Please send us your questions, comments and input. What do you need? How can we make TPI even more useful to you? Please scroll down to the bottom of the page to post your input under “Leave a Reply”.
TPI Events Calendar
Please send us your questions, comments and input. What do you need? How can we make TPI even more useful to you? Please scroll down to the bottom of the page to post your input under “Leave a Reply”.
Do you have recommendations on software for note-keeping and insurance billing?
Kimberly,
We are working on compiling a list of these and other technical tools for practice. Stay tuned…
We do a lot of psychological testing at our practice and we typically store the test protocols in a separate testing file from the actual patient chart. A copy of the final psychological report goes in the patient’s file as well as the separate testing chart. Do you know the standards of keeping the protocols? It would be nice to get rid of old protocols. Any thoughts on this?
Deborah,
It is my understanding that the protocols are part of the patient’s record and therefore must be treated like the rest of the record. Therefore, whatever record keeping guidelines are in place in your state are the standard for you to follow. It is important that these be retained. At a later date a client may need these for clinical reasons or forensic reasons. For example, if you are testing a six-year old child, someone else may re-test them later at twelve years old and may want to look for similarities/changes in test responses. As another example, an adult that you may see in 2011 may become involved in an automobile accident in 2015. As part of their forensic case they are claiming PTSD and your entire record may be helpful in someone else conducting the assessment in 2015.
Now with that being said I certainly understand storage of records being a difficulty or annoyance. I have “boxes and boxes” of test protocols because my busy practice has had a large assessment focus the past 10 years. However, I believe that I have come upon a solution. While visiting my CPA this year she told us that her office is now going entirely paperless. That is, she purchased a high powered scanner (I think she paid $1200 or so for it) that is capable of scanning 40 pages per minute. You have to check your State laws about record keeping but I believe you may not have to have the actual protocols but be within Standards if you can reproduce the protocol if requested.
This is one of my projects for this year that I will be doing in my practice in order to reduce the annoyance of having all of this paper to store. If you do go electronic be sure to have adequate backup systems in place. The records are still your professional responsibility to maintain, even if you go paperless.
If you do not have a large volume of protocols to archive you may be able to purchase a less expensive scanner. The task is also made easier if you make an electronic copy for each new protocol as soon as you have completed the assessment. It is always easier to do one at a time than to take the time and energy to do 10, 20, 50 or hundreds/thousands at a time.
Thanks and please let us know at TPI if you have any follow-up questions.
Steve Walfish, Ph.D.
Thanks Dr. Walfish, that is very helpful. We are in the process of exploring paperless options. In the meantime, a lot of our testing referrals are “in-house” so to speak. Meaning, an LCSW, LMFT, etc. will refer the client for testing to one of our psychologists. We then create a separate testing chart (apart from the medical chart) for the client. I am practicing in Virginia and couldn’t find any regulations on keeping a separate testing file. Any guidance on whether or not it’s possible to simply add the protocols and final report to the medical chart once testing is complete in order to avoid having two separate charts that require storage?
Deborah,
While you may “physically house” the test protocols in a separate place I believe that all testing is considered to be part of the medical record. This would be the case if the referral comes from within your practice or from an external referral source. If you can’t find this in the State regulations then you may want to consult with the risk manager from your malpractice carrier. They are there to help you avoid mistakes.
I keep the all of my records in one chart. This may include the test protocols, the written report, and my notes from the clinical interview or information that I have received from collateral sources in completing the evaluation.
What makes storing an especially “annoying task” is that if you see children then you need to keep the records a required number of years past the age of 18. So if you test a 5-year-old in Georgia you are required to keep those records until that little one turns 25 (7 years past majority; this may vary by State), so you are keeping these records stored for 20 years!
Steven Walfish, Ph.D.
Would love to learn the latest information on Asbergers Disorder, including syptoms; differenetial diagnosis, assessment and treatement.
Thanks,
Ronnie
Ronnie,
I do not know a specific definitive source for you. However, I just did a google scholar search on the term “Diagnosing Asperger’s” and there were a number of academic hits, both books (one related to misdiagnosing the syndrome by JT Webb), and journal articles where you can write the authors for reprints.
One thing that you may consider after doing these readings is to hire Jeff Jones, Ph.D. as a consultant. He has a program in Atlanta that is primatrily focused on individuals having these types of difficulties. His web address is http://www.beyondwordscenter.org.
Best of luck. This is an emerging practice niche that I think is worth exploring.
Steven Walfish, Ph.D.
Hello,
I am in the process of moving to Sacramento to possibly join a large private practice as an employee. Can you direct me to resources that can help educate me about the financial and legal/ ethical implications for me to break a contract before the designated period is over?
I have worked for the state before and this is a large paradigm shift for me. Hence I would greatly appreciate any ideas, suggestions and advice.
Thanks.
Priyanka Upadhyaya, Psy.D
Priyanka,
Congratulations on your upcoming move.
The short answer to your question is that you need to consult with an attorney who is familiar with the type of contract you want to break. They can review the contract and advise you as to the best course of action.
If you are in New Jersey (which I think you might be from my google search) consider contacting attorney Thomas Lewis in Lawrenceville. His web address is http://www.stark-stark.com/attorney-lawyer-1011454.html. He completed an interview in my book with Jeff Barnett Financial Success in Mental Health Practice related to the signing of noncompete agreements. It is my understanding that the NJ Supreme Court has outlawed them in the state. This may address the legal obligations part of your question.
The ethical part of your question may be more difficult to address without knowing the specifics of your situation. There are two ways to conceptualize ethics: personal and professional. Often they are overlapping, but not always. First, regarding professional ethics you have to determine what obligations you have made to your clients in your role as a mental health professional. Then apply the ethics code in your decision-making. If you are not clear about this then if you are a member of your State Psychological Association they may have an Ethics Hotline (many do) to call and consult with them. If you have malpractice insurance then you can call and discuss this with their Risk Manager.
Second, in terms of your personal ethics you have to decide for yourself what it means to you to break a contract you have signed. This is purely personal and I would suggest that you not allow outside sources to unduly influence you. Look inside yourself, consult trusted significant others, and then make your decision.
Best of luck in your decision,
Steve
Steven Walfish, Ph.D.
The Practice Institute
I am a bit confused over the latest information on psychologists and mandatory Electronic Health Records and more specifically, EHR incentives from Medicare and Medicaid. They seem very unclear (although this isn’t surprising!). A September 2010 APA practice update stated that psychologists were excluded from EHR incentives. A March 2011 APA article on the APA web site said Psychologists were being introduced as additions by the senate.
The other issue is the change to ICD-10 and the 5010 filing system to go into effect January 1, 2012.
Any info on these things?
Thanks!
Deborah
Deborah,
These responses are provided to you by our billing consulting expert, Susan Carlen.
Let us know if you have any further questions.
Thanks,
Steve Walfish, Ph.D.
Information about EHR and Meaningful Use and the Medicare and Medicaid incentive program can be found by going to this link on the CMS website.
http://www.cms.gov/EHRIncentivePrograms/01_Overview.asp#TopOfPage
Currently only certain provider types are eligible to participate. They include
* Doctor of medicine or osteopathy
* Doctor of dental surgery or dental medicine
* Doctor of podiatry
* Doctor of optometry
* Chiropractor
This is the most up to date information available.
The 5010 update is due to be implemented 1/1/2012. All covered entities who send and receive claim information in electronic format should be testing transmission now and must be fully ready to go by the live date of 1/1/2012. Talk to your clearing house and billing software vendor or billing service to ensure they are or have tested and are ready for the 5010 update.
For more information, please access the AMA 5010 fact sheet through this link:
http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/version-5010-electronic.page
ICD-10 has been used by the member states of the WHO since 1994 to track mortality and mobidity. The implementation to !CD-10 in the US has been a little slow in coming. Beginning 10/1/2013 all health care entities and providers must begin using !CD-10. The specific use effects services beginning 10/1/2013. Services performed prior to 10/1/2013 but submitted for payment after 10/1/2013 will be processed using the ICD-9 code.
It is recommended that full training not be undertaken until the deadline gets – why train to use a coding system now that you won’t use for 2 more years. However, if you want to get the best information and some practice, visit the WHO website. There you will find the current version of ICD-10 (2007), the history and background, and even a training module. Here is a link to the WHO site.
http://www.who.int/classifications/icd/en/
Hope you find this information helpful.
Susan Carlen
Practice Consultant for Behavior Health Professionals
spcarlen@gmail.com
I am in the process of developing information to streamline reporting and am interested in a software company that could assist with developing a software program for this purpose. I imagine that Dr. Walfish may have worked with a few software experts? I would appreciate any reliable referrals. I have been attempting to join the business development discussion, but have not been able to find the time and thought this may be a quicker way to an answer. I have enjoyed the Practice Institute thus far. Thank you.
Joan,
Glad you are enjoying TPI so far.
There are two suggestions that I have for you.
(1) Genie Skypek is a Tampa Psychologist who wrote a chapter in my book “Earning a Living Outside of managed Care” as to how she writes software for nonprofit agencies. You may want to contact her. Her e-mail address is skypek@mindspring.com
(2) You may want to check out Notes 444. It is a program written by psychologist Bill Picker. There website is http://www.notes444.com
Perhaps these two individuals may be able to partner with you on your product.
Kudos to you for finding passive ways to earn income and for using your entire skill set to generate an income.
Best of luck,
Steve
Steven Walfish, Ph.D.
The Practice Institute
Hello,
I just learned about TPI and your interviews of authors of new and current books. I have recently coauthored a book, “Integrating Psychodrama and Systemic Constellation Work: New Directions for Action Methods, Mind-Body Therapies and Energy Healing,” about the two major experiential methods that continue to grow and flourish around the world. I am interested in how you select authors for your interviews and would like to be considered for an interview. The book is scheduled for publication in October 2011.
You may find more information about this book at:
http://www.amazon.com/Integrating-Psychodrama-Systemic-Constellation-Work/dp/1849058547/ref=sr_1_1?ie=UTF8&s=books&qid=1301360216&sr=1-1
Karen,
Congratulations on the publication of your book.
If you would like to be considered for a Meet the Authors Interview, please contact me right after your book appears and we will discuss the possibilities. This is also the case for others in the TPI World who would like to discuss their book with other mental health professionals. Contact me at stevewalfishphd@thepracticeinstitute.com
Once again congratulations on the upcoming publication of your book.
Steve
Steven Walfish, Ph.D.
The Practice Institute