Synergistic Update logo

November 2014

In this issue:

Thank You!
Data Loss Crisis: Top 10 reasons you could lose your data
DSM-5 and the ICD-10
Filing Secondary Claims
SOS Staff Profile: Trish Merchant, Business Development
Customer Spotlight: Family Psychology Associates

Recent blog articles available:

Congress Throws a monkey wrench into ICD-10 Implementation, April 1, 2014
Encryption of Backups: Must I? April 10, 2014
Turbulence Ahead in the Behavioral Health Marketplace, April 15, 2014
Anxiety, Anticipation, Excitement: Prelude to..., April 23, 2014
Single Payer Systems: U.S. Medicare and Canadian Medicare, April 30, 2014
Vacation Time: Storm before the calm, May 7, 2014
SAMHSA Listening Session Important for SA Providers, June 3, 2014
Brain Training: What is it and does it work? August 6, 2014
Telehealth, eHealth, and Outsourcing: Where are we going? August 12, 2014
ICD-10 Implementation Rule Announced . . . Again, August 19, 2014
Perspectives on Stress: Is it all bad? by Jeremy Peres August 26, 2014
Fines as Motivators: How do they affect your actions? September 4, 2014
Dismantling Habitual Behavior October 3, 2014
Health Insurance Industry: Where is it going? October 7, 2014
How much control do you want over your health data? October 14, 2014
Doom for health insurers? October 20, 2014
Telemental Health: Is this your next way of providing services? October 30, 2014
Implementing New Practices: Are you fast or slow? November 4, 2014
Patient Privacy in an Emergency: New HIPAA reminders, November 11, 2014
Sharing Your Personal Health Data, November 20, 2014

Happy Thanksgiving graphic

Thank You!

We have reached that time of year when our calendar and our culture focus us on gratitude. We join with our families and our friends to express thanks for and to celebrate our privileges, our freedoms, our families, our friends, and all those things we have worked so hard to accomplish and to acquire.

The SOS Team would like to thank you. We consider you part of our family and hope you feel the same way about us. We want you to know that we are grateful to you for being our customer, and we feel that gratitude every day. . . even when we forget to express it. We are challenged every day to provide the best products, service and support to you so that you and your organization might thrive. Thank you for giving us that opportunity!


Data Loss Crisis: Top Ten Reasons You Could Lose Your Data

Ouch! graphicFor some reason that we have never understood, events wherein our customers lose their data go in batches. There is rarely one without another one or two following close behind. We wanted you to know the top reasons our users lose their data so you can make your chances of data loss smaller!
REASON #10: You backup every day. You rotate your media. You place a backup in the safe-deposit box each month. But. . . your backup procedure does not include daily checks to confirm that the backup ran successfully, and no one has ever tried to restore any of that data.
REASON #9: You backup to the cloud and you encrypt your data, but no one has a record of the encryption key.
REASON #8: The consultant you hired to install the new version of Windows onto your computer did not do a backup of your data or of your computer first and erased everything on your hard drive.
REASON #7: You leave all of your backups at the office. You have a burglary, a flood, a fire, a hurricane or a tornado and all those backups are lost along with the computer.
REASON #6:  You backup onto the same media every day.
REASON #5: The removable hard drive you backup onto is full.
REASON #4: You ran out of DVDs to backup onto.
REASON #3: You once bought backup software, but it is old and does not work on your current version of Windows.
REASON #2: No one remembers how to use the backup software. . . . . . . . AND
REASON #1: You never considered backing up your data. I mean, what could possibly go wrong?

Why is she telling us this, you ask? Well my friends, it is likely that many of you have never checked those backups that you regularly make.You do make regular backups, right? Or do you just walk around with your fingers crossed hoping that the sun will always be shining for you.

We feel terrible every time we hear your stories about not being able to access your data, but in the end, there is most often nothing we can do for you. It is very frustrating not to be able to help you recover years worth of valuable data. It is very sad for us to know that you are in breach of HIPAA because you have not securely stored your patient financial records. We feel your pain!

In fact, to prevent all of us feeling this pain, Seth has created a very detailed backup document with all the information and steps any organization, large or small, could need about backing up your data and testing that you can restore it given the need. PLEASE, read that article and follow the recommendations in it today!

DSM-5 and the ICD - 9 and 10: One more time!

We know that most behavioral health providers utilize the Diagnostic and Statistical Manual of Mental Disorders to diagnose their patients. We also are aware that many of you believe that you use DSM diagnosis codes for billing. It is very important that you begin to understand that you actually use ICD codes to get paid for the services you render. Most of the time, the DSM and ICD-9 codes are identical. Sometimes, they are not the same and your claim is rejected. When you correct the claim by entering the appropriate ICD-9 code into your claim, you usually get paid.

Now, some of your payers are starting to require you to use the DSM-5. What do you do?

DSM-5 and ICD-10 change everything.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was released on May 18, 2013. While it is controversial in its own right based on some of its content, the DSM-5 promises to add confusion to payment processing for behavioral health and chemical dependency providers. As we move toward the new October 2015 implementation deadline for the ICD-10, providers find themselves presented with conflicting information. On the one hand is the new diagnostic manual with its new diagnoses and criteria; on the other hand is the requirement to move to the ICD-10 for payment processing. We hear the following question often:

Question:

When will SOS include the DSM-5 in products?  DSM-5

Answer:

We will NOT license the DSM-5 from American Psychiatric Association (APA) for use in our products. APA has made the price for such licensure quite costly. You should buy your own copy of the DSM-5 for your reference. The codes associated with the DSM-5 descriptions are ICD-9 codes through September 2015, and ICD-10 codes thereafter. If you purchase the DSM-5 manual, you will see that each diagnosis has the two ICD codes next to it. You use the DSM descriptive information to make your diagnosis, but what you enter as the diagnosis code to go out in your claims will be an ICD code. THERE ARE NO DSM-5 CODES APART FROM THE ICD CODES REFERENCED FOR EACH DIAGNOSIS IN THE DSM-5.

If it makes you feel better to add the codes you use into SOS, or if some insurer is insisting that you do so, please add them to the DSM-IV Axis 1 list. However, we strongly suggest that you completely ignore both DSM lookups in SOS. Note that if you enter any DSM-5 diagnoses in the list, using ICD-9 codes now, you will have to go through and replace the codes with the APA-specified ICD-10 code on October 1, 2015. We do not see much purpose in that, but you may proceed as you prefer. APA expects you to develolp your diagnosis based on the description and criteria in the DSM-5 manual, then use the ICD code the DSM-5 tells you to use for that diagnosis when billing and when communicating information to other providers.

As we have said previously, most DSM-IV codes match ICD-9 codes. In some cases a claim will be rejected by a payer because you have not used a specific enough code. This usually happens when you have used a generic DSM code with no decimal characters; the payer wants the additional one or two characters that the ICD codes include. Except for some small, niche managed-care administrators, the health insurance industry is standardized on ICD coding. In fact, ICD-9 diagnostic codes are one of the standardized code sets required by the HIPAA legislation since at least 2004. Currently, and happily, for those of you who are using DSM documentation to determine your patients' diagnoses, the DSM codes overlap with ICD-9 codes almost completely. As a result, when your DSM-coded claim reaches the payer, it has been processed in accordance with adjudication rules that are actually based on ICD-9 codes. With ICD-10, that concordance between codes disappears! Please download American Psychiatric Association's document on DSM-5, ICD-9 and ICD-10 for a fuller understanding.

This is part of what the American Psychiatric Association says in the document linked above. We know the date is now October 1, 2015, but we are quoting from the document as it exists:

 ICD-10 manual image55
"On October 1, 2014 [sic], the United States adopts ICD-10-CM as its standard coding system. How will
diagnoses be coded then?
DSM-5 contains both ICD-9-CM codes for immediate use and ICD-10-CM codes in parentheses. The
inclusion of ICD-10-CM codes facilitates a cross-walk to the new coding system that will be implement-
ed on October 1, 2014 [sic] for all U.S. health care providers and systems, as recommended by the Centers
for Disease Control and Prevention’s National Center for Health Statistics (CDC-NCHS) and the Centers
for Medicare and Medicaid Services (CMS)."


Since many providers do not buy their own copy of the DSM, choosing to work from a list of codes rather than the manual, they will not be in possession of the cross-walk to ICD-10 codes. The transition to ICD-10 codes removes the overlap between DSM and ICD completely. In fact, the DSM-5 has no codes of its own. The older DSM-IV code books do not match up with ICD-10 codes, so you will have to change from the codes you are currently using to the appropriate ICD-10 codes starting on October 1, 2015 in order to receive insurance payment. The recently released DSM-5 manual sold by American Psychiatric Association includes appropriate ICD-10 codes, in parentheses, next to each diagnosis description, so purchase of those resources will be of assistance to you in selecting the correct codes to put on your claims starting in October, 2015. That said, your best resources for ICD-10 diagnosis coding to assure rapid insurance payment will be ICD-10 code books, not DSM-5 books.



Filing Secondary Claims

One of the most frequent questions our support staff are asked is "How do I file secondary claims electronically? Is there anything special I need to do?" Manon wrote an article last year that gives you step-by-step instructions on the most frequent mistakes our customers make when filing secondary claims and how to do it correctly. Please review this article if you are having any issues with secondary claims.



SOS Staff Profile

Trish Merchant, Business Development

We decided that it might be fun for you, our customers, to know a bit more about those of us who work here at SOS. After all, you talk to us often, but many of you have never met any of us. Trish Merchant is someone many of you have talked with. As our Business Development Manager, she spends much of her time on the telephone with or sending emails to potential new SOS Users. She also checks in with each of our customers with an annual call. These are Trish’s answers to our standard questions.  

Trish Merchant photo
How long have you worked at SOS?

It was 8 years in August.

How would you describe your role at SOS?

I work in sales and customer service. If an SOS customer inquires about our other software solutions, I am happy to answer their questions and will show them our products that they may not have known about. I also work with new prospective customers who are looking for practice management or clinical record software for their organizations.

How do you prefer to spend your time when you are not working?

I enjoy spending time with my husband, family and friends. I especially like to be doing something on our boat like fishing in the Gulf or enjoying any of the beautiful lakes here in Central Florida.

What else would you like our customers to know about you?

I am a newlywed!

SOS Customer Spotlight    Spotlight image   

Family Psychology Associates Logo
Family Psychology Associates
Safety Harbor, FL
www.fampsy.org

Family Psychology Associates is currently located in Safety Harbor, Florida. We have two offices in the same building, which has allowed us to expand our range of services. We are also in the process of building an office in Trinity, Florida, 15 minutes north of our current offices. Trinity is located in Pasco County, one of the fastest growing areas in Tampa Bay.

For how long have you been providing services to your community?

Family Psychology Associates was founded on February 1, 1992. We hope to open our Trinity office on February 1, 2015, our 23rd anniversary.

How many staff members are involved in your organization? What are their credentials?

Family Psychology Associates features the talents of 16 licensed mental health professionals and 7 office staff, allowing us to provide high quality customer service 6 days a week and 4 nights per week. Our team includes 11 psychologists, a school psychologist, two clinical social workers, a mental health counselor, and a marriage and family therapist.

What areas of specialization do you provide to your community?

Family Psychology Associates has specialists who serve preschoolers, children of all ages, emerging adults, couples, men and women, as well as older adults and their caregivers. We provide state of the art psychological evaluations to assist children with school adjustment and to help adults with career transitions. We also use psychological assessment for complex diagnostic questions, such as bipolar disorder or dementia. We have an array of social skills groups for children and teens. We provide specialized assessment and treatment for children on the autism spectrum. We have specialized groups for children and adults who suffer from anxiety. We also have seminars on Mindfulness and we provide parenting seminars for disruptive children or to enhance parent-teen communication.

What is your mission statement? How do you want your community to see you? 

Our mission statement is based on our core values of professionalism, integrity, privacy, fairness and ease of access. We have flexible hours and we accept many insurances so that we can serve many working families. We provide for the emotional needs of an entire family, regardless of age. We are also proactive in our coordination of care with other healthcare professionals in the community. We help our clients achieve a balance of physical and emotional health. 

What would you like to share with the SOS community of professionals who use our software? 

Family Psychology Associates is the leading group practice in Tampa Bay. We serve approximately 1000 new clients annually. Due to our partnership with SOS, we keep the billing and accounting functions of our practice in-house. As a result of the attention to detail of our Office Manager, Karen James, our practice has averaged a collections rate of over 98% during our 22 years of operation.

Our team balances the enthusiasm of early career psychologists with the experience of seasoned mental health professionals with over 20 years of experience. We are constantly innovating. For more information about our practice, please visit our website at www.fampsy.org.
 
 


Thank you for being our customer. We appreciate your business.

Synergistic Office Solutions, Inc.  17445 East Apshawa Road   Clermont, FL 34715   352-242-9100