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Chapter Meeting: The Changing World of Insurance
March 10 @ 3:45 pm - 6:00 pm
Educational Goals: In this presentation you will be given an essential overview of how to work with a client’s insurance, including what out-of-network providers should know. You will learn about recent changes in insurance that can affect your practice. You will gain understanding of how to keep new clients even when you aren’t on their plan. You will learn the pros and cons of joining plans, and what you are getting into. Also, we will discuss how to get in the door at “full” plans, as well as new opportunities for MFTs (ex. Medi-Cal). We will cover essential questions to ask when checking coverage. We will discuss the biggest mistakes therapists make when dealing with insurance and also learn how to use “medical necessity” to get more treatment approved.
- Identify 2 therapist insurance participation options and identify key differences between network providers and out-of-network providers.
- Identify 2 myths that are commonly held by providers about working with insurance.
- Recall 13 Essential Questions to ask when checking insurance coverage, in order to avoid later treatment disruption or claim denials.
- Be able to explain what “medical necessity” is and what plans look for when they review treatment in order to help advocate for clients.
Presenter: Barbara Griswold, LMFT (#27210) is author of Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance – And Whether You Should, now in its 7th edition. Barbara has 28 years of experience as a network provider for more than 20 insurance and EAP plans. In addition to her full-time private practice in San Jose, she provides consultations about insurance, progress notes, practice building, and difficult cases to therapists nationwide. She has been interviewed on NPR’s “Morning Edition” and her articles have appeared in Psychotherapy Networker and The Therapist magazines. Her latest mission is to educate therapists on what should be in their progress notes and to help them pass treatment reviews. Barbara previously served as Orals Examiner for the California Board of Behavioral Sciences, and on the CAMFT State Board and Ethics Committee.
3:45- 4pm Registration
- 4 – 6 pm
- Speaking the Language of Insurance: Some Definitions
- Finding Diagnosis Codes
- Starting Therapy, and the Biggest Mistake Therapists Make
- Checking Coverage — A Handout
- EAPS and Insurance Plan Types, In-network vs. Out of Network
- Keeping New Clients if Not on Their Plan, Single Case Agreements/Transition of Care
- Applying to Networks, New Opportunities for MFTs, Myths and Realities
- Medical Necessity: The Key to Getting More Sessions
- CPT Codes: Common Mistakes, and New Possibilities
- If Time: Telehealth Billing
- If Time: Billing for Extended Sessions
CEs offered: 2 CEs for $10, general admission is free.
SF CAMFT is a CAMFT approved CEU provider (#62283). The above course meets the qualifications for two hours of continuing education credit for LMFTs, LCSWs, LPCCs and/or LEPs, as required by the California Board of Behavioral Sciences. If you are interested in obtaining CEUs, you may do so by paying $10 (cash or check) at the beginning of the workshop. To qualify for CE credit, you must arrive on time, sign in at the CE table, stay until the end of the program, sign out at the CE table, turn in the evaluation and pick up your certificate.
SFCAMFT is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LCSWs, LPCCs and LEPs of any level of experience, in private practice, non-profit and hospital settings. SFCAMFT maintains responsibility for this program/course and its content.
Contact: For any questions, concerns, special needs accommodations or grievances related to programming, please contact the Programming Chair, Rose Dito at (650) 692 – 4118.
Location instructions: The Jewish Community Center is located at 3200 California Street between Presidio Avenue and Walnut Street. The March 10th presentation will be in the Beit Midrash room.