CPT Codes and Billing Changes

CPT Codes and Billing Changes 2021

admin Costs of Treatment, GPS Update Leave a Comment

In January of 2021 the AMA changed the way that physicians must choose the appropriate “CPT” or billing codes for outpatient visits. The changes simplify the process and also make it clear that we have been “undercoding” for psychiatric outpatient visits at Gateway Psychiatric for quite a while. The reason for this is that the previous system for choosing billing …

Cost of Sending Medical Records from Gateway Psychiatric

Peter Forster About GPS, Costs of Treatment Leave a Comment

It is our policy to provide you and other health care providers ready access to necessary medical information. Fortunately, it is easy for us to create a summary of your care that includes our initial assessment, your diagnoses, and a complete record of any medication we may have prescribed. Unfortunately, if you want a complete copy of your record, due …

Life Insurance or Disability Insurance and Confidentiality – the MIB and Limits of HIPAA

Peter Forster About GPS, Costs of Treatment, Physical Conditions and Health Leave a Comment

The Health Insurance Portability and Accountability Act (HIPAA) has a few limitations that should be considered when you are applying for life insurance or disability insurance. Life insurance and disability or long term care insurance companies ask you for the names of all the doctors who have treated you and your consent to get records from the doctors. The consent …

generic medications

Generic Medications

Peter Forster Best Practices, Costs of Treatment Leave a Comment

I have long been a strong proponent of generic medications. Recently, however, several of my patients have expressed concerns about the generic medications that they have received. This led me to do some research on generic pharmaceutical companies. The first thing to know about generics is that they are made by many different manufacturers in many different countries. This is …

Get Your Insurance to Pay for Your Care

Peter Forster Costs of Treatment Leave a Comment

Let’s face it: dealing with insurance companies is a drag. Because it can be tedious and sometimes involve hours of phone calls with (often unhelpful) insurance agents, the task of getting the reinubursemed for out-of-network claims often falls to the bottom of the to-do list. If this is a familiar story, you may want to take a look at the …

Telemedicine Coverage Mandatory in California

Peter Forster Costs of Treatment, Policy Leave a Comment

California Governor Signs New Telehealth Insurance Law On October 11, 2019, California Governor Gavin Newsom signed a new law requiring commercial health insurance coverage and payment parity for telehealth services, unfortunately the law won’t take effect until 2021. However, in consideration of the State of Emergency declared by the Governor and the Secretary for Health and Human Services, an industry trade group, America’s …

Invisible Work for New Patient Consultations

Peter Forster About GPS, Best Practices, Costs of Treatment Leave a Comment

New patient consultations at Gateway are expensive, in large part because of the hidden or invisible work that takes place as part of the consultation process. The table below contrasts the visible work, which is contained in the two sessions with clinicians, to the hidden work done by clinical and nonclinical staff in order to make those two in person …

Medication Cost Savings

Medication Cost Savings – Update 2017

Peter Forster Costs of Treatment, Website Update

Last year the New York Times reviewed two websites that offered significant medication cost savings, for those without adequate insurance and, even for those with good insurance who are getting expensive medications. Since then we have had a lot more experience working with patients to help reduce medication costs and we can definitely say that these sites can help reduce …

We Are Not “In Network” Providers

Peter Forster Costs of Treatment, GPS Update

Gateway Psychiatric Services is not an “in network” provider of care. Many of the patients we see get reimbursement for their care here, but this depends on the specific insurance plan and how it handles out-of-network claims. The most generous plans seem to be provided by larger “tech” companies which often have very generous out-of-network coverage. It is important to …