Transcript

[Transcript] Episode 431: Harnessing the Potential of Medicaid for Your Practice

 

Evan Dumas

You’re listening to Group Practice Tech, a podcast by Person Centered Tech, where we help mental health group practice owners ethically and effectively leverage tech to improve their practices. I’m your co-host, Evan Dumas.

 

Liath Dalton 

And I’m Liath Dalton, and we are Person Centered Tech.

 

Liath Dalton 

This episode is brought to you by Therapy Notes. Therapy Notes is a robust online practice management and Electronic Health Record system to support you in growing your thriving practice. Therapy Notes is a complete practice management system with all the functionality you need to manage client records, meet with clients remotely, create rich documentation, schedule appointments and bill insurance all right, at your fingertips. To get two free months of Therapy Notes as a new Therapy Notes user go to therapynotes.com and use promo code PCT.

 

Liath Dalton 

Welcome to Episode 431: Harnessing the Potential of Medicaid for Your Practice.

 

Liath Dalton 

I am privileged once again to welcome the wonderful Gabrielle Juliano-Villani, who is many things and wears many, many hats, but one of Gabrielle’s niche specialties and areas that she provides support to group practices in particular around is Medicaid, as well as as Medicare, because you do Medicare consulting for therapists. But increasingly, I know you’ve been getting questions around Medicaid, and PCT has also seen a big uptick in questions around accepting Medicaid, and what that looks like and what should be considered. So that’s why you’re here.

 

Gabrielle Juliano-Villani 

For a thrilling episode.

 

Liath Dalton 

Really, an episode about, well, I mean, it very well may be quite thrilling to to some practices, right?

 

Gabrielle Juliano-Villani 

Yeah.

 

Liath Dalton 

And it’s something I feel quite comfortable at this point, being able to extol the virtues and potential benefits of being a Medicare based practice. And I know that you know Medicaid and Medicare are not analogous, though there are some key crossover areas, but I’m just looking forward to your sharing more about the particulars of Medicaid, and maybe a good place to start would be, what are some of the main differences between Medicare and Medicaid?

 

Gabrielle Juliano-Villani 

That is a good question, because I think it’s confusing to people. We want to make sure you’re clear on the difference, because even though it is Centers for Medicare and Medicaid, they are totally separate things. And I think the big ones are: Medicare is national, it’s at a federal level, and it is for people who are over 65 or who have been on SSDI for, I think it’s like 23 months, basically two years. So those are folks who are on Medicare.

 

Gabrielle Juliano-Villani 

Medicaid is run at the state level, so each state is going to be different. Medicaid is based on people’s socioeconomic status, gnerally. There’s like, you know, some caveats to that too, but people can also have both. So I think that’s where we get confused. But they are two separate things.

 

Liath Dalton 

Well, so one takeaway there, you know, for some of the practices who may have decided to opt out of being a Medicare provider, because that’s not a population, you know that it’s 65 and older population, is not one that they have particular like clinical expertise in or that’s not not their niche, soo it wasn’t the best fit in the in those terms. ThatThat isn’t a limiter when it comes to Medicaid populations, right?

 

Gabrielle Juliano-Villani 

It could be.

 

Liath Dalton 

Oh!

 

Gabrielle Juliano-Villani 

Some states, Medicaid want you to also accept Medicare, because it’s a federal program. So they say that if you are going to be a Medicaid provider, you also have to be a Medicare provider. And that’s not across the board, and there are some states who don’t care, but some states do want you to be basically in network with both. So it is something to consider, if you, you know, because I know, for example, people who are in private practice, and they work a lot with kids, so they take Medicaid because they’re like, that’s our population, but we don’t want to take Medicare because we don’t work with that, I’m just going to opt out. So that’s one situation where I would say, just maybe check first with your provider rep before you do that, just in case.

 

Liath Dalton 

Okay? But in general, folks who are covered by Medicaid, are going to be all all age ranges and a lot of kiddos typically, too, right?

 

Gabrielle Juliano-Villani 

Yeah. So even though, like I said, people can have Medicare and Medicaid, Medicare would always be primary. So if you were just, you know, working with the Medicaid population, it could be, yeah, all people of all ages, lots of kids, especially if you, of course, are, like, contracted or working with DHS, kids in foster care will always be on Medicaid. So, yeah, there’s always a lot. There’s a younger population there, I feel typically.

 

Liath Dalton 

Okay, so that’s one main differentiator between the two, along with the state by state basis for Medicaid versus how Medicare is administered and at the federal level. When would you say there is kind of a particular practice that would be a really good fit for considering becoming a Medicaid provider?

 

Gabrielle Juliano-Villani 

Definitely if you work with kids, if you work with, specifically, like if you work with adoptions, also. Again, because kids are in foster care, they’re in county care, they’re going to be on Medicaid. Also, I think that, you know, there’s, of course, a big mis, though there’s a lot of misconceptions, but I think one is that I hear, and I’m not saying that, I think this. I’m just saying this is what I hear from people, is that Medicaid clients are difficult, and they’re higher acuity.

 

Gabrielle Juliano-Villani 

And they can be. There, there oftentimes is more of a crisis happening, but it’s not always like that. And there are, I just looked like a couple days ago, it’s either 80 million or 88 million people on Medicaid in this country, so that’s a lot of people. So it can also be a great resource if you are trying to build your practice, or if you’re trying to add another stream of referrals, if you accept Medicaid, they they will come to you. That will bring them to you for sure.

 

Liath Dalton 

Well, I know a big question that was coming up a lot when the Medicare expanded to including social workers and counselors, or sorry, counselors and MFTs, and not just psychologists and social workers, that a very frequent question as people were evaluating whether to opt in or opt out was what reimbursement rates look like.

 

Gabrielle Juliano-Villani 

Yeah, of course, that’s totally fair.

 

Liath Dalton 

Naturally. Well, show me the money. And is it, is it worth it?

 

Liath Dalton 

Wow.

 

Gabrielle Juliano-Villani 

Yeah, and that also, of course, is going to vary state by state, but just like with Medicare, I wouldn’t write it off. Because I have looked at Medicaid in a lot of states, and I’m surprised sometimes by how much it pays. Like some states over 150 for 90837, and

 

Gabrielle Juliano-Villani 

So,

 

Liath Dalton 

Which can be more than private insurance?

 

Gabrielle Juliano-Villani 

Yeah, exactly. So don’t write it off. In Colorado, where we took Medicaid, it wasn’t quite that much, but it was decent. It was decent enough that we accepted it, it was kind of on par with everything else. But of course, it is state by state. Some states are really low. I’ve seen ones where a 90837, was like $68, $80 so I can understand why that would not work for your practice model. But check, and it’s all public information,  out there, you do have to dig a little bit, but it is all out there.

 

Liath Dalton 

What is the best way, speaking of that digging, what is the best way for someone to identify what the Medicaid reimbursement rates in their state, or states of practice are?

 

Gabrielle Juliano-Villani 

Every state is going to have like, a Medicaid website, and sometimes it’s like the health department, sometimes it’s like DHS, but every single state has one, and every single state has a page for providers. And I know this because I’ve looked at all of them, they are there. You do have to, again, do a little digging, but they’re there. And every state has a provider handbook, a provider manual. So it’s either going to be in there, or sometimes they’ll have, like a Billing Guide or manual. Some, sometimes you have to dig through those manuals to find it, and sometimes they just have a page that like lists the fee structure, so it’s out there. But yes, you would want to go to your state’s Medicaid site and start looking on the provider page, and you’ll be able to find that information.

 

Liath Dalton 

That’s excellent, because I think that certainly will be a main determining factor for whether to then kind of continue the exploration further or not, right?

 

Gabrielle Juliano-Villani 

Yeah.

 

Liath Dalton 

And so in terms of the next considerations that people should be undertaking if this is something they want to explore, what would you kind of identify those to be?

 

Gabrielle Juliano-Villani 

So consider, first of all, that it will bring you more clients to your practice, but there is more paperwork. There is little bit of a burden there, and so you’ll want to have good systems in place. And also, I don’t say this to scare anybody, but I think it’s just the truth, that if you are a Medicaid provider, you’re going to be audited at some point.

 

Liath Dalton 

Mhm.

 

Gabrielle Juliano-Villani 

So just have that not to scare you, or to, like, have that pit in your stomach, but just know that, like, if you know that, then you can have those good practices in place from the beginning, and then you won’t have to worry about it so much.

 

Gabrielle Juliano-Villani 

So, yeah, the rates are a big thing. Thinking about the paperwork and the documentation, although I find it’s not too terribly different a lot of the time than some of commercial insurers. They do oftentimes have more specific needs, like the treatment plan pages need to be signed by the client, the assessment needs to be signed by the client. And those just are examples, because those can vary state by state too.

 

Gabrielle Juliano-Villani 

Just knowing there might be, like some other paperwork, administrative things that you want to have a good system and a good process in place for so they don’t get missed, because treatment plans do need to be updated more frequently. And oh, there was something else I was going to say about that. Where did it go?

 

Gabrielle Juliano-Villani 

Oh, no, shows and late cancels is another common thing that I hear as a issue with seeing more Medicaid clients. So I guess that could happen. Again, they, there might be more of a crisis happening with those clients, potentially. I mean, obviously that’s very unique and nuanced to every single person, but my practice was mostly Medicare and Medicaid. We didn’t have that many. We did sometimes. But, I mean, we just use the tools that were available to us in our EHR, you know, put people in the same time slot, use reminders. And I you know, we didn’t really have a high incidence for that particularly, so.

 

Liath Dalton 

So with the kind of documentation and administrative burden and the increased likelihood of audit you say, would you say that is greater with Medicaid than it is with Medicare?

 

Gabrielle Juliano-Villani 

Maybe. I feel like Medicare has been auditing more post public health emergency, but generally, Medicaid definitely audits more than Medicare does.

 

Liath Dalton 

Now, and you’ve been through the audit process, right? Been through, and passed. So you know, for for folks who are thinking that it makes sense in terms of the referral source and revenue and access to care and the populations they work with, etc, but feel scared because of that administrative burden for documentation and just what the process of an audit entails. What would you share in response to that? Or say yeah, it’s, can still be totally worth it if…

 

Gabrielle Juliano-Villani 

I think that it can still be worth it because I, I just really do believe in access to care, and I know that there are, what did I just say, 80, 88 million, I can’t remember, one of those numbers, people on Medicaid, and they they need care, and they need providers.

 

Gabrielle Juliano-Villani 

And like, like I said before, don’t just write it off, because it might not be as bad as you think. And every state is different, but I’ve been through an audit like you were just saying. I think getting that email was terrifying. I was like, oh shit, you know?

 

Liath Dalton 

Mhm.

 

Gabrielle Juliano-Villani 

But, we had done all of the work up front, and so I felt really confident with that. And I’m glad that I did, because we did pass. You do get dinged on a couple things always, but we passed because we had done the things that they had asked us to do that were very clearly laid out in our provider manual that said, this is what your documentation needs to look like.

 

Gabrielle Juliano-Villani 

And so sometimes I’ll consult with people, and they are Medicaid providers, and they’re like, didn’t even know that that manual existed, had no idea. So I hope everybody listening to this hears that. They do put everything out there for you. And in most cases, they don’t just swoop in and just claw back a ton of money it’s m of a little bit of collaboration situation. They’ll say, you know, here’s the toolkit that we used, this is where you missed. This is where you can be improved upon. We’re going to come back in 45 or 90 days and look at it over again. It does, of course, depend on the state and what type of audit it is, but I find in most cases, it’s not as bad as people think it’s going to be.

 

Liath Dalton 

Now, in terms of the, sort of because what I’m taking away from this is, like with HIPAA, you know, and general security risk management and just trying to optimize and fortify your practice, that the key is to be planful and intentional, to be able to be proactive rather than reactive, right?

 

Gabrielle Juliano-Villani 

Mhm.

 

Liath Dalton 

You don’t want to just sort of haphazardly fall into something or, or start, start taking Medicaid, but not have all of the infrastructure and policies and procedures in place, right?

 

Gabrielle Juliano-Villani 

Mhm.

 

Liath Dalton 

And so what are some of those key components or areas where people will will overlook something that is crucial?

 

Gabrielle Juliano-Villani 

I think the big one is treatment plans. So not doing treatment plan, like not reviewing them as often as they need to be, not writing them to Medicaid standards, which is usually using SMART goals, which stands for specific, measurable, achievable, relevant and timely.

 

Gabrielle Juliano-Villani 

So you know, some of the templates out there you can’t just copy and paste. Those are not smart goals. They want the treatment goals to be individualized and strength based. So I think treatment plans is a really big one, and then I think the other thing that I see is, like the policies and the procedures from the beginning.

 

Gabrielle Juliano-Villani 

So a lot of states, and actually, maybe not all of them, but most of them, want Medicaid clients to be given a copy of their rights and responsibilities, and you need to document that you did that. So people who are on Medicaid, they they have member rights. They get to choose their provider. They can’t be discriminated against because they have Medicaid. They, if they want to file an appeal, they need to know the process to do that. So typically, like I said, not everywhere, but I would feel pretty confident saying most states want, you know, you to document that you either had that discussion or you provided that to the clients.

 

Gabrielle Juliano-Villani 

Sometimes they want other really specific things when you’re getting started as well, like specific assessments, and you want to make sure those are in their charts as well.

 

Gabrielle Juliano-Villani 

So what I find is helpful is, you know, make a template. That’s what I did. That’s what I do. I have one you can buy, and that’s just use that for everything and for everyone. And have a checklist. You know, when I had my group practice, we had a checklist, if they were a Medicaid client these, we need to make sure these were the things that they signed when we got started. This is their assessment. We had to have them sign their intake assessment. So we made sure they signed that. We made sure they signed the treatment plan page. We put a reminder in for six months to do the treatment plan review, like we just had a very streamlined process. So I think if you do that, just makes it a lot easier, and you don’t have to go backwards and try and fix things after the fact.

 

Liath Dalton 

Right, if you just identify what are the needs that we need to be met, like, what is the outcome that we have to achieve here, and then you set up processes and systems to accomplish that. That seems, it seems totally attainable and reasonable. Now, what is the the process to become a Medicaid provider? Because I know it’s different to the Medicare provider enrollment.

 

Gabrielle Juliano-Villani 

It is. So for Medicaid, you’re going to go to your state’s Medicaid website and do the provider enrollment through there. And that’s where you will always start. And this is where it can kind of get a little tricky or confusing, because each state is a little bit different. So some states, there’s just state Medicaid, and that’s it. Many places also have managed care companies that manage the Medicaid in that state, so you have to go and get credentialed first, kind of like a Medicare Advantage plan. But with Medicaid,

 

Liath Dalton 

I was gonna say, wait, this seems oddly familiar.

 

Gabrielle Juliano-Villani 

It is. So you get credentialed with state Medicaid, and then you go to, you know, each managed care company, and they’re all different in every state. Some are specific to those states, like Georgia has like, Peach State. But then a lot of states have, like, an Anthem managed care plan, and it can vary by clients counties, and some states it’s only managed care, and some states have both.

 

Gabrielle Juliano-Villani 

So you want to just figure out those little nuances, because clients might not know the difference. And so you’re going to have to, you know, figure out, and it can be county by county. So if it does that in California, so if you have a client coming from a different county and you’re not credentialed with that county’s plan, then you wouldn’t be able to see them.

 

Liath Dalton 

What does the credentialing time frame typically look like?

 

Gabrielle Juliano-Villani 

In some states, it’s pretty quick. I’ve seen like two weeks to get credentialed with the state Medicaid. I’ve also seen it take like maybe six to eight weeks. I don’t think it usually takes longer than that. California is one that’s a little difficult.

 

Liath Dalton 

I’m stunned.

 

Gabrielle Juliano-Villani 

I know. So theirs might take a little bit longer. I’m trying to think of other states off the top of my head that take longer. There are some more that are a little not as straightforward, that can take a longer time. But honestly, I find that Medicaid credentials faster than a lot of commercial insurance. I know, like Aetna and Humana take forever in every state.

 

Liath Dalton 

Well, I was just gonna say even the oh, as long as six to eight weeks is generally shorter than the time frame for commercial like private insurers, in many instances. And so then I guess the next sort of follow on question is for the managed, the commercially managed Medicaid plans, do those credentialing timeframes typically look more like just the commercial private insurance credentialing timeframes? Like if the plan’s managed by Aetna, it’s going to look similar to just becoming Aetna credentialed.

 

Gabrielle Juliano-Villani 

Yeah, I find that those managed plans do take longer, often times, so.

 

Liath Dalton 

Andnd then what,

 

Liath Dalton 

Yeah, not, not unsurprising. What do the what is the kind of application process entail? Is it similar to the Medicare enrollment process in terms of information that needs to be provided and the just the application itself?

 

Gabrielle Juliano-Villani 

It’s usually pretty straightforward, and it is similar information. So you’re always, of course, going to need, like name, NPI, addresses, date of birth. You have to disclose ownership for Medicaid and for Medicare too. So they’ll always ask you a question about, you know, do you have 100% ownership, or is there a partner here? So you’ll answer questions about that. Some of them are more detailed than others. Some of them are just like, kind of the basics. And then some of them do get more detailed about asking questions about your structure and the setup and what that looks like. And that’s just to help them differentiate, like, what kind of practice you are.

 

Gabrielle Juliano-Villani 

So you know, obviously, if you were applying as, like, a community mental health center, that’s going to be a lot different than if you’re just a sole owner private practice. So they might ask you some questions about that. And they will ask you your taxonomy, your provider type.

 

Gabrielle Juliano-Villani 

I know I had somebody doing the Medicaid credentialing for my group practice, and I don’t know what happened, she got confused, she was overwhelmed, I don’t know, she clicked the wrong button, but she put, well, first of all, before I say that, she was credentialing, two of my my people and Medicaid came back and they wanted all of this stuff. They wanted their supervision records and a letter talking about, um, their, like, professional experience and their degree and all of this stuff we had never had to do before. I was like, this is so weird. Why are they doing this? And I just happened to have a Zumba student of mine who worked at Colorado Medicaid, and she was like, you know, I can help you. And she took a look at it, and the credentialer had put our provider types as like ABA therapists, which we’re not, at all. And so they, I think we’re looking they saw ABA, they saw we were LCSWs, they were like, we need more information here. So that was a moment where I was like, what the hell is going on Medicaid is just making this so much more complicated? And it was just an error. So just, you know, a story to always slow down and read what the question is asking you.

 

Liath Dalton 

Absolutely. Now, I know, and as we’re talking like more and more of your training on Medicare credentialing is rising to the to the top of my brain. And so the whole pieces around, like, if you’re a group practice, the initial enrollment at the practice level being under the NPI 2, right?

 

Gabrielle Juliano-Villani 

Yes.

 

Gabrielle Juliano-Villani 

So same thing if you’re a group practice. Even if you’re not a group practice, it’s my recommendation that if you have an LLC, you have an NPI 2 just to make things a little bit cleaner. And a lot of Medicaid plans want that also. So that also would vary state by state. Some of them will still let you just do like a sole ownership under your NPI 1. But I think if you have an LLC, it makes it cleaner to have both of them. So yeah, if you’re a group practice, you’re going to do your NPI 2 and enroll with that first. Or if you build like an organization, like, if it is just you, but you have an LLC, and you do have an NPI type two, you’re gonna always do that application first.

 

Gabrielle Juliano-Villani 

Yes.

 

Liath Dalton 

But then you have to add each provider that’s going to be seeing, so in the Medicare context, that’s going to be accepting Medicare or needs to enroll under their NPI-1, right you add them on. Is that equivalent when it comes to Medicaid?

 

Liath Dalton 

And with Medicaid, are there any provider type restrictions?

 

Gabrielle Juliano-Villani 

That’s also a good question. There can be so you’ll definitely want to check. I think it’s not as common anymore. There is a situation happening right now in New York about LMHCs not being able to diagnose and so that is a very unique situation to them, where I’m not sure that they can enroll in Medicaid right now because of whole thing that’s happening. Generally though, LCSWs, LMFTs, LPCs psychologists, can all enroll, but there could be, there could be some other restrictions with incident-to or supervisory billing.

 

Gabrielle Juliano-Villani 

So I know a lot of people want to do that with Medicaid, and it is allowed in a lot of states, but some states don’t allow it, and they’ll be very clear about that if they if they do, or if they don’t. I also read a lot in the manuals that some of the things that maybe, I don’t know, some people do, so might be helpful are not covered. Like marriage counseling, I was just reading, and some states won’t cover, like if you do hypnosis with your clients, that’s not covered. Biofeedback might not be covered. Sometimes art therapy or music therapy might not be covered. So you just want to check with those as well.

 

Liath Dalton 

None of this seems undoable or unreasonable, though, right?

 

Gabrielle Juliano-Villani 

It’s not as bad as you think. And trust me, when we’re talking about digging, I have read like most of the state’s manuals. It’s not as bad as you think, but I mean, it’s true that there is more documentation that’s needed, but I didn’t really find it to be that inconvenient with running a practice where we saw a lot of Medicaid clients.

 

Liath Dalton 

Now, you had talked about like the you’re having policies and procedures in place, and I am going to imagine that those policies and procedures are the ones that are specific to meeting the requirements for documentation, for the assessment instruments, for treatment plan review, for the signatures, those pieces of things, right?

 

Gabrielle Juliano-Villani 

There’s those, and then there’s also certain things, like, there can be internal things. Like some states, Medicaid has requirements on how fast you need to respond to clients. So if a new client calls you, they might have restrictions on how quickly you need to respond to them and how quickly you even need to give them an appointment. They might have requirements on discharging clients that you, you know, obviously client abandonment, that’s for everybody, but there might be other guidelines about, you know, if clients no call or no show, and what that looks like, and having like emergency care. There was one other one that I was thinking of two that just left me, but it’ll might come back. Those were a couple examples.

 

Liath Dalton 

You’re like me. It’ll come back when you are wakeful in the middle of the night, at 230 this morning. Your tomorrow morning, you’ll sit bolt upright? Like, doh, the thing!

 

Gabrielle Juliano-Villani 

I was gonna say that! And I forgot!

 

Liath Dalton 

Right.

 

Gabrielle Juliano-Villani 

I’m trying to think so of like other policies and procedures that sometimes Medicaid asks for. That member rights and responsibility is a big one.

 

Liath Dalton 

So following that, then a question that also comes up, and I’m looking forward to addressing a little bit, we’re just being like from your lips to everyone’s ears. So we can state that if you are a Medicare or a Medicaid provider, you absolutely qualify as a HIPAA covered entity, and need to be in formal compliance with the HIPAA Security Rule and privacy rule requirements and standards, right?

 

Gabrielle Juliano-Villani 

Yeah.

 

Liath Dalton 

And like, in a very documented way. Not in a haphazard way of we’ve had, I’ve had conversations with my staff about all of all of the standards and what their HIPAA responsibilities are. But you have to, it’s extra imperative that you really have documentation of your compliance, all the compliance activities in order.

 

Gabrielle Juliano-Villani 

Yes, because they will be looking at that. And if you know, depending on how your practice is set up, but if you are a group practice, and Medicaid comes and does a site visit, which they can, or Medicare, they’re going to want to know about that. And they’re going to want to see that your staff has taken HIPAA compliant training, the fraud, waste and abuse training, they’re going to want to see that on file as well. And I even was just chatting with somebody who is being audited by Connecticut, and they were doing phone sessions, and they wanted to know the phone numbers. They wanted to know, like how you were calling them, like dates.

 

Liath Dalton 

Oh yeah, if you’re using a HIPAA appropriate phone service system and logging all of that data, which equals PHI, correctly, yep.

 

Liath Dalton 

But there, I think also can be a little bit of a misconception that somehow HIPAA changes, right, if you are a Medicaid or Medicare provider, that there are additional requirements that be become applicable. And that is not, not, in fact, the case.

 

Gabrielle Juliano-Villani 

I just took the fraud, waste and abuse training this morning, it’s like fresh on my mind.

 

Liath Dalton 

Right.

 

Liath Dalton 

Yeah, so, so if someone is actively engaged in the the HIPAA compliance process, right, and they are tending to those requirements, in order to become a Medicare or Medicaid provider, they don’t need to do something additional, above and beyond that, right? With regards to, but it doesn’t like trigger a higher level of of compliance requirements or standards.

 

Gabrielle Juliano-Villani 

All the same.

 

Liath Dalton 

Now, again, from your lips to everyone’s ears. But then following, following that the credentialing process itself, or enrollment process itself, they want and require, if I understand correctly, attestations and agreements that you are HIPAA compliant and have documented compliance, right? And that you will continue to do those pieces.

 

Gabrielle Juliano-Villani 

It’s all in that handbook. It’s all in there. And it says in that handbook that, yes, as a provider, you are agreeing that you are upholding HIPAA standards and all the other standards, of course, too. Like, you know, anti kickback statute and all those other legal things, those are important. And even in the manuals, in, I don’t know, most of the ones that I’ve been reading, and yesterday I was reading Georgia, so we can at least say for Georgia, because that one is also fresh in my head. Like part of that is that you have to keep up to date on it. If you’re a provider, you’re also agreeing that, like when things change, you will change as needed, and you’ll keep up to date on those changes.

 

Liath Dalton 

What would be your sort of parting piece of wisdom that you would would share with folks as they you know maybe are just considering whether or not they should explore being a Medicaid provider in in their practice?

 

Gabrielle Juliano-Villani 

I think it would be the same thing that I probably left off on in my Medicare podcast episode, and also the episode we just recorded about selling your practice, and that is to just be open.

 

Gabrielle Juliano-Villani 

Don’t just completely write it off and buy into, you know, fear mongering and negativity, because Liath knows this about me, and if anybody listening has ever talked to me for five seconds, you will know that I’m all about empowerment. And I just think be open to it. It might not be as bad as you think, it might not be as much paperwork as you think. It might pay better than you think, and it can be a really great way to increase your caseload and also serve clients who are really amazing and who really need access to care.

 

Liath Dalton 

That, as you well know by now, is a compelling message,  that really resonates with me. And I think there are a lot of folks in the community and the professional community for whom that resonates as well. That access to to care piece, that and when it is something that can also really strengthen your practice, potentially, it’s it is worth exploring to see if it’s the right fit or not. So.

 

Gabrielle Juliano-Villani 

And in that same vein, I’ll also say this because I think this is important too. Being a Medicaid provider can also open you up to other opportunities, like grants. So that’s something else to think about, because my practice actually got a grant for us being a Medicaid provider in the certain zip codes that we served. So that’s another thing, like there are other opportunities as well that it could open doors to.

 

Liath Dalton 

That’s wonderful. Well, Gabrielle, thank you for being a resource and source of clarity in this space, I’m so glad that I’m able to refer folks to you when they reach out with questions around this very particular and significant thing. So thanks for being you, and thanks for taking the time to chat with us today.

 

Gabrielle Juliano-Villani 

I was happy to do it, and I hope that this was hopefully insightful and maybe shed some light on Medicaid for your listeners too.

 

Liath Dalton 

I have have no doubt that it did. And also, just sort of like a to put this on folks radars, coming up in October we’ll, an announcement and details forthcoming, Gabrielle and I are going to be doing just a joint panel talking about basically the intersections of Medicare, Medicaid and HIPAA, and doing some Q and A and just wanting to give you more direct access to get particular questions answered and help you in in these areas. So stay tuned for details on that that will be forthcoming.

 

Gabrielle Juliano-Villani 

Yay. I can’t wait to do that actually, and I know that people have so many questions. So I hope that you will join us so that we can answer them for you.

 

Liath Dalton 

Yes, please.

 

Liath Dalton 

All right. We will chat to you good folks next time. Bye, everybody. This has been Group Practice Tech. You can find us at personcenteredtech.com. For more podcast episodes, you can go to personcenteredtech.com/podcast or click podcast on the menu bar.

evan

Your Hosts:

PCT’s Director Liath Dalton

Senior Consultant Evan Dumas

Gabrielle Juliano-Villani, LCSW

Welcome solo and group practice owners! We are Liath Dalton and Evan Dumas, your co-hosts of Group Practice Tech.

In our latest episode, we’re chatting again with Gabrielle Juliano-Villani, this time about what to consider when accepting Medicaid as a group practice. 

We discuss:

  • The main differences between Medicare and Medicaid 
  • What makes a practice a good fit as a Medicaid provider
  • Reimbursement rates and to find what they are in your state
  • Things to keep in mind when considering accepting Medicaid
  • Being prepared for an audit 
  • The process to become a Medicaid provider 
  • Credentialing timeframes 
  • What the application looks like 
  • Provider restrictions under Medicaid 
  • HIPAA responsibilities for providers who accept Medicaid 
  • Our upcoming panel discussion on the intersection of Medicare, Medicaid, and HIPAA

Resources are available for all Group Practice Tech listeners below:

Therapy Notes proudly sponsors Group Practice Tech!

TherapyNotes is a behavioral health EMR/EHR that helps you securely manage records, book appointments, write notes, bill, and more. We recommend it for use by mental health professionals. Learn more about TherapyNotes and use code “PCT” to get two months of free software.

*Please note that this offer only applies to brand-new TherapyNotes customers

Resources for Listeners

Resources & further information

Resources:

 

PCT Resources:

     

    Group Practices

    Get more information about how PCT can help you reach HIPAA compliance while optimizing and streamlining your practice.

    Solo Practitioners

    Get more information about how PCT can help you reach HIPAA compliance while optimizing and streamlining your practice.


    v2.0.3-beta

    Scheduled Maintenance

    We will be temporarily taking the website offline at 10:00 PM Pacific (1:00 AM Eastern) tonight, July 6, in order to make some improvements. We plan to be back online by midnight Pacific (3:00 AM Eastern). We apologize for any inconvenience this may cause. Dismiss