Wiki billing question - records

[Rpollock623]

I am new to behavioral health, and I have a question in-regards to insurance requesting medical records. Our office submitted a corrected claim and per the third party payer; the claim can not be adjusted until medical records are obtained. I was advised today by one of my staff that per federal law our office can not submit medical records. After some research I have found that medical records can be submitted, but the psychotherapy note can not be submitted. Are my findings correct? if not where can I find the legal language proving that medical records can not be submitted?

Thank you in advance,
Rebecca

 

[jdyoutsey]

Psychotherapy Note vs. Progress Note

Here are a couple links that should help you:

http://www.apapracticecentral.org/business/hipaa/faq.aspx
http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/medicalrecords.html

The key with these records is determining if you have psychotherapy notes or progress notes. You have to have a progress note to bill insurance. The trouble seems to lie in what all is included in the note. In order to be considered psychotherapy notes, the details and notes about what actually happened in the session have to be kept separate from the rest of the medical record. Hope this helps!

 

[Rpollock623]

Thank you, You helped me a lot.

Rebecca