Insurance/advertisement/fee/referral Flashcards Preview

Law and Ethics exam > Insurance/advertisement/fee/referral > Flashcards

Flashcards in Insurance/advertisement/fee/referral Deck (22)
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1

The patient must have "?" for the therapy to be paid by their insurance. If I made up a diagnosis, it would be -

medical necessity
fraud

2

If patient's insurance company denies coverage when a patient does have a medical necessity (diagnose), I have an ethical obligation to -

to advocate on behalf of client.

3

It is fraud to increase ? of condition to get paid.

severity

4

It is fraud to bill insurance ? when treating them as a couple.

individually

5

It is ? wrong to charge higher fee because patient's insurance pays lower.

legally and ethically wrong

6

When you are seeing patient under EAP, it is important to discuss limitations such as -

the number of treatment allowed
therapy could be not completely confidential if the focus of therapy is work related.

7

What needs to be on every single advertisement?

My license number and license designation (LCSW)

8

When must I discuss fees with patients?

prior to starting a session

9

When discussing fees with patients, what do I need to include?

methods of payment; frequency of payment; who is responsible for payment (parent/insurance).

10

When raising session fee, what needs to be given to client?

Ample notice - at lease 3 months. (this must be in IC)

11

If a client faces hardship (e.g. lost job) and can't pay full fee, what do I do ethically?

lower fee during hardship

12

If a client doesn't pay fee, what am I allowed to do?

send overdue payment to collection agency.

13

When sending to collection agency, what information can I tell them?

the name of the client
and the amount owed

14

If client didn't pay and moved to a different therapist, what am I still obligated to do?

release the record

15

Bartering for services is only acceptable if-

if it is a common practice among the professionals in that community
AND initiated by client.

16

It is unethical to allow client to continue therapy when -

cannot pay and have a huge amount of debt.

17

It is acceptable to terminate client for nonpayment, if -

client is NOT in crisis.

18

What do I do FIRST if client cannot pay?

discuss payment plan with client

19

When is it appropriate to refer client out?
1. Client seeks advice outside of-

1. outside of scope of practice (medication/psychiatry)

20

When is it appropriate to refer client out?
2. Terminating client -

2. prematurely (e.g. moving/closing practice)

21

When is it appropriate to refer client out?
3. Client is not making progress even after -

3. changing course of treatment and trying everything.

22

When receiving referral, what am I NOT allowed to do?

giving reward for referral