Billing and Insurance Updates
Information About Insurance
Currently the majority of our therapeutic services are considered “private pay” services, meaning that all of my services must be paid for by the guardians of the client (if client is a minor) or the client himself (if adult).
However, if a client wishes to file a claim themselves (which will be considered out-of-network), we will provide an invoice showing payment has been received, along with other information often required by insurance companies (i.e., diagnostic code(s) and specific dates of service). This request for an invoice to display this information must be provided to the BSMS employee prior to the first billing cycle.
*Parents will need to submit to the office a copy of a document (e.g., evaluation) which states an official diagnosis. In order for the insurance provider to accept the invoice a diagnosis must be present.
Many established mental health professionals do not join or remain on insurance panels for a few reasons. First, the in-network filing process usually requires a significant breach of client confidentiality. To meet the requirements for in-network reimbursement, the professional must submit an official client diagnosis and ongoing progress report, treatment plan, etc. This requires the professional to divulge personal information about clients, which then becomes part of his or her permanent medical record (potentially driving up client insurance rates and creating problematic “pre-existing conditions”). Next, there is a great deal of paperwork to submit for in-network benefits, which takes time and energy away from the focus on the client and his or her needs. Finally, insurance panel fee schedules are well below national averages, and therefore not ideal for established professionals who wish to spend the majority of their time working directly with their clients.
BSMS LLC is currently investigating the benefits of offering insurance billing for our current and future clients. If/ when BSMS LLC becomes paneled with Insurance additional information will be placed on the website and shared with the clients and community.