For most clinicians, administrative tasks are not what they went to school for! They are interested in working with their clients and their clients' families. Unfortunately, administrative tasks are a fact of life in our practices and to neglect them invites revenue disruption! Many third-party payers (both Medicaid and Commercial) have streamlined their credentialing and [...]
As a private practice, you and your team have seen its fair share of changes over the last few years. Some of those changes felt like they occurred overnight. But as you prepare your practice for the future, there are certain trends that you need to recognize now to prevent being caught off guard financially [...]
The question I receive most often from my Behavioral Health clients today is Are we in-network with this Payer's Product line? That seems to be the question of the day. Long gone are the days when we could assume a Payer was only a commercial payer or a traditional Medicaid Payer was only a Medicaid Payer. [...]
This question has been perplexing private practice clinicians for the last couple of years. When I have conversations with clinicians trying to answer this question, I begin to go down my punch list of questions: Was your overall volume more/less/the same as the previous year? What does your volume of activity look like when comparing [...]
Nothing brings terror to the heart of an Executive Director than to hear that a Managed Care Organization (MCO) is coming to conduct a clinical audit! Remember, the MCOs are charged with among other things, to "bend the cost curve" for their client, The Ohio Department of Medicaid. Their mission is to ensure that their [...]
From time to time, G&M Consulting receives questions from the behavioral health field asking guidance regarding various commercial insurance payers. Here is a question that was received recently that we felt would be beneficial to the community at large: Question: My practice just signed a Group Agreement with a large commercial payer. How do I [...]
For the last couple of years, many Community Behavioral Health Centers (CBHCs) have been focused on their administrative and clinical operation systems in meeting the needs of their clients' Medicaid Managed Care Plans (MCPs). At the same time, many agencies are beginning to see an increase in the number of requests for clinical services from [...]
Are you treating your contracted Medicaid Managed Care Plans (MCPs) like customers? A customer whose relationship will need to be valued and nurtured and one that will require constant attention. The key to any customer service relationship is to find a need and fill it. So, the question that begs to be asked is what [...]
Welcome to the G&M Consulting website! This website is dedicated to enhancing the administrative practices of behavioral health providers. Our world is becoming more and more complicated. Many clinicians are being overwhelmed with administrative requests (billing, authorization, credentialing) taking precious time away from what they wanted to do when they began down this career path- [...]
