• Practice Solutions

New! Mental Health News Bulletin

Welcome to our Mental Health News Bulletin!

We will be regularly publishing articles and new related to mental health, billing, health insurance, and more directly on our blog! As we monitor trends in the industry we want you to be kept up to speed on the latest news, so we will be publishing regular news updates.

Stay tuned for more, but for now here is our news bulletin:

Show Me the Money, Faster

Recently, I persuaded my mom to download the Venmo app after a digital transaction between our bank accounts expired.

Who knew 2019 would be the year I’d swap electronic cash with my parents on a payments and social networking app—or that sending $27 with a smiling emoji would be just the tip of the iceberg?

The consumer applications for financial technology get the lion’s share of attention, but behind the scenes, fintech is changing the way many industries do business.

This issue’s cover story profiles Fattmerchant, an Orlandobased company that offers flat-rate payment processing with price transparency that it says its competitors lack. But the company’s services go beyond just financial transactions. By integrating with accounting software and displaying data in a meaningful way, Fattmerchant provides customers with tools that enable better informed decision-making.

Opinion | Time to close Michigan’s access gap to mental health services

Hundreds of thousands of Medicaid-enrolled Michiganders need mental health support, but only about half receive help. We can do better for family members and neighbors in need.

That’s why we, the leaders of six leading mental and behavioral health organizations in our state, are calling on state legislators and our governor to allocate the needed resources to fill funding gaps amid rising rates of behavioral health-related conditions locally and across the United States.

Society’s inattention to mental and behavioral health needs is the result of misinformation and misunderstanding. Stigma and the inability to pursue treatment continues to hold back the effectiveness of Michigan’s behavioral health structure.

The 2 big health care fights coming up this fall

Lawmakers return to Washington this week with, what else, health care on their minds and their agenda.

In the coming weeks, there are two issues lawmakers want to address, if they can overcome the sizable political and special-interest obstacles to doing so: surprise medical bills and drug prices.

Tackling surprise medical bills has seemed like the ripest opportunity for bipartisan action to reduce Americans’ health care costs. The tales uncovered by Sarah Kliff for Vox, who documented people getting hit by a bus and then faced a $27,000 ER bill, prompted public outcry. Lawmakers are under intense pressure to get something done.

Key House and Senate panels have approved proposals that would limit patients’ financial liability if they visit an out-of-network hospital or are treated by an out-of-network provider during an emergency.

5 Things to Know About Student Health Insurance

Between navigating campus life and completing coursework, incoming freshmen are unlikely to be concerned about their health insurance coverage. But aside from getting oriented and stocking up on dorm room essentials, getting health insurance should be a top task on students' checklists. Most colleges and universities require students to have health insurance, and chances are they're already listed as a dependent on a parent's plan, which they are eligible to stay on until age 26, under the Affordable Care Act. Students can also opt to join a campus health plan. Though there are many ways for students to remain covered, insurance options and rules can be confusing. So, if your child is headed to college, here are health insurance options to consider.Here's what to know about health insurance for college students:

-- Students may have access to health insurance through their college or university.

-- You must notify your health insurance agent that your child is enrolled in college.

-- Discuss medical care options and parental involvement.

-- You'll likely want to keep students with pre-existing conditions on your plan.

-- Evaluate the benefits of the university health plan.

This Is What Therapy Is Like Around The World

All around the world people are turning to mental health services, like therapy, in order to tackle the issues of daily life like depression, anxiety and relationship dynamics.

But therapy means something different depending on where you are in the world. Curious how other countries compare to each other? From India to France and beyond, here is what therapy is like around the world.

OIG tags California medical group for erroneous billing

Santa Monica, Calif.-based Oceanside Medical Group failed to comply with Medicare requirements when billing for psychotherapy services, according to a report from HHS' Office of Inspector General.

The OIG said none of the 100 sampled beneficiary days, consisting of 103 psychotherapy services, complied with Medicare requirements. In the majority of cases, psychotherapy either was not provided or psychotherapy time was not documented, according to the OIG.

The claims that did not comply with Medicare billing requirements resulted in the medical group receiving $5,317 in combined overpayments during the audit period of July 1, 2015, through June 30, 2017, according to the OIG.

Private Equity Tries to Protect Another Profit Center

Surprise medical billing has quickly become a small but critical flashpoint in health care reform. Because doctors and hospitals negotiate separately with insurance companies over reimbursement rates, it’s possible for a patient’s insurance to cover hospital charges while failing to cover the fees of some doctors in the hospital who are “out of network.” Patients who visit an emergency room (ER) or are admitted to an in-network hospital by an in-network doctor may find that some of the professionals who treat them are not covered by their insurance.

That is because hospitals have outsourced ER, anesthesiology, radiology, or other specialized services to outside physician practices or staffing firms. Patients often find themselves on the hook for thousands, or even tens of thousands of dollars in surprise medical bills.

Arbitration process would fix problem of surprise medical billing | Opinion

Tennessee’s health care system is in rough shape. Our state has lost 1 out of every 6 doctors and nearly 20% of its hospitals in just 10 years. Today, 2.5 million Tennesseans lack adequate access to care.

This is a looming crisis for Tennessee. Our families, friends and neighbors must receive medical care when they need it. They should be able to do everything they can to meet their health care needs, with as little government intrusion as possible.

CVS-Aetna merger approved despite objections from health, consumer advocates

With little fanfare, a federal judge in Washington, D.C., removed the final obstacle to CVS’ blockbuster merger with Aetna last week.

The $70 billion consolidation, announced in 2017, will combine the nation’s third-largest health insurer with a company that owns the nation’s largest pharmacy-retail chain and the second-largest pharmacy benefit manager.

During hearings in June, attorneys for the two businesses defended the combination, contending that it would enable the merged company to provide better, more-efficient care, while a proposed settlement with several states would answer any competitive concerns. The settlement requires Aetna to sell off its Medicare prescription drug plans.

Illinois healthcare exec accused of falsely billing BCBS

The executive director of an autism center in suburban Chicago faces federal fraud charges related to potentially illegal billing practices, according to the Department of Justice.

Latrice Harrell, operator of The Champion Center for Autism in Oak Forest, Ill., was indicted on federal fraud charges for allegedly billing Blue Cross Blue Shield of Illinois for therapeutic services that weren't rendered. According to the indictment, Ms. Harrell billed false claims by using the names and information of the center's occupational therapist and behavioral analyst without their knowledge. She fraudulently obtained at least $1.6 million from BCBS of Illinois, according to the DOJ.

Ms. Harrell pleaded not guilty to the charges. A hearing is scheduled for Nov. 18

#Falsebilling #PrivateEquity #Surprisebilling #Studenthealthinsurance #Therapyaroundtheworld