It wasn’t very long ago that counselors were not considered eligible for any insurance or managed care reimbursements. The hard work by the American Counseling Association and state counseling organizations has changed that. Now managed care companies are coming to ACA and asking that its members consider becoming providers on their panels.
ACA Professional Projects Coordinator Martha McIntosh recently received the following inquiry:
“My name is Rachel Milazzo, and I am in charge of new provider relations at American Behavioral. We are a Managed Care and EAP company with nearly 1,000,000 covered lives. After reading an article in April’s edition (of Counseling Today), I am interested in the process of positioning my company or my contact information on the list of Provider Relations Contacts for the top 55 Managed Care companies.
Here is a little background about us.
- We currently manage Mental Health, Substance Abuse and EAP benefits for more than 800,000 members and are growing rapidly.
- Payment for Master’s-level therapists in both EAP and MH is $60/hour. That also holds true for the EAP program. Doctorate-level fees obviously depend on licensure.
- Our Website address is www.americanbehavioral.com. My personal e-mail is rmilazzo@americanbehavioral.com, which is a surefire way to get the information needed and ask questions.
- Our phone number is 1.800.925.5327 or 1.800.677.4544.
We are an international company and have just celebrated our 11th anniversary here in Birmingham, AL. We have URAC accreditation on top of the privilege to serve BCBS and their federal members as well as VIVA healthcare. I think that I mentioned we are having a credentialing meeting tomorrow, so I will get back with you if (there are) any extra questions about this new relationship.”
After ACA responded to the request, the following e-mail was received:
“I’m glad to hear that you have the information that you need to put us on your website. Our Board of Directors (was) very pleased and honored that the American Counseling Association took such a prompt interest in helping us. We are also in the process of linking your website to ours.”
ACA also received the following message from ACI:
“ACI (Employee Assistance Program) is open to new counseling providers. To inquire about being paneled, contact them at:
ACI, A Specialty Benefits Corporation
5414 Oberlin Dr. Suite 240
San Diego, CA 92121
P: (800) 932-0034
F: (858) 452-7819
www.acieap.com
A comprehensive list of 57 managed care and insurance companies that accept counselors can be reviewed and downloaded from a member’s-only section of the ACA website at http://www.counseling.org/Counselors/TP/PrivatePracticePointersMembers/CT2.aspx.
Q: I want to start a “limited” private counseling practice. Initially, I plan to only accept self-pay, fee-for-service clients. I may venture into insurance and managed care later as my practice grows, but not to start. Do I need a tax ID number (EIN) and an NPI number?
A: To begin your fee-for-service practice, you are not required to have either a tax ID or National Provider Identifier (NPI) number. But we highly recommend that you have both.
In lieu of a tax ID number, counselors in private practice can use their Social Security number to report annual profit or loss for tax purposes. For income of more than $600 in a tax year from a single payer (consulting, contract, fee for a speech, etc.), a 1099 miscellaneous income form is sent to the counselor and the IRS to report the income. This form will have to include your Social Security number.
Moreover, a client may want to deduct medical expenses and will need your Social Security number to do so. Now your Social Security number is being seen by your clients. For this reason, we think it is much better to use a tax ID number.
By having an NPI number, your clients can submit your charges to their insurance or medical flexible spending accounts themselves. This would add value to your fee-for-service practice.
We will be presenting our workshop, “Starting, Maintaining and Expanding a Successful Private Practice,” on Sept. 21 in Charlotte, N.C., and on Sept. 22 in Durham. The North Carolina Counseling Association is sponsoring the workshop. For more information, contact NCCA by calling 888.308.NCCA (6222) or e-mailing www.nccounseling.org. Hope to see you there!
Robert J. Walsh and Norman C. Dasenbrook are coauthors of The Complete Guide to Private Practice for Licensed Mental Health Professionals (www.counseling-privatepractice.com). ACA members can e-mail their questions to walshgasp@aol.com and access a series of “Private Practice Pointers” on the ACA website at www.counseling.org.
Letters to the editor: ct@counseling.org