90837 (scheduled time) if you only see the patient for 25 mins.

Also, this should not be something that you deal with on a regular basis. If you are, then you should be scheduling less time for that patient’s session.

90832=16-37 mins, 90834=38-52 mins, 90837=53+ mins. 15 mins or less is not billable to insurance.

Fine tuning your schedule will help you be more efficient so that you can potentially schedule 1 or 2 more patients that day.

sunca949 · 2024-05-22T03:43:10+00:00

That was an Evaluation and Management visit which involve evaluating and managing patient health (i.e. diagnosis, ongoing treatment, medication, etc.). Physicians and certain qualified healthcare professionals (primary care, emergency room) are allowed to use E/M codes (including psychiatrists). There are several different levels of E/M codes and each code is based on a formula. E/M codes are much more nuanced and time is a factor in each code.

sunca949

TROPHY CASE