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Billing for Counseling Center

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PMRNC:

--- Quote ---They are going to the treatment centers and other treatment centers are sending them over. The workshop/program is group therapy sessions over 3 days where they address abuse, trauma, etc. and this group therapy program will be offered in inpatient and outpatient treatment facilities. There will be an assessment, lecture, and group and individual time.
--- End quote ---

Usually this entails an arrangement between the treatment center and program doing workshops. You need to first find out what that will be. The facility charges will be billed by the facility and maybe even professional charges depending on the arrangement. I've seen providers go to treatment centers and just get paid from treatment center with them taking care of the billing.

asilva03:
Thanks Linda.

"I've seen providers go to treatment centers and just get paid from treatment center with them taking care of the billing."

This is the scenario I have seen, but the counseling center is stating that the treatment centers are running into billing problems when dealing with clients that are IOP or RTC because the counseling center's workshop will be outside of the time allotted by the insurance contract.

I will definitely talk to them about their current arrangements and if they are trying to go a different route to see if that is why there are so many billing issues and concerns.

PMRNC:
If these are "workshops" it's not the "allotted" time it's the TYPE of services, ONLY covered charges are going to be considered. You had stated there would be lectures, group and individual, remember that carriers will not pay both individual and group on same day. I think this is more of a "covered" services issue in which case they can look at their contracts and see if they can bill patient. Since they are GOING to the treatment centers their billing is their own correct? So I would also think they need to look at their contracts. Many treatment centers know that carriers don't pay for both group/IOP on same day so they accommodate that by breaking up the sessions.

asilva03:
When the counseling center goes to the treatment center, they usually get paid from the treatment center and then they bill the insurance. The treatment centers are running into problems when trying to bill for the "workshops". These treatment centers have patients that are at the IOP level.

asilva03:
So, I spoke to the counseling center to gain more insight into what they are looking for. An independent therapist/counselor goes to the treatment center on a weekend and provides an assessment, individual, and group therapy to patients. The independent therapist/counselor gets paid by the treatment center and the treatment then bills the insurance carriers.

My question is if the patient is IOP, PHP, or RTC, can the professional services (therapy sessions) be billed separately from the daily rate? If the patient has already had group therapy with a different counselor, can the independent counselor still bill for group therapy for his session?

The facility is billing its own charges for the facility, we just want to make sure that the counselor can go in, perform his services, get paid by the facility, then the facility can then turnaround and get paid by the insurance carrier for the services he has performed and how if the patient has multiple therapy sessions a day.

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