Relationship Solutions Center, P.C.’s Post

#suicideprevention is a joke! Here's the stupid thing about these hotlines and text lines: Before the counselor comes on, there is a message that, if you're having a medical or mental health emergency, call 911. Then, they get you off the phone or out of the chat, if you're NOT actively s*icidal, saying they have to keep the lines open for those who are actively s*icidal. Being actively s*icidal IS a medical AND mental health EMERGENCY and all the hotline, text line counselor will do is direct you to get off the phone, out of the chat, and call 911! These hotlines, text lines are USELESS; except, that they are effective in pushing someone who is NOT actively s*icidal into some who is! And, here's what most people fail to understand. When you call 911, you get taken to the ER and you are held there until either, a bed becomes available in a psych hospital (good luck with that!) or they send you home after you've sat waiting for 48 hours. No one comes to counsel you after the initial assessment. You receive discharge instructions to contact a mental health professional. Good luck with getting an appt when no one is accepting new patients. And, if they are, they likely turn away those on insurance because those who are taking new patients are those who are NOT licensed to a high enough degree for insurances to pay. LPCs cannot accept insurance! Only LCSWs and higher can! And, those practitioners are usually booked out 3-4 months in advance! Many also refuse to take Medicare/Medicare Advantage because HMOs and organizations that oversee PPOs deny referrals and claims. Those who do take Medicare take only a few, called a Medicare Panel, because Medicare pays them 40% LESS that market value for their services!

Behavioral health conditions affect people of all ages: About one in five people over age 65 lives with a mental health condition such as depression, anxiety, dementia, schizophrenia, and bipolar disorder, and about 8 percent of people with Medicare younger than 65 and 2 percent of those 65 and older have a substance use disorder (SUD). Addressing the country’s behavioral health crisis is a key priority for CMS. Medicaid and the Children’s Health Insurance Program (CHIP) are the largest national payers for behavioral health services, financing more than a quarter of the country’s behavioral health services.

MedPage Today released an opinion piece detailing the impact of prior authorization denials from the perspective of patients receiving mental health care. One staggering statistic: Over 1 in 4 (26%) insured people with these conditions have had access to therapy and medications blocked by insurance companies via prior auths. There is a long way to go in the fight to alleviate prior authorization burdens, and we’re seeing states like New Jersey and Washington push for increased reform. Additionally, at least 80 prior auth bills are underway in 27 other states. For more on this story, follow this link: https://hubs.la/Q02rb-Bt0

Last month, IL Gov. JB Pritzker signed a transformative legislative package into law, poised to revolutionize the insurance sector in Illinois. For me, one of the pivotal components of this bill is the mandate that insurers cover the first 72 hours of inpatient mental health treatment at a hospital (with the provision that the facility notifies the insurer within 48 hours). Illinois is now the first state in the nation to require such comprehensive coverage for behavioral health services. 👏 In my work, I see the extensive need for community behavioral health, and feel this is a groundbreaking step in enhancing behavioral health services and addressing mental health with the urgency it deserves. Other key points of the bill include: ✅ Step Therapy Ban: Starting in 2026, insurers can no longer require patients to try less costly treatments before approving more expensive alternatives. This move aims to ensure timely access to the most effective treatments without unnecessary delays. ✅ Network Adequacy and Transparency: The bill raises standards for network adequacy, including mandatory 90-day internal audits by insurers and the publication of treatments requiring prior authorization. It also sets standards for appointment availability and the number of in-network doctors, ensuring better access to care. ✅ Ban on Short-Term Plans: Starting next year, short-term, limited duration plans will be banned, ensuring more consistent and reliable coverage for Illinois residents. This landmark legislation was shaped by extensive feedback from legislative colleagues and the provider community, addressing the barriers to care faced by patients and providers alike. Governor Pritzker emphasized that these reforms will put medical decisions back in the hands of patients and their doctors, combating predatory practices by insurance companies. Kudos to everyone involved in making these reforms a reality! I'm hopeful about the positive impact these changes will have access to and quality of care in Illinois. Do any of these reforms resonate with you? Which ones and why? #HealthcareReform #Illinois #PatientCare #InsuranceReform #MentalHealthMatters

Navigating the world of mental health care and ABA billing can be complex, but understanding their intersection is crucial for providing proper care! 🧠💼 Here are some key points to consider: - Mental health diagnoses impact ABA treatment plans - Accurate billing ensures proper reimbursement for services - Compliance with insurance regulations is essential To optimize patient care, providers must understand how mental health and ABA billing intersect. By staying informed and educated, we can support individuals in receiving the comprehensive care they deserve. Ready to learn more? Click the link in our bio for valuable resources. #MentalHealth #ABABilling #ProperCare #HealthcareTips 🌟

Never ask a colleague how old they are. Today is Traci Crosby's birthday. So instead, let's talk about other numbers: x1000%: higher likelihood that a child's behavioral health visit will be out of network compared with any other visit. 40%: lower willingness to pay out-of-pocket for mental health care compared with any other form of care. 99.25%: proportion of covered lives in NJ that Fort Health is in-network for thanks to Traci's work. 90837, 90832, 90791, 90792, 99214: some of the CPT codes Traci works with every day, ensuring our clinicians focus on clinical work, our patients' insurance plans get charged for the right services, and our company keeps growing. Thank you for everything you do Traci Crosby! #affordablehealthcare #birthday Sources: https://lnkd.in/eX69mv2u. https://lnkd.in/eJYBJJck She's 90837, 90832, 90791, 90792, 99214

The behavioral health landscape is subject to many regulations, and staying compliant is of utmost importance to avoid audits and unnecessary penalties. This is vital for ethical practice but also for successful revenue cycle management. Two regulations that need to be closely monitored are the Health Insurance Portability and Accountability Act (HIPAA) and the Mental Health Parity and Addiction Equity Act (MHPAEA). Implementing best practices in revenue cycle management safeguards the financial operation, ensuring a consistent cash flow and the opportunity to provide high-quality patient care.

Half of Americans will experience a behavioral health issue during their lifetime, yet nearly all providers in the US are in short supply. This scarcity is preventing people from receiving timely care, a situation exacerbated by a lack of investment in behavioral health care by public insurance programs, private insurers, and employers. In 2021, fewer than half of those with a mental illness could access timely care, with those with substance use disorders being even less likely. Workforce shortages are disproportionately affecting certain groups. #BehavioralHealth #MentalHealthAwareness #HealthcareShortages

The Gallup poll, conducted in partnership with West Health, reveals strong bipartisan support for the Mental Health Parity and Addiction Equity Act (MHPAEA), which mandates equal insurance coverage for mental health and physical conditions. Despite this support, many Americans doubt insurance companies will comply with the law. The survey indicates widespread dissatisfaction with mental healthcare access, with majorities across political lines believing the government should do more. Additionally, six in ten Americans are pessimistic about improvements in affordable mental healthcare access in the next five years. https://lnkd.in/ecr6qYU6