“Billing and Collecting for Your Mental Health Practice: Effective Strategies and Ethical Practice”
By Jeffrey E. Barnett and Steven Walfish
American Psychological Association
Washington, D.C., 2012
Authors offer ‘nuts and bolts’ advice
Reviewed by James K. Luiselli, Ed.D., ABPP, BCBA-D
If you are a psychologist in private practice, the matter of billing and collecting for services rings true. Quite simply, your clinical skills alone do not drive success. Rather, you must be paid in a timely manner without impacting the care you deliver to clients. While most of us acquired billing and collecting pragmatics through trial-and-error, reading this book is probably the best thing you can do to learn about and execute successful business strategies.
“Billing and Collecting for Your Mental Health Practice,” by psychologists Jeffrey E. Barnett and Steven Walfish, has all of the best features of an informative and user-friendly guide: it is brief (102 pages), well organized, written clearly and reasonably priced. The basis for the book is the authors’ considerable expertise, the American Psychological Association’s professional code of ethics and conventional standards of insurance and third-party payers. Barnett and Walfish acknowledge that “even clinicians who are out-of-network providers and those who work on a fee-for- service basis will benefit from many aspects of this book because they must collect fees, even if directly from their clients.”
There are eight sections in the book, starting with an overview of financial arrangements between a psychologist and client. The authors drive home several key points: be familiar with and adhere to prevailing ethical guidelines, have set policies for fees and payment, consider every person’s financial limitations and define what role insurance might play in paying for services rendered. The issue of ethics is particularly salient and repeated throughout the book.
After delineating the basics of financial obligations, Barnett and Walfish offer extensive “nuts and bolts” advice that applies to insurance reimbursement, for example, obtaining pre-authorization, verifying benefits, completing claims forms, submitting documents and collecting client co-payments.
They instruct further about the pros and cons of accepting credit cards, functioning as a Medicare provider and enduring an audit. This book is must reading for anyone expecting or contemplating a private practice career.
I was pleased to see a separate section of the book devoted to the advantages and disadvantages of out-sourced billing versus going it alone. Certainly, the process of billing is time consuming, can detract from clinical care and requires continuous self-monitoring. Barnett and Walfish not only pin-point the dominant concerns but recommend many conflict-prevention procedures that the hurried and harried clinician can implement effectively.
If you do forensic work the book has an especially useful section on fee collection within this unique discipline. However, all psychologists, regardless of specialty, will find great suggestions for establishing informed consent, avoiding contingency arrangements, setting flat and hourly fees and interacting with attorneys in highly litigious cases. There are two supplemental sections that cover ethical lapses by clinicians in the billing process and case examples of fraud and abuse.
As if the book proper is not enough, there is also an appendix with an illustrative financial agreement template and samples of an insurance claim form, credit card guaranty of payment and “super bill” statement. These documents are a terrific resource for designing new or revising existing forms in your practice.
“Billing and Collecting for Your Mental Health Practice” is a model of efficient, professional, self-help advice. Before reading the book, I thought about topics that had to be included and, sure enough, all of them were and then some! Barnett and Walfish also let the reader know that their suggestions may not be applicable to every private practice – instead, adjust and adapt accordingly. My resolute conclusion is that having this book will not only give you confidence for succeeding financially but the attitude and skills to do so.
James K. Luiselli, Ed.D., ABPP, BCBA, is senior vice president, applied research, clinical training and peer review at the May Institute in Norwood, Mass.
By James K Luiselli EdD ABPP BCBA-D