I’m in agreement with the comments already made. As many may know I have coached and served as a mentor to advocates in our industry and wish to point out that there is an opportunity here at this juncture.
To get a leg up on the “attorneys don’t know what we do” and to begin to fill your own funnel now is a good time to begin to cultivate a…[Read more]

“God’s waiting room” — love it, Trisha! Wanted to let folks know I’m now a SHIP counselor for WA State, the program here is called SHIBA. It’s a natural evolution to do this kind of volunteer work after my career in patient advocacy. Lots of training in Medicare nuances (there’s always more to learn) and a great experience so far. I encourage oth…[Read more]

Gayle, the adequacy of the network may be considered at any time. But yes, justification for OON gap exceptions or single case agreements has to be shown at each point in time you apply. It may be done retrospectively, particularly if it’s a self-funded plan with employer discretion, but it is usually harder to make that case. Like Carol above,…[Read more]

Kim, I can help remotely with the strategy and pre-auth side of things, mental health parity enforcement and if there are developmental disabilities or long term needs involved. It is vital the client gets ahead of the insurance process if they are out of network. I don’t have local knowledge of the providers so if that is the focus I would…[Read more]

Thank you ladies for sharing your experiences. I really appreciate this. You’ve all been so helpful.

Hi Katy,

I took the service agreement & payment guaranty forms from APHA, gave it to the attorney I was using to set up my LLC, & asked him to “California-ize” them for me so I’d be covered here.

I also told him I’d like the final version to be 5 pages max to try to avoid overwhelming the client, while protecting me.

In the end the service…[Read more]

Kim, my office is in Colorado. I can assist in person or remote.

Viktoria Cabral, DHS, MPH
Owner & Manager, Wellington Lane
Phone: 413-330-2882
Email: advocates@wellingtonln.com
Website: wellingtonln.com

Hi,
I have a Doctoral education which covered mental health and psychiatric disorders. I have experience in this area. Please check out my website and give me a call today!

Viktoria Cabral, DHS, MPH
Owner & Manager, Wellington Lane
Phone: 413-330-2882
Email: advocates@wellingtonln.com
Website: wellingtonln.com

I have extensive knowledge in adolescent health as well. I am in California but work across the country. The problem in this field is that very few psychologists and psychiatrists take insurance.

Gabrielle Hochberg, MHA
President: Health Advocate Experts

Kim,

We have helped and are currently assisting many clients across the country who need psychiatry.

Happy to assist.

AnnMarie McIlwain
Patient Advocators
http://www.patientadvocators.com
908-273-4043

Katy,

Thank you for posting this! I just launched on January 1st and had many of the same questions that you did. I appreciate reading the responses that your post has generated.

Ashley, I am in the process of doing what you are doing now while I am looking for an attorney to look it over. Having the contract legally sound while making it…[Read more]

Good morning,

I may be able to help. Currently, I’m limiting my practice to Michigan but I do have extensive knowledge in adolescent psychiatric issues due to personal experience with my daughter’s issues.

That being said, if another advocate who also has this experience can help, that would be my preference.

Donna

Hi Katy,

I’m glad you’re thinking about making your contract easier to read and understand for your clients. That is really important to me, too. When I started my business, I took the contracts on APHA and simplified the phrasing to make them easier to understand, being careful to maintain the intent of each statement. I also took out some…[Read more]

Katy,

I did utilize an attorney and continue to do so. He is a general attorney with litigation experience. This is an expensive undertaking as attorneys charge hundreds of dollars an hour.

As you work in the field and encounter “bad actors” as I have, you will want to modify your contract to make it more protective. In addition, as you…[Read more]