New Practice...LCSW...Providing licensure supervision, and taking interns

[ksmtmfh]

Greetings all, and thanks in advance for your recommendations.

1.  I am a LCSW in TN, and will be providing supervision for a LMSW accumulating hours for her clinical license.  What is the proper way to bill for the services she renders?  I am in a private practice group/outpatient setting.  I have both a group NPI and my own individual.

2.  I will have graduate students from varying programs in the fall, also providing direct supervision (99% of the time) in both individual and group therapies.  My assumption is that if I am sitting in the room, I simply bill for myself.  My understanding is that I am not able to bill at all for these interns.

3.  What recommendations would the group offer for hiring a service to keep me out of hot water with billing?  The business is a startup, at this point...so I'm watching every penny.

[Michele]

1.  I am a LCSW in TN, and will be providing supervision for a LMSW accumulating hours for her clinical license.  What is the proper way to bill for the services she renders?  I am in a private practice group/outpatient setting.  I have both a group NPI and my own individual.

You should check you state and local laws but I believe if you are providing supervision you would bill with your information

2.  I will have graduate students from varying programs in the fall, also providing direct supervision (99% of the time) in both individual and group therapies.  My assumption is that if I am sitting in the room, I simply bill for myself.  My understanding is that I am not able to bill at all for these interns.

Again, as above (after checking state and local laws) billing would be under you.  Interns do not have their licenses yet (correct?) therefore the billing cannot be done under their name

3.  What recommendations would the group offer for hiring a service to keep me out of hot water with billing?  The business is a startup, at this point...so I'm watching every penny.

As a billing service it's hard to be unbiased, but you are asking my opinion.  I believe outsourcing is the answer.  I have seen many instances where billing is done in house and it's a big mess.  It is hard to hire someone and know exactly what their knowledge and experience is.  With a service you can ask for references of colleagues.  Also, it is your license on the line if they are doing anything wrong.  You want to make sure you have a professional.  The billing is your complete income stream.  You don't want to mess with it.  I have seen so many providers lose money due to billers in the office (and some billing services).

Even as I write this I'm realizing that the important thing is that you know what's happening with your billing whether it is being done in house or out.  It is not ok to just let it happen without paying attention.  Many providers just look at what comes in and if it's enough, they are good.  That is not a good way to handle it.  There are some providers who do in house billing but have a great staff (not too many!) and there are some billing services that give the rest of us a bad name. 

You need to interview your service just like you would interview an employee.  Ask them about their experience, references, what they have for a rejection rate, how much on average is out over 30 days, etc.

[PMRNC]

I agree with Michele on all points and I would add that I understand being on a budget for startup, but you want to also be in full compliance with all laws/regulations, you should seek out an experienced healthcare attorney for advice on supervision and compliance.   In regards to billing, I've seen it OVER and over again, start up small provider wants to save money and they do the billing themselves and 99.999% it leads to bigger problems than when they started. 

[ksmtmfh]

Thank you ladies.  There is a no-crap medical biller sitting at my machine right now, and I am perusing attorneys and accountant types now.