Posts by Barrett Merrill
What’s an Ombudsman? (And how they can help therapists)
As behavioral health providers, dealing with insurance companies and Medicaid payers often feels like an uphill battle. Delayed reimbursements, denied claims, or constantly changing regulations can make it challenging to focus on what matters most — caring for your clients. Fortunately, there’s a resource that can help: the ombudsman. So, What Exactly is an Ombudsman?…
Read MoreWhat’s the Difference Between MCOs and PHPs?
If you’re a behavioral health provider accepting Medicaid, understanding the complexities of different types of managed care programs is crucial for optimizing your practice. Two key terms you’ll encounter are Managed Care Organizations (MCOs) and Prepaid Health Plans (PHPs). Although these terms are often used interchangeably, they represent distinct structures and operational models. Let’s break…
Read MoreWhat are Payer IDs and EDIs?
In the world of behavioral health, understanding insurance and Medicaid billing is crucial for therapists who want to maintain a smooth revenue cycle. Two terms you’ll often encounter are Payer IDs and EDIs. While they may sound technical, knowing what these terms mean can help providers submit claims more effectively and reduce billing headaches. Here’s…
Read MoreHow to Prepare for a Medicaid Audit as a Therapist
As a behavioral health therapist or practice, participating in Medicaid or Managed Care Organizations (MCOs) offers a valuable opportunity to provide care for individuals who may otherwise have limited access to mental health services. However, one of the obligations of participating in these programs is the potential for audits. Audits are a regular part of…
Read MoreWhat Are MCOs and How do they work in Behavioral Health?
Managed Care Organizations (MCOs) play a critical role in the healthcare system, particularly in the United States. At their core, MCOs are organizations that provide or arrange managed care for health insurance, Medicaid, or other health programs. Their primary aim is to deliver quality healthcare services while controlling costs. They often achieve this by negotiating…
Read MoreMedicaid 101: What it is and its Role in Behavioral Health
Behavioral health Medicaid refers to the coverage provided by Medicaid, the United States’ public health insurance program, specifically for mental health and substance use disorder services. Medicaid plays a crucial role in ensuring that millions of low-income Americans have access to behavioral health care, including therapy, medication, and treatment – both inpatient and outpatient. Understanding…
Read MoreHow to Setup your Behavioral Health Practice to Accept Medicaid
Getting set up to accept Medicaid or a Managed Care Organization (MCO) as a payer for client sessions is crucial for behavioral health therapists. It opens doors to serve a broader population, particularly those who may not have access to other forms of insurance. The process can be complex and often involves meeting specific requirements…
Read MoreFun Committee: 20 Activity Ideas for Playing as a Team!
Build team morale by having fun and playing games together. Teams that play together, stay together! Throughout the lifetime of CheckpointEHR, our team has realized that if we’re going to work together for 40+ hours each week, we need to create intentional spaces to loosen up, get to know each other, laugh, and play some…
Read MoreGetting Ahead of the “Summer Slowdown”
The “summer slowdown” is a common experience for mental and behavioral health clinicians. Typically occurring from mid-May through July, client loads can decrease significantly as individuals and families take vacations, children are out of school, and routines are disrupted. Surveys have shown that client attendance for therapy sessions drops by 20-25% on average during the…
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