Information for Therapists:
Due to our new-found flexibility and virtual office space, you can schedule your patients for other days on your TheraNest Calendar. Here are the instructions for opening up your calendar preferences and expanding your availability.
Please be sure to delete appointments that have been switched to another time. Designate new spaces as T Open or T old. In this way, Renee and Mike will know if they can schedule a new patient in those time slots. Once an established patient is entered in a virtual time slot, you can make that recurring. It will then, not need the TH old designation. Please restore that if you change it again.
Use Zoom. If you are having trouble please reach out!
From TheraNest, click your name in the top-right corner, then click "Calendar Preferences." If you scroll down a little, on the right, you'll see a section labeled "Calendar Availability Preferences for Scheduling." You can change your available times there. Then just remember to click "Save Preferences"!
See a video with these instructions below!
Orientation for New and Ongoing Therapists
Acquiring new patients:
1.You will receive an email when a time slot has been filled by a new client. You will see the appointment on your calendar and be able to access the client’s complete chart. You should be assigned to all cases ( if the client was seen previously by anther therapist, there will be another case. You can close the previous case after you have reviewed it.
2.Go to the DEDUCT AND AUTH PAGE. Here you will see details about the appointment, the patient’s insurance, co-pay, co-insurance, deductible etc.
3. Go the Client Details. Here you can access their email and telephone numbers.
4. They must have an emergency contact. If not be sure to get one from them at your first session.
5. Reach out to your prospective client before your first session. Making this connection will help your show rate! Confirm the time, and ask them for a brief idea of what they want to work on. Explain about 24 hour cancellation policy.
6. Check the Client Details section and go to General Documents at the top of the page. Here you will find the materials they submitted from the Portal. These documents include for Consent for Treatment and Telehealth treatment, Permission to share their information with a physician or other designated person, and their HIPAA forms.In addition, there is a brief initial eval. They must sign and submit. The consent for treatment and the HIPAA form are also in TheraNest. If you do not see the Portal docs in your client’s chart, go to the details page and look on the upper left. You can see if the client has an active portal account. If so, they just didn’t finish submitting or they had trouble with their signature.
You can copy and send them the login link from the Organization page. Go to Organization and look for the “client portal” link in the blue side bar. Remind them to save their signature before submitting. If they are not “active” copy and paste the invitation link.
7. Send Psych Assessment Materials: We will give you digital versions of the BDI and the BAI. Send these to your patient and ask them to submit their responses to you. You need to store them in the patients Clinical Documents as PDF documents. Note the scores and their implications in your Initial Evaluation or Progress Note.
8. Complete Initial Assessment, Progress note and Billing.
Initial Assessment: You must complete the diagnosis code, presenting problem, pertinent history, observation (patient presentation) and the Risk section. If you check something in the list, you must explain in the attached field. If there is no sign of any symptoms in the list, you need to write: “none present” in that field. Remember: absence of documentation is not proof of the absence of symptoms. No other fields are required. Remember to click “SAVE” until you see “Data Saved”
Treatment Plan: You are not required to create a treatment plan in the app. It is a valuable tool, however, and will appear on every page of your progress notes for reference.Remember to click “SAVE” until you see “Data Saved”
Progress Notes: In order to bill for your first session, you will also need to complete a progress note. Complete all fields.You can click to populate the mental status fields as “All within Normal limits” and add any modification you wish. Focus field is the presenting problem for the day.. Therapeutic Intervention is the documentation of what you did to address problems or symptoms in the session. Planned intervention can be assignments of future focus. It must include when you will see the client for their next appointment.” Patient will be seen in one week.”
You must do the Risk Assessment, even though you did that on the Initial Eval. There is a drop down list for suicidality and homicidality. Even if you choose: “Not present” You must write “none present” in the adjacent field, if that is the case.Remember to click “SAVE” until you see “Data Saved”, before leaving the page.
- See instructions below for procedures re suicidal, homicidal or self-harm risk.
This will bring you to the invoice page. Click on “New Invoice at theta of the page. The date, service type and financial information will appear. This will be in blue, as an active link in the system. If it is in black, it means that your appointment on the calendar is either missing or is missing a service code. Note: Your service code should either be 90791 for Initial Assessment or 90837. This code means you spent 50 minutes to an hour total with your patient, including writing your notes. You can use 90834 which is 45 minutes or less (total).
If you have completed psychological assessment you can bill for this as well. If you employ two or more instruments you will receive an additional fixed payment (pending payment by the insurance company). We are not testing anyone below the age of 13. Everyone else should have an assessment. You can repeat these after 6-8 weeks, if you think it would be of benefit.If the patient has a high deductible, we may defer assessment to a later time, so as not to create an undue financial burden.
Billing for Assessment: Below the invoice you just created there will be a button “add invoice item”. You will add from the drop down list (under the date): Testing for one instrument and Testing ext for 2 or more.
You can click save, save and accept payment or save and “add to claims awaiting submission”
Accepting payment Click accept payment. Choose payment method (credit card for now). No need to do anything further. you should see the amount in un applied payments. Jen and Kim will process these during billing.
Click save and submit to claims awaiting submission. Although your EAP will not be billed immediately( unless its Cigna) submit anyway. You will still see the invoice in the ledger, until all sessions are completed.
EAP’s: Even though you submit these, some cannot be billed immediately.
EAP forms will be in the patient’s General Documents. You can upload these, fill them out and send them back to Kim and Jen in billing, when you have completed the sessions. They will then all be submitted to the EAP company. If the patient is continuing, Kim or Jen will switch them to their commercial insurance. (There may be a deductible or co-pay)Kim or Jen will let you know.
MAINTAINING YOUR CALENDAR
Be sure to update your calendars weekly. Put “OPEN” in time slots that are available. If a patient’s name is in there, we will know that it is not available. If you want a break in the day write “HOLD” in that slot.
Going forward, we will continue to see patients through Telehealth and hopefully see some in person, as well. Designate your Telehealth slots as “OpenT”.
Scheduling your patient beyond the initial 8/ editing appointments.
Two ways to do this:
- Go to your patient’s Chart and click on “Appointments”from the Blue Bar on the left of the page. You will see the status of past and upcoming appointments. If you need to change that, you can click on it and choose another label. You can also enter a reason. You can also edit the appointment here. At the top of the page, you can also choose “new appointment”. Be sure to enter a service type, the correct date and time. Click on Repeat event “disabled” to schedule recurring sessions.Be sure to “save”.
- Go to your calendar go to an empty time slot and double click. The appointment field will appear. Any registered client’s name will pre-populate in the Event or Client field. Choose the one you want. If you want to edit an entry, click on the on the body of the entry. You will see 3 icons. The middle one allows you to edit. Click here and you have 3 choices: (if this is a recurring appointment). “Edit Series” “Edit Occurrence” or Cancel.(Cancel means do not edit the appointment). If you just need to change the date or time for that week, edit the occurrence.
- If you want to delete the appointment- trash can it.Sometimes when scheduling a new set of recurring appointments, you need to start fresh.
Admin side: (Client Details) General Documents (Portal documents must be present).
Billing Problem Log: If you notice something unusual in your Ledgers you can check here, to see the documentation from Billing.
*Risk If your patient reports greater than mild suicidal, self-harm or homicidal symptoms:1. Fill out Suicide Risk Assessment 2. Text or email Dr. Ellen alerting her to the situation. 3.Fill out the Incident Report.
Any sign of these symptoms (other than mild, and other than, in the past) requires the Commitment to treatment/ Agreement for safety form. This is the documentation of a therapeutic intervention. Be sure there is an emergency contact and that you have a plan to keep the patient safe.
Active symptoms will most likely require sending the patient to the ER. Be sure to connect with their SO to get confirmation.
Suspected Child Abuse form: Complete and call Child Protective Services.
Treatment Agreement/No legal services: Patients are told upon registration that we do not provide legal services. That is: no custody assessments or interactions with attorneys. If subpoenaed for a court appearance, we will charge $800/hour. We will provide a summary of treatment upon request. We will not comment on parental fitness. If your patient has these issues, please have them sign the form to continue treatment.
Developmental History Form: Required if you are seeing anyone under the age of 18.
- Maintain your cases. Please terminate clients who will not be returning. You will need to go to CASES and close the case. That means you need to fill out that form with a disposition. When you are finished “archive” the patient. (Go to “Clients” and populate your list). If you have not seen the patient in 2 months or even if the patient is taking a break for 2 months or longer, please archive the patient. Be sure your notes and billing are up to date before you do so. We can still enter payments as they come in. Our subscription to TheraNest is based on the number of ACTIVE patients. Archiving helps us maintain a lower cost.
- Manage your caseload. You can run the Detailed Attendance Report any time to look at your statistics and identify problem areas (like no-shows). You can also run a report for missing progress notes, etc.
- Intakes are due within 24 hours of seeing the patient. Progress notes are due within 48 to 72 hours.
Peer Consultation: Peer consultation is a bi-weekly meeting that occurs via Zoom. You may join the 3pm group on Tuesdays or the 2 pm group on Wednesdays. This is how we maintain community, and continue to learn from each other. This is a required part of the contract. If you have an occasion where you must be absent, please notify Mike. Scheduling a patient in the P.C. time slot is not a valid reason for absence.
4. Please be kind and considerate of our staff. They are doing their best to help you maintain a full case load, and get paid timely. Taking care of your end allows all of us to function smoothly and successfully.
Thanks for your attention to these details! We look forward to a long and mutually beneficial relationship.
Welcome to PsyCare!