Photo of a person entering numbers on a calculator. Text over the image reads, Episode 240. The Modern Therapist's Survival Guide. The Surprise of Good Faith Estimates.

The January 2022 Surprise of Good Faith Estimates Requirements

Curt and Katie chat about the No Surprises Act, specifically how to navigate the requirement for clinicians to provide Good Faith Estimates to clients. We talk about the impact of Good Faith Estimates on the intake process, potential complications when providing these estimates to your patients, and suggestions for how to simplify and systemize this requirement.

Transcript

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In this episode of the Modern Therapist’s Survival Guide we talk about the No Surprises Act and the Good Faith Estimate Requirement

When we heard about the planned implementation of these new requirements, we decided to dive into the legislation and articles from professional associations to understand what we actually need to do starting January 1, 2022.

What is the No Surprises Act and the Good Faith Estimate (GFE) Requirement?

“Some folks don’t have a clear sense when they come into therapy, how long they’re going to be there for.” – Katie Vernoy

  • The goal of the No Surprises legislation is to avoid surprising patients with large medical bills
  • There are benefits and challenges with the requirement to provide good faith estimates to our clients
  • The Good Faith Estimate requirement is to provide the estimated cost of services (fee times number of sessions) at the beginning of treatment (if asked) and at least annually, if needed

How will the Good Faith Estimate Requirement impact the Intake Process for Therapy?

“These are not contracts; this is not guaranteeing the therapy is going to end after that many sessions.” – Curt Widhalm

  • We are required to determine whether someone is hoping to get insurance reimbursement
  • We must communicate the ability to obtain a written good faith estimate from providers
  • We are required to estimate the number of sessions and total cost of treatment
  • We talk about when you may need to provide a new good faith estimate (and explain changes)
  • We provided a suggestion to start with a GFE for the intake session and then provide a second GFE after that initial session

Potential Complications Curt and Katie see for Therapists Providing Good Faith Estimates

  • The requirement for diagnosis very early in treatment
  • The requirement for a diagnosis written on paper – both for folks who don’t know or have not asked before, as well as for folks who do not want a written diagnosis
  • Concerns related to putting forward the total cost of therapy for the year
  • The elements of bureaucracy that could negatively impact the therapeutic relationship
  • The No Surprises Act legislation isn’t finalized and may have additional components or changes

Our Suggestions to Systematize the Good Faith Estimate (GFE) Requirement for Therapists

“There are certain aspects of this that I think – while onerous as far as communication with our clients – have the potential to make us actually talk with our clients about their treatment more frequently.” – Curt Widhalm

  • Consider coordinating the timeline for updating GFEs, treatment plans, frequency of sessions, progress in treatment, and a reassessment of the sliding scale
  • Think through how you talk about diagnosis and treatment planning ahead of time
  • The idea to create some sort of mechanism for folks to either decline a GFE or to request an oral versus paper GFE
  • Use recommended language to create your notice for your office as well as on your website
  • Create your own template to simplify the process, including a boiler plate GFE for your intake
  • Create a template for GFEs for on-going treatment

Our Generous Sponsor for this episode of the Modern Therapist’s Survival Guide:

Logo Image of Simplified SEO Consulting, our very generous sponsor for this week's podcast episode of the Modern Therapist's Survival Guide. Simplified SEO provides search engine optimization services and training to improve your organic search rankings on Google.

Simplified SEO Consulting

Simplified SEO Consulting is an SEO business specifically for therapists and other mental health providers. Their team of SEO Specialists know how to get your website to the top of search engines so you get more calls from your ideal clients. They offer full SEO services and DIY trainings.

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Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

APA Article: New Billing Disclosure Requirements Take Effect in 2022

Suggested Notification Language for Good Faith Estimates

Template for a Good Faith Estimate

Good Faith Estimate Legislation Language from the No Surprises Act

Federal Register: Requirements Related to Surprise Billing; Part II

CMS.gov: Requirements Related to Surprise Billing; Part I, Interim Final Rule with comment period

Relevant Episodes of MTSG Podcast:

Should Private Practice Therapists Take Insurance?

Make your Paperwork Meaningful

Who we are:

Picture of Curt Widhalm, LMFT, co-host of the Modern Therapist's Survival Guide podcast; a nice young man with a glorious beard.Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Picture of Katie Vernoy, LMFT, co-host of the Modern Therapist's Survival Guide podcastKatie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

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Consultation services with Curt Widhalm or Katie Vernoy:

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Connect with the Modern Therapist Community:

Our Facebook Group – The Modern Therapists Group

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano http://www.crystalmangano.com/

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Curt Widhalm 0:00
This episode is brought to you by Simplified SEO Consulting.

Katie Vernoy 0:03
Simplified SEO Consulting is an SEO business specifically for therapists and other mental health providers. Their team of SEO specialists know how to get your website to the top of search engines so you get more calls from your ideal clients. They offer full SEO services and DIY trainings.

Curt Widhalm 0:21
Stay tuned at the end of the episode for a special discount.

Announcer 0:26
You’re listening to The Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 0:41
Welcome back modern therapists. This is The Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy. And this is the podcast where we talk about things that affect therapists, our practices, the ways that we practice, the ways that we interact with clients and today I’m going to start by talking about back when I was in high school, I had to take chemistry class, and studying the periodic table.

Katie Vernoy 1:08
Where are you going with this?

Curt Widhalm 1:10
My favorite element at the time was tungsten because the W on it, but over time, my new favorite element is the element of surprise.

Katie Vernoy 1:26
Surprise!

Curt Widhalm 1:27
I think actually, a lot of providers are surprised at the No Surprises Act, which we’re actually talking about today. Going into effect January 1 of 2022 and many people have been over the last couple of weeks, speculating on what this means for their practices, what actions that they need to take. And it’s seeming to get to be a little bit of a game of telephone out there in therapy land when seeing everybody talk on Facebook groups and this kind of stuff. So Katie, and I have done an adequate job of diving into this. And…

Katie Vernoy 2:10
Adequate is the right word, I think.

Curt Widhalm 2:13
So we wanted to be able to talk about the big scary aspects of this, the not so scary aspects of this, and the parts of this that are TBD, because it’s not even fully out there yet. And much like the Spanish Inquisition, nobody knows when it’s coming. So. So we are going to include some helpful things in our show notes, you can find those over at mtsgpodcast com. I’m sure we’ll be doing a follow up episode to this a little bit later, we will also include a whole bunch of very boring and dense government regulations in those show notes as well. So that way, you know that we at least can link to other things in our show notes.

Katie Vernoy 3:09
We’ve already started off great, very adequate Curt, very adequate.

Curt Widhalm 3:13
Yes. So probably the best resource out there, at least as far as condensing down a bunch of…

Katie Vernoy 3:22
At the time of recording.

Curt Widhalm 3:24
Yes. There is an article from the American Psychological Association originally created December 10 2021, that outlines what this means for psychologists. But if you are a healthcare provider of any other status, and you are operating within your license or your credential, this article pretty much applies to you too. So we’re going to go through this, we’re going to add little bits here in there and also make some suggestions that aren’t included in this article. And continue to listen to the show and join our Facebook group for further updates on any of the stuff that we’re talking about here today as we find important stuff to share. So now, actually, to the content of the show, if you haven’t left yet, but the No Surprises Act was part of a broad package that was signed into law during the Trump administration. This was a bipartisan bill. And this was really to be a very consumer friendly bill that prevents patients from getting surprise billing. Now, if anybody’s ever been in kind of an emergency situation before, what you’ll know is that you don’t get a whole lot of time to be in the hospital and ask every single provider Hey, are you in my insurance network? Is this going to be covered? That it’s kind of just who you get and not every person who’s working on you is necessarily in network, not necessarily an employee of the hospital. And so what ends up happening is that all of your your treatment stuff gets submitted to insurance companies. And then, like the Spanish Inquisition, surprise, there’s bills that show up in the mail. And this is generally not seen as very consumer friendly, because people don’t know what’s coming.

Katie Vernoy 5:32
Yes.

Curt Widhalm 5:33
Having been on the receiving ends of those kinds of treatments myself in the past.

Katie Vernoy 5:38
Not fun.

Curt Widhalm 5:39
I kind of like where this bill is going, being a healthcare provider, in my own little practice, not liking where this is going. Because there is a lot of regulations that are being added into this that while intended very well, for kind of emergency situations, our field is a little bit different.

Katie Vernoy 6:04
Yes. And I think that for private pay providers, there can be times when folks are surprised, not by Oh, the anesthesiologist wasn’t in your network. And this extra special treatment that happened because of you were under sedation, cost $27,000. But it is something where some folks don’t have a clear sense when they come into therapy, how long they’re going to be there for. I think, as a profession, I think we’re very good at making sure someone understands the fee before they come into the first session. They know what they’re going to be charged when they sit down with us. I think the part that feels both, I guess positive, but also onerous is having to say like, Hey, this is how long your treatment is going to be. This is what it’s going to cost and, and giving so much information, I mean, it’s it’s a lot of information that you’re having to provide very early in treatment to a client. And they basically will hold you to it, and then they’re given information that they can hold you to it if it does shift, too, dramatically. So I see that I see the point. But I also see that it’s going to be a lot of work. Especially I think just to set it up, I think that there’s a way to systematize it. And we can talk about that when we have our kind of discussion around suggestions later. But to begin, it’s going to take some work.

Curt Widhalm 7:32
And so the main crux of what you’re talking about here is providing clients with a good faith estimate.

Katie Vernoy 7:38
Yes.

Curt Widhalm 7:39
Before we get into what the good faith estimate is, let’s talk a little bit about the intake phone call with clients. Because I think certain aspects of this, many providers are doing in one way or another where in many jurisdictions we’re required to discuss our fees with clients before they come into our first session. It’s, you know, no surprises. It’s not that they’re showing up in our office, it and then all of a sudden being like, wait, what that we do provide that, usually verbally in an intake phone call. What that good faith estimate now adds to our work is in that intake phone call, we need to start having language around, are you planning to submit a claim to your insurance company for the services that you’re going to receive from me. Those of you who are in network with insurance companies, that’s all to be determined in the future. As far as how that works with insurance companies, we’re really talking to those cash paying clients, those out of network therapists, those who provide superbills, if you have a hybrid practice, half listen to this, turn off the insurance side of your brain. But in that initial phone call, you need to ask clients, are you planning to submit this for a claim? Now, the way that most of us are already doing this is around this language for superbills? Hey, do you want a superbill for our services?

Katie Vernoy 9:11
And I also do “Do you want me to do courtesy billing” and actually take the reins on, you know, kind of getting insurance information and that kind of stuff? So I think those of us who are that have a sizable portion of our practices that are private pay, navigate this, but there are some clients that come in never discuss insurance and I think that the the shift that I’m going to make is I’m going to ask that directly versus kind of allowing it to organically happen in conversation because if somebody comes says, What’s your fee? I say $200. They say okay, like, I don’t necessarily take that extra step, all the time, about that. I mean, sometimes they’ll say, you know, do you have insurance benefits? And do you want me to do courtesy billing or would you like a superbill, but I’ve not been diligent about it for folks that don’t seem interested, so at this point, we have to ask the question, we have to know about that. I don’t know what we do with that information, but we just have to ask, we have to know, that’s probably more of the to be determined.

Curt Widhalm 10:12
Well, so from the APA article, what we do after asking if they intend to submit a claim to their insurance is inform them, that they can get a good faith estimate of the expected charges, and that we can provide it to them in a written document if they want. And that needs to include things like a CPT code, the the billing code for those service sessions that you’re intending to do, it needs to include information about the client on it, and the anticipated number of sessions. Yeah, and I think that this is a part where I’m seeing some of the chatter in the therapist community around. Some of the conversations are well, what if people hold us to, you know, you said, this was gonna take 20 sessions, and it took 40. These are not contracts, this is not guaranteeing the therapy is going to end after that many sessions. And I suggest being clear with clients about that, that as far as I can tell from this vantage point, if you follow treatment, if things go well, this should take X number of sessions.

Katie Vernoy 11:27
And then I think the other piece, if you truly think it’s going to be 20 sessions, I think, put down 20 sessions, if you think it’s going to be longer term treatment, I think you you know, you have to do this, it needs to be a good faith estimate for the next 12 months, I think you do it as an annual or to the end of the year. And maybe you do all your good faith estimates in January. But each new year of treatment for each client, you have to do a new good faith estimate. And each time you change the fee, or the cadence of treatment, the way I’m reading it is that you need to then do a new good faith estimate. So if somebody increases the number of sessions, like they go from once a week to twice a week, or they shift from twice a month to one month, you know, like you’re gonna want to adjust down. It feels onerous. And I think that there’s probably a way to make this pretty streamlined if you have a form and you just are changing that number and that number. But the part up front that I get worried about is that it’s supposed to have the clients diagnosis. And we’re talking about an intake call where people can request these good faith estimates. And so I’m assuming you put at that point to be assessed or to be diagnosed at the first session or something like to me, it seems like some of the information requested doesn’t really hold up when you’re just getting a good faith estimate from a potential client.

Curt Widhalm 12:51
Sure. So I’m gonna go back two points that you made and then come to where you’re talking about here.

Katie Vernoy 12:57
Okay. Okay.

Curt Widhalm 12:59
Some of us have clients who are lifers, that…

Katie Vernoy 13:02
Yes…

Curt Widhalm 13:03
they are…

Katie Vernoy 13:03
Yes, both you and I are in that category.

Curt Widhalm 13:05
So what I intend to do with those clients is, hey, you generally come 50 weeks out of the year, here’s your fee for 2022.

Katie Vernoy 13:17
Done.

Curt Widhalm 13:17
Done, there you go.

Katie Vernoy 13:19
Yeah, I think it’s supposed to be in a form. But we can argue if it can be verbal, or if it has to be that whole form.

Curt Widhalm 13:27
I’ll give them a form. To your second point. I wonder if the implementation for a lot of therapists is very standard going to have the first session be, actually to Bill 90791 as an actual diagnostic interview for your first session, that would have your appropriate rates, go back to our CPT code episode and hear us talk about most therapists don’t actually bill for that one. Yeah. But that, I think, actually, if I step back, this whole process might actually make us follow through on things that we’re supposed to be doing a little bit better. If we’re not having formal diagnostic first sessions, if you’re concerned about putting a good faith estimate out to a client that you’ve talked to for about five minutes on the phone, and four minutes of them are about what a good faith estimate is, that you can actually create a space to say, here’s a good faith estimate of what this first diagnostic session is going to cost. And you’ll get a new good faith estimate for our sessions after that session based on what comes out in that diagnostic interview.

Katie Vernoy 14:49
So, private pay providers are now going to have to act a little bit like insurance providers and diagnose in the first session and predict how much treatment is going to be needed.

Curt Widhalm 15:01
Yes.

Katie Vernoy 15:03
Welcome!

Curt Widhalm 15:05
Well into your other points is, if you, misjudge or if services need to continue, it’s not like your relationship with the client just has to stop, you do get to provide new and updated good faith estimates…

Katie Vernoy 15:22
Yes.

Curt Widhalm 15:22
as anything changes, like you said, if you’re going to more sessions a week, if you change your fees mid year, if any number of different things changes, potentially even diagnostics, then you’re going to want to provide good faith estimates that are updated and I would recommend that you put language on those updated ones that this replaces the previous Good Faith Estimate from whatever the previous date is.

Katie Vernoy 15:52
And it does say in the language, and I don’t know if this is in the APA article or the actual legislation, but it does say that when you provide a new good faith estimate, you do need to identify what is different. And so if it’s, hey, everything’s rolling along, same fee, same number of sessions next year, I think it’s saying, this is continuing and it’s you know, there’s no changes in the fees, no changes in the predicted number of sessions this year, this is for this year. I think for folks where you’re changing fees, or dramatically changing the cadence of sessions, I think that would be an important thing to put and definitely I like your language of ‘this replaces the previous good faith estimate.’ One thing I’m thinking about with this is that if you’ve got a niche that that generally you know, or your lifers that generally have this is how many sessions you have per year. And so maybe it’s 48, or 27, or whatever it is, you know, depending on the cadence of their treatment, shifting from every other week, to once a week, back to every other week, to once a month, like assuming you’re kind of still in that number of sessions per year, I think you probably are fine. Changing fees, definitely need a good faith estimate. But like if you’ve said, This is what you’re what we were looking at this year. I think that could I think that could work. What do you think?

Curt Widhalm 17:15
I’m not a lawyer.

Katie Vernoy 17:18
Yes, nor am I.

Curt Widhalm 17:21
It’s probable, and, you know, any challenges to this are still to be determined. This is all, you know, this is what regulations are going into effect. The HHS has not you know, had any opportunities to enforce any things yet. So we’ll wait for somebody to get punished, and then we’ll be able to tell you what they’re doing. But realistically, it seems like a good faith estimate is exactly that. It’s good faith that Hey, you know, you typically come to three out of four sessions a month, in case you come to more, you know, some months you do make a ball. So good faith, I’m going to put that you’re gonna make all of the sessions over the next like five months. And we can evaluate at that point, you know, what’s needing to be changed. There are certain aspects of this that I think well onerous, as far as communication with our clients, have the potential to make us actually talk with our clients about their treatment more frequently.

Katie Vernoy 18:31
Yeah.

Curt Widhalm 18:31
And I think that that’s part of what’s scary to a lot of therapists is that clients are gonna see, I spend how much on therapy each year?

Katie Vernoy 18:41
I know, that’s the part that I’m like, oh, yeah, that’s gonna be rough. Most people don’t want to think about it.

Curt Widhalm 18:49
I could buy several cars for this. That I think if you know, you’re not wanting to sticker shock your clients on January 1 with, here’s your good faith estimate of 50 sessions at $100 per session, or 200, or 300, whatever your fee is, that they can see some therapists breaking it down and say, Alright, here’s only six months of anticipated treatment. And I’ll just put out a new good faith estimate when that one runs out. But I think that that makes us be able to talk about clients progress, as far as what do you think that you need as continued services going forward and to actually review your treatment plans with them more frequently.

Katie Vernoy 19:37
Yeah, I think it’s actually a good process to to align this with a treatment plan. I think process wise, I see it as being something like every January 1, I put out my good faith estimate. But I think there’s an element to that where, you know, someone coming in, in December and then giving a new one to them in January feels silly. So but I do think talking to folks at their treatment plan anniversary, or every six months or whatever your timeline is, and then talking about cadence, talking about, you know, how they’re feeling, you know, what they’re thinking about. I think that’s a good process. And I know when I was working in community mental health that was, you know, like, you talked about termination from the beginning, you know, and I feel differently in private practice, like you might a lot of my clients are lifers, but I think it is, it’s really easy to get complacent, when you’re just kind of meeting every week, and you’re not actually taking the time to look at what are we actually working on? What are you getting from this? You know, what is your financial situation compared to what we’re talking about? I mean, for folks that do sliding scale, this could also be an opportunity to reassess sliding scale and saying, okay, you know, my fee is going to be x January 1, and, you know, this is what you’ve been paying, you know, is that still appropriate? Are you able to increase towards the, you know, can you decrease the subsidy, so to speak, you know, like, you can have those conversations, it’s just a money conversation that a lot of people don’t like to have. And so I think this kind of thoughtful, you know, kind of transparent conversation about number of sessions, length of treatment, cadence and money is important and needed, but pretty uncomfortable for a lot of folks.

Curt Widhalm 21:27
Being the optimist that I occasionally am, that I think that there are some providers out there, especially when it comes to things like sliding scales, who don’t know how to bring the conversations back of, hey, you got a job. And now you can afford the fee that we had agreed upon before. This does provides those clinicians with an opportunity to have a better touch point, as far as renegotiating some of those sliding scale things.

Katie Vernoy 22:01
It’s a natural benchmark. I think the other thing that is interesting on what’s being required in these good faith estimates is the client diagnosis. We mentioned it kind of like, you know, do the diagnostic session separate and then a good faith estimate for ongoing treatment. But for some of my clients, they may never see their diagnosis unless I do this, right. And so for folks that don’t do superbills, or don’t talk about it, don’t request their records. And so I think that’s another thing for folks, you know, before they provide their first good faith estimate, you may want to be ready to have that conversation because it does show up on the billing, or does show up on this form. And so being able to make sure that your clients understand how you diagnose, why you’ve diagnosed, what you’ve diagnosed, and what it means, how it’s impacting treatment or not, it does mean that we need to diagnose our clients. And I think some folks are unlikely to do so when they’re completely private pay.

Curt Widhalm 23:06
And I think for people who provide superbills, if this worries you, you’re already doing this. It’s just now with the potential of a more explicit conversation with your clients. And helping clients as Katie just mentioned, to understand what this process is. And, again, this is all very good spirited as far as being consumer friendly. And that’s, you know, where it does put some of these onerous things on our behalf. But I think it has the potential because of all of these extra contact points in talking about treatment, and talking about money’s impact on treatment, that clients are going to get better outcomes, which…

Katie Vernoy 23:55
Maybe.

Curt Widhalm 23:57
I was gonna say if clients get better outcomes, that’s good for you as the therapist.

Katie Vernoy 24:02
Sure, sure. I think that there’s, there’s an element of this that feels very paperworky and could take away from the relationship, you know, like, if you have to explain a tough diagnosis that, you know, wasn’t something that was in the regular conversation that can, that can impact the relationship. If you have to really dig deeply into some of this. I think it’s life. I think it’s it’s therapy, it’s good therapy, but I don’t know that it’s necessarily I’m not going to just, you know, rainbows and sunshine about like, hey, you need to do this, because I don’t know, I think that there are ways that you can make a benefit your client, I don’t know that it’s necessarily designed to benefit outcomes. The thing I was thinking about, which is an open question, there are folks who do not take insurance because they don’t want a diagnosis and they don’t want to have anything on record around diagnosis, whether it’s based on their job, whatever, some reason, they don’t want to have a diagnosis. My assumption I’m not reading anything in here that you have to have a full DSM diagnosis, you could do a V code, you could do something that was subclinical. Is that how you’re reading it? Or is this an open question where we have to determine like if people want to refuse a good faith estimate, a written in good faith estimate? Are we allowed to do so?

Curt Widhalm 25:18
So for those people who are not in network, and if you know, the diagnosis question is a thing. If people, you still have the obligation to ask people, if they are planning on submitting their claims to their insurance company.

Katie Vernoy 25:32
Sure, sure.

Curt Widhalm 25:34
If they are, you’re still required to provide the proper diagnosis to them, not not just one that is reimbursable. And so if you are treating somebody for a Z code, if you are treating somebody for something that is traditionally not reimbursed, that is still the diagnostic code that you’re supposed to put on there, that has not changed that is already in place. And if you’re not doing that, that’s insurance fraud. Spanish Inquisition is coming after you.

Katie Vernoy 26:07
Okay, so you didn’t answer my question. But all of what I said, What you said was, I agree too. If someone does not want to submit any claims to insurance, doesn’t want a superbill barely wants a record? Can they decline one of these good faith estimates?

Curt Widhalm 26:24
Absolutely.

Katie Vernoy 26:25
So that they don’t have any diagnosis on any paper anywhere?

Curt Widhalm 26:30
Absolutely.

Katie Vernoy 26:31
Okay.

Curt Widhalm 26:33
You as the clinician still need to chart your treatment plans and what it’s based on and all that kind of stuff, whether your clients want a good faith estimate or not.

Katie Vernoy 26:42
Are we required to diagnose a client?

Curt Widhalm 26:44
You need to have a reason for treatment, and you need to have a treatment plan that is based on something other than a client just showing up? And you started a session with Where do you want to start today and ending it with? You’re where you need to be. That…

Katie Vernoy 27:03
That may be a whole other conversation. But…

Curt Widhalm 27:05
I mean, that that is acting within the scope of your license that…

Katie Vernoy 27:08
Sure, sure. So we can have a conversation about diagnosis, but from what you’re reading, we could either put a non-clinical DSM code and for this good faith estimate, or someone could decline it if they don’t want to have a piece of paper with their diagnosis on it.

Curt Widhalm 27:28
Sure, yeah.

Katie Vernoy 27:30
So we may also, at some point, need to put together a, I am declining a good faith estimate form that people sign.

Curt Widhalm 27:38
You know, that’s a great idea. You know, it’s not like a subpoena where you have to, like, throw it at a client if they’re running away from you. Anyway, there are…

Katie Vernoy 27:50
I would prefer for an oral, good faith estimate versus a written faith, good faith estimate. I think these are the things that are kind of the to be determined, we’ll wait and see if anybody gets sued or or in trouble. But I think there are probably some some reasons why these would not be customer friendly, or consumer friendly, is all I’m saying. So we’ll we’ll table that for now.

Curt Widhalm 28:13
So there are some other requirements that I think are important for everyone to be aware of. You have to prominently post that clients can and are entitled to a good faith estimate. And this needs to be put on your website. It needs to be prominently displayed in your office. I’m I’m on Amazon right now, ordering one of those neon like scrolling things, just put it up behind me in session.

Katie Vernoy 28:46
Oh, that sounds awful.

Curt Widhalm 28:50
Or really just posting…

Katie Vernoy 28:53
a paper.

Curt Widhalm 28:53
a piece of paper that says you’re entitled to a good faith estimate.

Katie Vernoy 28:57
And the APA article has both samples of the good faith estimate itself as well as this notice, the language for the notice. And it has instructions on it. Well, we’ll link to those in the show notes. But I think it is big enough that it might be not quite a poster, but still a piece of paper on your wall. And then for your website. I think my suggestion when if you have a section on fees, this may be a reason to post your fees on your website. People have different feelings about it. And I think that would be the appropriate place to have it listed, is in that that section of your website.

Curt Widhalm 29:36
To be clear, you don’t need to put on your website just a general I expect people’s treatment to last 25 sessions.

Katie Vernoy 29:46
No.

Curt Widhalm 29:47
The language that you need to put out there is…

Katie Vernoy 29:51
You can request a good faith estimate.

Curt Widhalm 29:52
Yes, exactly.

Katie Vernoy 29:54
And that’s in that APA article. I think the other thing that I was starting to get to get in the weeds and I think this is is more kind of standing questions that will be to be seen. There are a difference between convening providers, which is the person providing the primary service and co-providers, from what I can read the convening provider is the person who has been asked for this good faith estimate. And maybe it’s a primary provider, maybe it’s just the person they thought to ask. And if there are co-providers who are providing treatment with you for the identified patient. So for example, you’ve got a an eating disorder treatment group that, you know, you’ve got different folks either in your group practice, or that you do a lot of work with, you may end up having to put together kind of this full package of good faith estimates where everybody’s services are on there. I think that’s a little bit more detailed than we need to get for today’s conversation, I think typically, you’re just going to be doing your own services. But for folks who have group practices that maybe share an identified patient with another provider, or have a little complexity, you probably are going to want to reach out to your professional association or legal counsel to identify how best to take care of those good faith estimates is my opinion.

Curt Widhalm 31:09
Yes. If this sounds like a lot of extra steps, you’re right. And some of the things that I’m seeing across the healthcare industry is that this does impact smaller businesses a lot more than group practices and agencies, because it is a lot of extra steps and does have time deadlines that oftentimes you’re going to need to provide this in writing to clients who want it within one business day. And if you have a very, very busy schedule, this is something that you’re going to need to accommodate, you’re going to have to get these systems in place. And you know, our friends over at SimplePractice that we’ve seen some chatter in the SimplePractice community requesting that some of this stuff be added to their platform, I hope that a lot of the EHR systems, will be addressing this so that way, it does help to streamline these things. But this is stuff that whether you like it or not, it’s here. And, you know, we’re trying to give you just a even if this is a, hey, I have to go and look at this stuff and I need to make some changes now. Go and make those changes, because this is things that our world is changing, we have to adjust to as providers and our clients are going to be overall probably better for it even if that means that we’re not.

Katie Vernoy 32:47
So I want to just before we close up, I want to talk through what I see as a potential path to try to make this as efficient as possible. And so I’m stealing one of your ideas, and then putting together the rest. So I think what makes the most…

Curt Widhalm 33:00
Your plan is everybody quits and go find retirement early on some cheaper cost of living place.

Katie Vernoy 33:09
No, everybody become coaches… Um, no, the plan is, I really like this idea of having a boilerplate, good faith estimate for your diagnostic session. So your 90791 I think the difficulty unless there is like some sort of a form created in your electronic health record, you may have to create this separately, but putting together that good faith estimate so it is sent over with all of your intake paperwork, and it’s part of the the process. So this is the fee, this is the service. I think that the nuance and you can have all of your information, the nuance is the clients name and those types of things. And so I’m going to look in SimplePractice myself to see if I can figure out a way to do it if if they don’t fix that themselves, or don’t put that together themselves. But I think even creating, you know, a form that you can upload and send to them where you can, you know, kind of do that, that becomes with your intake paperwork, it goes out immediately, you’re in compliance. I think the next stage is having that good faith estimate that is for ongoing treatment, has all of your information already in place has all of the services and fees in place and then it goes into you know, there’s a little bit that you have to fill out for each client that has their information, their diagnosis, and then the number the expected number of sessions, and that goes out after the first session.

Curt Widhalm 34:43
I think it’s brilliant, until they change things and that’s what we will address in some future episodes. We do know that there is language that is written into this no surprises act that even for out of network therapists, might be needing to submit some of this paperwork directly to a client’s health insurance company. That part of the law or the regulations has not yet been written. We just know that it’s coming. It’s reserved in there. And that’s what some of the future languages, if you’re a member of a professional association, check out any guidance that they have, as those regulations continue to roll out. We will almost guaranteeing an episode in the future on what that means, especially for those of us who aren’t used to talking with insurance companies and what kind of means, so we kind of want to hear you lamenting these kinds of things. You can share your thoughts with that in our Facebook group, the Modern Therapist group, and share it with us on our social media. We’ll include links to all of that in our show notes. And until next time, I’m Curt Widhalm with Katie Vernoy.

Katie Vernoy 36:02
Thanks again to our sponsor Simplified SEO Consulting.

Curt Widhalm 36:05
These days, word of mouth referrals just aren’t enough to fill your caseload. Instead, most people go to Google when they’re looking for therapists. And when they start searching, you want to make sure they find you. That’s where Simplified SEO Consulting comes in. It’s founded and run by a private practice owner who understands the needs of a private practice, and they can help you learn to optimize your own website or they can do the optimizing for you.

Katie Vernoy 36:28
Visit SimplifiedSEOconsulting.com/moderntherapist to learn more. And if you do decide to try your hand at optimizing your own website, you can get 20% off any of their DIY SEO courses using the code MODERNTHERAPIST. Once again, visit simplifiedseoconsulting.com/moderntherapist and use the code MODERN THERAPIST all caps.

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