record keeping and fees Flashcards
what are the aspirational principles
-Beneficence and nonmaleficence
-Fidelity and responsibility
what are the seven standards under record keeping and fees
Documentation of professional and scientific work and maintenance of records
Maintenance, dissemination and disposal of confidential records of professional and scientific work
Withholding records for nonpayment
Fees and financial arrangement
Barter with clients/patients
Accuracy in reports to payors and funding sources
Referrals and fees
what should we be including in records
Information for the client’s ongoing file
Identifying data and contact information
Fees and billing arrangements
Guardianship status, if appropriate
Informed consent and waivers of confidentiality
Mandated reporting if relevant
Diagnosis or basis for request for services
Treatment plan (update as appropriate)
what to record for each client contact
Date of service and session duration
Type of service
Nature of professional intervention
Nature of professional contact
Current assessment (formal or information) of client/patient status
HIPAA and FERPA regulations
how long should we keep records
PA
-5 years since last point of contact
APA
-7 years since last point of contact
-Children: 3 years after a minor reaches the age of majority
-APA record keeping guidelines
HIPAA
-6 years from the date of creation or when it was last in effect
Institutional
-What are the policies of your institution?
steps to take to maintain, disseminate, and dispose of records
Keeping records in secure place
Limiting access to staff who require it
De-identifying records using code numbers or other methods
`Disposing of tapes and other identifiable records when they are no longer needed and their disposal is consistent with law
explain tips for fees and financial arrangements
As early as is feasible in a professional or scientific relationship, psychologists and recipients of psychological services reach an agreement specifying compensation and billing arrangements
Fee transparency
-Co pay
-Responsibility
-Payment schedule
-Phone sessions
-Charges for consultation with professionals
-Cancellation policy
explain how to do fee transparency
Competitive pricing
Pricing by negotiation
Pricing by time
Pricing by income goal
Sliding-scale fees
standard about withholding records?
Standard 6.03: psychologists may not withhold records under their control that are requested and needed for a client’s patient’s emergency treatment solely because payment has not been made
Examples of instances when records can be released in case of emergency
-For client’s/patients in an acute state of mental disorder (e.g. schizophrenic episode, depressive episode with suicidal ideation)
-To help determine the cause of an incapacitating cognitive or language disorder
-Records must be under the psychologist control
-Records must be requested
Though ethically permissible under standard 6.03 withholding for nonpayment under nonemergency conditions may not be legally permissible
tips for getting paid
Make it a standard practice not to allow clients to run up large bills
If payments are deferred be sure to set an upward limit
The longer the delay the smaller the collection
Both parties feel bad if therapist allows for nonpayment
Unpayable balances may contribute to licensing board complaints
Cash checks immediately
Charge clients for bounced check fees
what is upcoding
submitting insurance claims for diagnoses that are more serious than actual diagnosis to get better reimbursements
what about bartering
Providing services in return for bartered goods is ethically permissible when to not do so would deprive clients / patients of needed services or run counter to a community’s economic or cultural practices
what about upcoding/therapy
Accurate diagnosis
-Must provide accurate diagnosis to third party payors
Billing for missed appointments
-Clearly identify sessions for which charges are for a client/patient
Accurate representation of billing practices
-Must provide accurate representation of billing practices
