A.
1) Get an office address
2) Set up an LLC and EIN number using your office address, NOT YOUR HOME ADDRESSS
3) Get an NPI using your office address
4) Get an NPI for your LLC using your office address and EIN
5) identify a billing company or software.
6) Open a business bank account using the LLC and EIN
7) enroll as a CMS provider for medicare.
B.
1) Use the state or federal licensing website to look up every nursing home within 50 miles of you. If you live somewhere oversaturated, you'll want to look at more rural ones.
2) Got an SO? Friend? Number of a temp agency? Have one of those call up #1, and ask, "Hey, who is the attending physician there?" wihtout identifying who they are or why they are calling. Write that down.
3) Look up the attending physician's contact information using the NPI tool or your state's licensing website.
4) Send a business letter and business card to those physicians. Tell them you're a psychologists who likes geropsychology work in medically compromised patients. DO NOT MENTION PSYCHIATRIC ILLNESS.
5) Do #4, but to the nursing homes's directores. Offer to meet with the nursing director. Mention that you know that CMS requires that CARF residents receive annual depression screening as part of quality assurance whatever.
6) Wait 2-3 weeks. Call those physicians up. Ask him if he'd be interested in some help with behavioral stuff. Mention that you know that CMS requires that CARF residents receive annual depression screening as part of quality assurance whatever.
7) One of those people or places will say yes. Ask him if they would be willing to write an order for psych consult. They will.
8) Go see that person. Use H&B codes at the facility fee location. Chart it. Look at
@Sanman 's stuff from recent posts about how to make money in H&B codes. It looks legit.
9) On site, sweet talk staff. Bring food. Mention that you're interested in helping increase treatment compliance for medically compromised patients. Repeatedly.
10) Consult that one patient as clinically appropriate, once a week maybe? Repeat #9 each time you are there. Flirt if you have to, but do not start any relationships.
11) Ask staff if there's anyone else they want you to check on, each time you're there. Grow that population, with the goal being every patient there for which H&B services are clinically indicated.
12) Create a form for your charting. Look up what the CPT official descriptor requires for that service. Put that on the form. Look at your state regs, put whatever they require in your form. You want to document appropriately, but you're trying to have that chart note done before the end of that 15 min consult. Remember, you're NOT treating mental illness.
13) Create a form of a daily log of services, times, dates, medical dx, cpt code. Goes like: LOCATION (header), DATE, NAME, CPT CODE, START TIME, END TIME, ICD10 CODE FOR MEDICAL DIAGNOSIS.
14) Take #13 to your office every single day. throw it in a pile. Periodically take that pile to whoever bills for you. Or hire someone to put it into your billing software, if that's your thing. NEVER DO YOUR OWN BILLING. Why? I'll assume you're not trying to commit fraud. Insurance is gonna audit you at some point. There are going to be some billing mistakes, at some point. Someone else is doing your billing and making mistakes? Itlooks like a mistake. You doing everything and making a mistake= looks like fraud.
Ideally, you're gonna identify a nursing home with long halls, that is staffed by an attending physician that finds H&B services to be helpful (or straight up does not care what anyone does), that is populated with 50-200 patients who are in said nursing home because they have a qualifying medical dx for which H&B services are clinically indicated.
Why long halls? You're billing in 15 min intervals. Walk in, do your service, walk to the next one.
Make sure to treat my buddy Sanman well. He lives in one of those because he’s old AF. But he has Worthers originals in the pockets of his cardigan (I assume).