Medicare calls a patient new after three years without a visit
Your colleague saw a patient last year, and the patient now books an intake with you. Check three years of your group's visits before you pick a new...
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Your colleague saw a patient last year, and the patient now books an intake with you. Check three years of your group's visits before you pick a new...
Read more →You see medication patients by video, and each visit needs a code: 99214 or 98006. Check each payer's telehealth policy before you set the code.
Read more →Your practice has offices in two states, and Medicare claims from the second office come back unpaid. Find each office's Medicare contractor first.
Read more →Your patient's card says UnitedHealthcare, UMR, or Oxford, and your claim came back rejected or paid months late. Look up the plan's payer ID before...
Read more →Your patients fill out a Patient Health Questionnaire-9 (PHQ-9) and a Generalized Anxiety Disorder-7 (GAD-7) before each visit. No 96127 shows on...
Read more →Your Medicare patient's 90837 session turns into crisis psychotherapy and runs past the hour. Pick your code by what happened, not by the minutes.
Read more →Your client carries Medicaid and an employer plan, and Medicaid sent your claim back unpaid. Medicaid pays only after the other plan pays or denies...
Read more →You bill most medication visits as 99214, and a Medicare report compares your share with your peers' shares. Treat the report as a comparison, not a...
Read more →You billed Medicaid for two services for one patient on one day, and Medicaid denied one code. Look the pair up in Medicaid's code-pair file before...
Read more →Your Medicare client comes back after months away, and you'll need a code for the first session: 90791, the psychiatric diagnostic evaluation, or a...
Read more →Your patient's Blue Cross card comes from another state's Blue plan, and the claim came back denied or paid to your patient. Send the claim to your...
Read more →Medicare may not pay for your patient's next service, and your staff hand over the Advance Beneficiary Notice (ABN). Who signs it decides whether you...
Read more →You billed two codes for one patient on one day, and Medicare paid one. Medicare's code-pair edits decide which code pays.
Read more →Your therapy group ran past an hour. You'd like to bill the extra time.
Read more →Your patient joins a video visit from work, and your claim says place of service (POS) 10, the code for home.
Read more →Your clinicians use an AI tool that drafts notes from session audio, and your intake consent form says nothing about AI. Write an AI consent form...
Read more →You sent a Medicare Advantage plan a prior authorization request for transcranial magnetic stimulation (TMS) eight days ago. You're still waiting...
Read more →You prescribe stimulants or benzodiazepines by video to patients you've never met in person. Those prescriptions depend on a temporary DEA rule. The...
Read more →Your Cigna explanation of payment shows a 99214 paid as a 99213. Don't accept the lower payment yet.
Read more →Your payer offers your practice a 4.9 percent increase by email.
Read more →Your receptionist has an offer: $2 more an hour at a clinic across town. Do you match the offer? Start with the going rate .
Read more →Your first patient is at 8:00. You're opening the night's faxes one at a time.
Read more →Some of your clinicians' notes are days old and unsigned, and you can't tell who is furthest behind. Pull two numbers for each clinician: the count...
Read more →You'd already paid your clinicians for last month's sessions when claims for some of those sessions came back denied.
Read more →Your new pay plan is ready for January, and your clinicians haven't seen it yet. How do you change their pay without losing anyone?
Read more →You're deciding whether your practice should apply to ACCESS, short for Advancing Chronic Care with Effective, Scalable Solutions. Your charts hold...
Read more →Your AI scribe records every session you hold this week, with new clients and current ones. The only mention of the scribe sits in paragraph nine of...
Read more →Your patient with bipolar disorder lost a job in the spring and hasn't worked since. Medicaid covers the visits, through the Affordable Care Act's...
Read more →Your Medicare claim came back unprocessed, with remark code MA130. You'll have to fix your claim and send it again.
Read more →Your practice's therapist sees your Medicare patient between your visits. You'd like to bill the visit under your National Provider Identifier (NPI)...
Read more →Your Medicare patient joined a Medicare Advantage plan, and your claim still went to original Medicare. Medicare denies your claim.
Read more →You're finishing Monday's and Tuesday's progress notes on Friday afternoon. Each note gets your name and your electronic signature.
Read more →Your 2:00 session ended five minutes ago. The AI draft of your note is ready, and the draft suggests 90837. Your 3:00 is in the waiting room.
Read more →Your 2:00 is a medication follow-up. Since the last visit, your patient spent days in a hospital, and your chart doesn't say so.
Read more →You add G2211 to your Medicare follow-ups, and it pays the same at every level. In 2027, your mix of levels would decide whether you gain or lose.
Read more →Your social workers and counselors bill hour-long Medicare sessions as 90837. Medicare proposes a higher amount for that code in 2027. You can lose...
Read more →Your Medicare patient gets transcranial magnetic stimulation (TMS), and you bill a 99214 with modifier 25 the same day. Medicare's 2027 proposal...
Read more →Your biller spends hours each week on one payer's denials, records requests, and phone calls, while another payer pays you about the same rate and...
Read more →Your payer's network rep says 3 percent is the most the plan can do.
Read more →Your rate letter to a health plan is drafted: raise the rates, or your practice leaves the network. The plan will sell 2027 coverage with your...
Read more →Your contract with a commercial payer is up for renewal. Your clinicians bill that payer for 90837 and 99214, and you're deciding what rates to ask...
Read more →Your follow-up note lists four chart diagnoses. You raised the sertraline for depression and decided against a benzodiazepine because of an alcohol...
Read more →Your 3:00 appointment is a depression follow-up. The Patient Health Questionnaire-9 (PHQ-9) score is 14, the goal is under 5, and you raise the...
Read more →You fix and resend each denied claim. Next month you'll see the same reason code again. Find the step that failed.
Read more →Your biller moves an unpaid claim's follow-up date to next month. Call the payer that day instead. Ask whether Optum has the claim and what's missing.
Read more →Your new biller can start next month, and you're about to give your old biller notice. Don't send that notice yet.
Read more →Your new patient misses an 8 AM intake, so your clinician's hour sits empty and the patient's care starts later. You can't tell yet whether 8 AM is...
Read more →Each of your prescribers charts the med check a different way, and many don't finish notes until after clinic. One template for each visit type gives...
Read more →You told your front desk to collect at the visit, and patients with deductibles still leave without paying. Replacing your front desk person looks...
Read more →Your patient switched plans. Your front desk scanned the new card, but the plan on file still shows the old payer, so your next claim goes to the...
Read more →Your patient's plan wants a prior authorization before the next refill or the next round of visits. Your staff make the calls. Your patient waits.
Read more →Your patient says a chatbot helps with sleep. You don't know which chatbot, what the chatbot said, or what your patient typed.
Read more →Your clinicians sign their own notes. Some notes may reach a payer's reviewer next.
Read more →Your clinician signs the note, and the visit is ready to bill. After the claim goes out, files come back from a clearinghouse and the payer.
Read more →Your front desk answers the phone 9 to 5, and a new patient decides to book at 9 p.m. on a Sunday. Your booking page lets that patient pick a time...
Read more →You're renewing a patient's stimulant or benzodiazepine. The prescription is ready to send, and you haven't signed the visit note yet.
Read more →You finish the visit and send the prescription. Your patient asks which store to go to, and when the medication will be ready.
Read more →Your AI drafts come back in sections you didn't choose, so you move text into your note format before you sign each note.
Read more →Your patient has checked in to your video waiting room, and you're about to join the call. Check the consent to record, the telehealth consent, your...
Read more →You treat older adults for depression, and a follow-up starts in a few minutes. The newest Patient Health Questionnaire-9 (PHQ-9) score sits in one...
Read more →You're writing Medicaid progress notes at the end of a full day, and your template fills most of each one.
Read more →Recoupment means a payer takes back money it already paid you on a claim. Which limit applies to you depends on the payer: a state-regulated insurer...
Read more →Your remittance shows a denial: the payer pays nothing on a claim line and gives a reason code. Your payer's demand letter asks for money back on a...
Read more →Blue Cross/Anthem and Cigna average more than Medicare's national psychologist rate for a 90791 intake, and UnitedHealthcare and Aetna average less...
Read more →Your intake template bills every new patient as 90791, even after you do a medical assessment. Write your medical assessment in the note, and bill...
Read more →Your patient arrives 20 minutes late. You have 30 minutes left for psychotherapy. Bill the session as 90832, and write the 30 minutes in your note.
Read more →You've spent 20 minutes on psychotherapy inside a medication visit, and the claim carries only the 99214. With 90833 on the claim, Medicare's 2026...
Read more →Your remittances show the same 90834 paid at a different amount by each payer. For a 90834, Medicare's 2026 national rate is $85.43 for therapists...
Read more →You add 90836 to a 99214 when the visit includes 38 to 52 minutes of psychotherapy. Use three note lines.
Read more →Your 90837 note describes the session but gives no start time, stop time, or total minutes. Write the psychotherapy minutes in every note, as a start...
Read more →You see a patient for a long medication visit, and the psychotherapy alone runs 55 minutes. Add 90838 to your 99214. Write those 55 minutes in your...
Read more →Group psychotherapy pays the least per patient of any code in this series, by a wide margin. It is also the code where the per-clinician-hour math...
Read more →Your patient's depression is stable, and you renewed the antidepressant in a 12-minute visit. You're about to bill a 99212.
Read more →You refilled two prescriptions today, one for stable depression and one for stable insomnia. You're about to bill the visit as a 99213.
Read more →You saw a patient today in a severe manic episode of bipolar disorder. You weighed a hospital admission and chose outpatient care. Your visit ran 45...
Read more →Your patient took a 56 mg Spravato dose at 9:00 AM. You'll observe until at least 11:00 AM. Then you'll write the G2082 note.
Read more →When your patient's Spravato dose moves from 56 mg to 84 mg, the visit takes three nasal spray devices instead of two . Check two facts first. The...
Read more →You're planning next year, and many of your patients have Medicaid. The expansion group is adults ages 19 to 64 covered through the Affordable Care...
Read more →Cigna, Optum, and Aetna each publish the rules their reviewers use. Nobody reads your note against those rules. Then a reviewer opens it years...
Read more →You have this month's denied claims in front of you, and each one carries a reason code from the payer. You're working them one at a time.
Read more →Your patient's Medicare Advantage plan denied a prior authorization request for transcranial magnetic stimulation (TMS) within hours. The denial...
Read more →You see Medicare patients by video at home. From January 1, 2028, each patient who starts home video visits needs an in-person visit in the 6 months...
Read more →Work requirements take effect January 1, 2027. For a behavioral health (BH) practice carrying 30% or more Medicaid census, that is not a policy deadline...
Read more →Your patient's Medicare Advantage plan denied prior authorization for an item or service. The 30 days of a standard reconsideration could seriously...
Read more →You finish a Medicare psychotherapy session and open your note. Write the psychotherapy time and the therapy you gave, so an auditor can match your...
Read more →Your quarterly totals show what came in. They don't show which payer denies most, pays slowest, or pays below your contract.
Read more →Your Medicaid patients check in with the cards you scanned at intake. You checked their coverage once. You've booked every visit since on that one...
Read more →You're setting next year's charges. Some codes still carry a charge you entered years ago.
Read more →Your remittance posts a commercial claim as paid, with no denial. You don't look again.
Read more →You bill a 99214 for most medication management visits. You're updating your 2026 charge. The national physician rate in Medicare's 2026 fee schedule...
Read more →You could keep your web-based EHR and add Eleos as a browser extension , or replace that EHR with JotPsych.
Read more →You finish the note in Freed, push it into your EHR, and then prescribe and bill there. Choose a tool by where the rest of the visit should happen.
Read more →You're trying Heidi Health, and your medication follow-ups end in a note, a prescription, and a claim. Check which of those three outputs each tool...
Read more →You've narrowed your search to mdhub and JotPsych. Both platforms list notes, e-prescribing, scheduling, and billing. Your 99214 follow-ups with the...
Read more →Nabla can draft notes inside Epic or another major EHR your group runs. Your group could also replace that EHR with JotPsych. Check what your...
Read more →Your therapists already work in Upheal, and your first psychiatric nurse practitioner (PMHNP) starts seeing medication patients soon. Check whether...
Read more →Since March 1, 2026, UnitedHealthcare's commercial and Individual Exchange plans can deny your outpatient or professional claim for two diagnosis...
Read more →Psychiatric care often requires a dual focus: medication management and psychotherapy. This template covers both.
Read more →A complete psychiatric progress note template designed for medication management and follow-up visits.
Read more →A comprehensive psychiatric intake template covering the initial evaluation, history, and treatment planning.
Read more →A specialized addiction assessment template for substance use disorder evaluations and treatment planning.
Read more →A comprehensive look at how AI is transforming behavioral health documentation, billing, and clinical workflows in 2025.
Read more →Your after-hours notes are the notes your clinicians finish after their last visit of the day, at the office or at home. You'll need two weeks of...
Read more →You open an AI-drafted note and type "make this better" in the AI Note Assistant. Your prompt names no section and no change. The result is a guess.
Read more →You've tried an AI scribe, and the note was only part of your visit. Pick the next one by what your most-billed visit needs after the note.
Read more →You're looking at Suki for your notes. Compare what's left after the note with Suki and with JotPsych.
Read more →