Admin Pointers

New Client

When a potential client calls, it’s very important to probe the client in order to ensure that we:

1. Accept their insurance

2. Can provide services to them based on their location

3. Have therapists/nurse practitioners available whom are able to work with the client’s presenting problems or the type of service they are seeking

It is also very important that the client knows at the very beginning that all sessions are virtual and that we are no longer doing consultations (if asked). We are also not accepting Highmark BCBS. Our NPs do not do Psychological/ADHD Tests, they can be referred to Cognitive Solutions LLC - Dr. Stephanie R. Johnson [e-mail].

If we are unable to see a client you can refer them to Psychology Today

CSR NEW PROCESS (MAY 2024)

Updated Call Script

“Thank you for calling Lartey Wellness Group, this is _______. How may I help you?”

“Are you a Maryland (MD) or DC or VA resident?”

• WE ARE LOCATED IN LAUREL, MARYLAND

• We cannot accept DC or VA Medicaid. Using Incedo will confirm whether they are MD Medicaid or not (no records will show if not MD).

• Dr. Nganga can see DC clients with UHC and BCBS only

• Clients with a (787) or (939) area code are from Puerto Rico and should be transferred to Veronica. The same goes for Spanish speaking clients within the US.

“May I ask what your presenting problems are? This will help me to identify the right therapist for you”

For example: depression, anxiety etc.

“Will you be using insurance?”

We accept CareFirst Blue Cross Blue Shield, Cigna/Evernorth, United Healthcare, and Maryland Medicaid

"Do you have a preference in the gender or ethnicity of the clinician?"

“Our Therapy and Medication Management Sessions are virtual and in-person."

Use the Find a Therapist Tool to identify a clinician who meets these criteria. ALL clinicians and their information can be found here

*Recommend our Full Time therapists first*

If you were unable to proceed because of the following reasons:

• We do not accept their insurance

• Located outside of MD or DC or VA (for some clinicians)

• Fully booked

• Preferred therapist/NP is fully booked

Collect a name and call back number and add them to the excel sheet under the appropriate tab. Refer to Psychology Today if needs be.

“If you're still interested, may I have the following information please?”

- Name

– Date of birth

– Email address

- Address

– Phone number

– Insurance/Member ID #

• Private Insurance: “I would like to have your insurance verified beforehand to inform you of your benefits. Once verified, I will let you know.” Send in Whatsapp group chat the client's name, date of birth, insurance and Member ID. Ramel, Benjie, Mike, Ayesha or Leigh will work on this.

• Medicaid: “I will be verifying your insurance to confirm if your coverage is active."

• • ​​​​​​​"Since we are an Out-patient Mental Health Clinic, it is a requirement by the State of Maryland that all Medicaid clients meet ONCE with a Nurse Practitioner for an evaluation to be completed."

• Create a TherapyNotes profile (Use the database under “Interaction Notes” to add any notes about the client.)

• Send Welcome Email and share required documents to portal

1. Lartey Wellcome email with HIPAA Docs

2. No Show and Attendance Policy

3. Client Information Form

4. Client Insurance Form - This is to be shared especially for BCBS/CareFirst clients

5. Client Contact Form

6. BluePrint Guide (only if their clinician is on BluePrint. See Find a Therapist)

7. Adult/Minor Mentorship Interest Form

8. The correct Ad Source Lead along with your New Client Interaction PDF

9. *For Edna’s client(s) - Don’t forget to share her Disclosure Portal Doc as well.

10. **LWG Transition Plan - Therapist will complete/sign this form with the client. You may proceed to schedule clients even if it is not completed.

“I have created your profile and sent you your portal account invitation. Please create your portal account and have the documents completed. I will have you scheduled once this is done.”

PLEASE NOTE: WE REQUIRE ALL OF OUR SELF-PAY & PRIVATE INSURANCE CLIENTS TO COMPLETE THEIR PAYMENT AUTHORIZATION FORMS THROUGH THEIR PORTALS

Scheduling the Client’s Appointment AFTER signing the portal documents

"Do you have a preferred day and time?"

• Find the next best day and time if not available. Schedule the session(s) using the correct service codes and location. Pay special attention to the therapist’s Session Preference.

Summary before Ending Call

• “You were scheduled for a (phone/video session) with (therapist’s name) on (date) at (time). You will be charged (copay/OOP fee amount) per session. Please give us a call at 1 [phone] within 48 hours to reschedule or cancel an appointment. We are in office Mondays to Fridays from 9am-5pm. Thank you for calling and have a nice day.”

Add to Daily Admin Team Tracker

For clients scheduled for Phone Sessions/Assessments, please let the client know that they should not be driving at the time of the session.

An email should be sent to those therapists once an appointment has been scheduled/rescheduled. This email must include a screenshot of the appointment.

EAP clients

DO NOT SCHEDULE AN INTAKE. Please ensure you state in your email and appointment alerts to the therapist that EAP clients are not required to do Intakes.

• Confirm with their insurance companies their EAP information (Authorization number, number of units, start and end date, modifier to be used, acceptable CPT codes (90837, 90847 etc).

• Insurance Gurus: For UHC clients, please confirm on the provider website. Please see the screenshot below. Select “Auth Inquiry”

• Let Leigh or Kerri-Ann know so any necessary updates can be made to accommodate any new CPT codes.

• You can confirm EAP for UHC clients on the provider website. Cigna’s EAP number is [phone].

• If the client has Cigna EAP but is not a Cigna member, please let us know.

Medicare Clients

• ALL Medicare clients must have their benefits checked before scheduling.

• If they have a deductible and are Qualified Medicare Beneficiaries, they are not to be scheduled for an intake (both therapy & med mgmt) until their 4th session.

• Insurance Gurus: Please remember to ask in your verification calls:

• • If the client is a QMB client

  • If they have a deductible, how much has been met and if it is renewed yearly

• The therapy service code should be 90837

Insurance Pointers

• There are many forms of Medicaid: Amerigroup, United Healthcare Community Plan, CareFirst Community Health Plan Maryland, Maryland’s Physician Care, Priority Partners, Medstar, Jai Medical Systems. The same goes for CareFirst BlueCross BlueShield.

• If a client is with United Healthcare and their Member ID starts with 10, most times this is Medicaid. How to verify this? Search for the client on the UHC’s provider website. Under Plan Information for the Group Number you will see MDCAID.

• We are out of network with John’s Hopkins Healthcare EHP (through Cigna). The clients would therefore be charged the out of pocket fee.

• If a client does not have their UnitedHealthcare Member ID on hand, you can still verify their benefits by using their name, date of birth and the state. https://www.providerexpress.com/content/ope-provexpr/us/en.html

• If a client does not have their Medicaid Number on hand, you can still verify their benefits by using their name, date of birth and their sex. https://omd.infomc.biz/iPC/login.aspx?ReturnUrl=%2fiPC%2fIncedoPC.aspx

• If a client does not have their CareFirst Member ID on hand, you would not be able to verify the benefits because a Member ID and date of birth are required. https://provider.carefirst.com/prv/#/home

• Medicaid Numbers are always 11 digits long. Example: 40601682400

• If you have to call the insurance companies, use this excel sheet to assist you.

• When calling to verify insurance, you are calling to find out the Eligibility/Benefits for Behavioral Health/Mental Health or Medication Management in an Outpatient Office Setting. It’s also good to ask if authorizations are required for the following CPT Codes for therapy: 90791, 90837, 90832 and for Medication Management: 99205, 99213 99214 and 99215 or if you prefer using the CPT codes to obtain a client’s benefits, feel free to do so. Ensure you ask if they have a deductible and if they do, ask if it applies to this specific service. Also ask for the amount that has already been met or satisfied.

• For the private insurances, find out if the client has Coordination of Benefits (insurances elsewhere that are considered as their primary insurance) with another insurance. If they do, this will affect the claims.

• Always have on hand our Tax ID or NPI, the client’s Member ID, Date of Birth and Name. The insurance representatives always ask for this.

• It’s always best to get a second opinion from a representative when verifying insurances.

• When verifying insurances, United Healthcare and Medicaid are the easiest to verify on their provider websites.

• United Healthcare will almost always have the Mental Health Outpatient benefits as the default. You are interested in finding out In-Network/Network benefits for Outpatient/Office visits.

• If a client mentions that they have GEHA, UHC Student Resources or UMR, you will have to call the insurance company for their benefits.

• Medicaid clients do not have a copay. All sessions are covered by Medicaid. We also do not send these clients invoices nor collect their credit card information.

Insurance Login Information

Ways to Reduce Call Time with Insurance Companies

• CareFirst - https://provider.carefirst.com/prv/#/home

Username: LarteyAdmin

Password: WfyFjkqSPZH1Btz

• CareFirst Administrators

Username: larteyadmin_1

Password: qkn7D*nu!4@AD9b

• United Healthcare - https://www.providerexpress.com/trans/eligAndBenefits.uol

Username: LarteyAdmin

Password: 532L33@5UVo0oS1

UMR: https://provider.umr.com/tpa-ap-web/?forcemainsite=true&siteCd=fh

UHC All Savers: https://provider-allsavers.optum.com/tpa-ap-web/?navDeepDive=APAS%20publicProviderHomeDefaultContentMenu

Optum: https://www.uhcprovider.com/

MDONEX Benefits under UHC: https://www.uhcprovider.com/

• Allegiance - https://www.askallegiance.com/Account/Auth/Login

Username: larteyadmin

Password: D@@rhQ5@JirKn7A

• Medicaid -https://omd.infomc.biz/iPC/Home/Index

Login using your personal logins

• Cigna - https://provider.evernorth.com/app/login

Username: Lartey32

Password: f5OoL5E!U3gisN

• Blueprint - https://clinician.blueprint-health.com/login

Username: [e-mail]

Password: Password1!

• Member Benefits Online - https://benesys-prod.webspyglass.com/logonE.jsp

Username: LARTEYWELLNESSGROUP

Password: om_hc_lWG2024%!1

Responding to Psychology Today Emails

You can tweak the following scripts to your liking but ensure that these questions and points are mentioned.

1. This is the general script. Please remove the questions that were already answered by the client in the Psychology Today email to prevent the client from repeating themselves:

Good morning/afternoon/evening *client’s name*

Thanks for reaching out! We are accepting new clients for virtual and in person sessions. In order to better assist you, please answer the following questions:

1. Will you be using insurance or paying out of pocket?

We are only accepting Cigna, United Healthcare, Maryland Medicaid and CareFirst BlueCross BlueShield. Please confirm with the Find a Therapist or Excel Sheet if these therapists are accepting new clients.

2. Do you have a preference in the ethnicity or gender of the therapist? If so, please advise.

3. What are your presenting problems? For example: depression, anxiety, etc. NOTE: Clients with schizophrenia are typically not seen by our Nurse Practitioner nor PaulineJo. Check the database for those Nurse Practitioners who can administer injections. Confirm with the Find a Therapist database first before scheduling these specific clients with a therapist. Our Nurse Practitioners do not do Psychological Tests. Please refer the client to Mount Washington or Kennedy Krieger.

4. Have you been having any suicidal thoughts or thoughts of harming yourself or others in the past 6 months? This question should ALWAYS be asked unless the client mentions it to you. DO NOT schedule suicidal clients or clients with suicidal ideation with an intern. Verify with a licensed therapist if they are able to work with this client. If they are unable to, refer the client to Psychology Today.

5. Are you located in MD or DC or VA?

NOTE: We are not accepting DC or VA clients with Medicaid. DC or VA (no BCBS) clients with private insurances or self-pay can be assigned to Laurie’s interns, or clinicians licensed in DC or VA. Please use the Find a Therapist database to locate those interns/therapists using the DC or VA location.

6. Will this be for therapy or medication management?

NOTE: Dr. Patrick is the only NP who can work with DC clients at this time. UHC and BCBS only.

These answers will assist me in identifying the correct therapist for you. I look forward to hearing from you. If the client is seeking Medication Management, please ask if they already have a therapist elsewhere. If they do, let them know an ROI will be shared to their portal for them to complete in order for the Nurse Practitioner to work in conjunction with their therapist/psychologist. Have the ROI shared to their portals. If they do not have a therapist, please remind them that they would need to be assigned one since it is recommended that both services go hand in hand. Our Nurse Practitioners do not do Psychological Tests. Please refer the client to Mount Washington or Kennedy Krieger.

Regards,

*your name*

1. If the client mentioned wanting to have a consultation. The same thing applies with the questions, remove those that were already answered in the client’s email to prevent them from repeating themselves:

Good morning/afternoon/evening *client’s name*

Thanks for reaching out! We are accepting new clients for virtual and in-person sessions at this time. Unfortunately we are no longer offering consultations, this would mean that the first appointment will be an actual session. If you're still interested, in order to better assist you, please answer the following questions:

1. Will you be using insurance or paying out of pocket?

We are only accepting Cigna, Maryland Medicaid, United Healthcare and CareFirst BlueCross BlueShield. Please confirm with the Find a Therapist or Excel Sheet if these therapists are accepting new clients.

2. Do you have a preference in the ethnicity or gender of the therapist? If so, please advise.

3. What are your presenting problems? For example: depression, anxiety etc. NOTE: Confirm with the therapist first before scheduling these specific clients with them.

*4. Have you been having any suicidal thoughts or thoughts of harming yourself or others in the past 6 months? This question should ALWAYS be asked unless the client mentions it to you. DO NOT schedule suicidal clients or clients with suicidal ideation with an intern. Verify with a licensed therapist if they are able to work with this client. If they are unable to, refer the client to Psychology Today.

5. Are you located in MD or DC or VA?

NOTE: We are not accepting DC or VA clients with Medicaid. DC or VA (not BCBS) clients with private insurances or self-pay can be assigned to Laurie’s interns, or clinicians licensed in DC or VA. Please use the Find a Therapist database to locate those interns/therapists using the DC or VA location.

6. Will this be for therapy or medication management?

NOTE: Dr. Patrick is the only NP who can work with DC clients at this time. UHC and BCBS only.

These answers will assist me in identifying the correct therapist for you. I look forward to hearing from you. If the client is seeking Medication Management, please ask if they already have a therapist elsewhere. If they do, let them know an ROI will be shared to their portal for them to complete in order for the Nurse Practitioner to work in conjunction with their therapist/psychologist. Have the ROI shared to their portals. If they do not have a therapist, please remind them that they would need to be assigned one since it is recommended that both services go hand in hand. Our Nurse Practitioners do not do Psychological Tests. Please refer the client to Mount Washington or Kennedy Krieger.

Regards,

*your name*

• You are still also to verify their insurance and ensure that the client signs their forms before scheduling them.

• If they are interested in being scheduled you can continue this discussion over the phone or through email.

Additional Pointers

• Laurie Persh & Wendy Pitts are the only supervisors who are licensed in DC and VA. You can schedule clients in Washington DC with any intern they supervise. This should only be private insurance clients or Self-paying clients. Please use the Find a Therapist database to locate those interns/therapists using the DC or VA location.

• We are currently not accepting clients with Aetna or Medicare A and B.

• Clients doing couples counseling cannot have the same clinician for individual sessions.

• Consult with the therapist first before scheduling siblings. Not all supervisors allow this.

• Do not hesitate to ask the therapist any questions. It is best to ask for confirmation before scheduling.

• Use the Whatsapp Group chat to ask questions or speak on any issue you’re facing.

• Our Nurse Practitioners are the ones who complete FMLA (disability) paperwork for clients. They would need to be scheduled with them for assessing before they can complete this.

• Pauline Jo, Stacey, Tahja-Rae, Angela can meet with children 7 years and younger who are interested in PRP. These sessions should be scheduled as Family sessions since a parent needs to be present to speak on the child’s behalf. Therapy should be once a month. Please remember to do an authorization for 90847.

• If a client is being reassigned due to a clinician leaving or for any other reason, it is best not to reassign the client to an intern who will be leaving shortly.

Process for Confirmation of Attendance

Please make use of the process and ensure this is being done on a daily basis.

ADHD Assessments/Evaluations or ADHD Tests

• The difference between ADHD Tests and ADHD Assessments

• • ADHD Tests are a series of tests which include those on intelligence, memory and attention, language, executive functioning, and even personality. These tests can only be conducted by a licensed psychiatrist or psychologist.

  • ADHD Assessments/Evaluations are for clients seeking therapy to manage their ADHD symptoms, are seeking medication for ADHD or want to be assessed to determine if they meet the ADHD diagnostic criteria. They can be conducted by all licensed social workers, counselors, nurse practitioners or interns.

• Not all clients know the difference between the two, therefore, it is very important that you ask the right questions:

• • Do you want to be assessed to determine if you meet the diagnostic criteria for ADHD?

  • Are you currently seeking therapy to manage your ADHD symptoms?

  • Are you currently seeking medication for ADHD?

• If they answered “Yes” they would need to be scheduled with the respective therapists who are assigned for ADHD Assessments and added to BluePrint.

• If they answered “No” and are in fact seeking ADHD Testing, they can be referred to Dr. Stephanie Johnson from Cognitive Solutions at [phone]. Her email address is [e-mail]. She can only work with clients in Maryland.

Sessions with Jenel

• Jenel can conduct both Therapy and Medication Management Sessions. Check the FAT.

• Do not schedule clients who need BOTH services with Jenel. She can only do one service per client.

• All Intakes should be scheduled as 99205 with Jenel

• • Please put in the appointment alerts whether it is for therapy or Med Mgmt, if it is in-person or virtual and also the service code to be used for scheduling follow-up sessions.

• You do not need to schedule the OMHC Intake with another NP if they will be or have already done the intake with Jenel.

IMPORTANT PROCESSES

Form/Letter Completion Process

• All clients will be required to pay $100 out of pocket for this service. This service is unfortunately not billable to insurance companies.

• Please let the clients know that their FMLA requests are subject to review and approval by the Nurse Practitioners

• This fee applies to clients requesting:

1. Recommendation letters

2. Emotional Support Animal letters,

3. Forms for schools,

4. FMLA or disability forms - FMLA forms MUST be completed by one of our Nurse Practitioners, who requires that the client attends at least 3 or more sessions prior to complying with this request.

5. Letters to employers

• Letters of Attendance are at no cost to the client

STEP 1

The client is required to have:

• Signed our “Form/Letter Fee Policy” form.

• A credit/debit card on file for Medicaid, Medicare and Private Insurance clients. A “Payment Authorization Form” is to be shared to the portal should one not have already been completed.

STEP 2

The client is scheduled on the clinician’s calendar. Please see the screenshot below and make note of the “Appointment Type” and “Service Code”. For those clinicians on Setmore, it should be scheduled as “Miscellaneous Medicine Services”

PRP PROCESS

1. PRP Screening Questions Form (Children/Adolescents)

2. PRP Screen Questions Form (Adults)

3. Kids Free Mentorship Program Landing Page

Hi, do you have an emotionally unstable child who exhibits troubling behavior and can benefit from a free mentoring program for kids? Although the program is free, the state makes it very hard to qualify for the free services. In order to qualify, Medicaid clients 17 and under have to be exhibiting emotional disturbance which causes serious dysfunction in multiple life domains (home, school, community)

Below are the criteria to qualify for the free mentorship program:

The impairment as a result of the youth’s emotional disturbance results in:

a. A clear, current threat to the youth’s ability to be maintained in his/her customary setting, or b. An emerging/impending risk to the safety of the youth and others, or c. Other evidence of significant psychological or social impairments such as inappropriate social behavior causing serious problems with peer relationships or family members. Benefits Include: If you are able to qualify, benefits include a free monthly membership to Urban Air in Laurel, Maryland. Urban Air is an indoor theme park that has go-karting, trampoline, wall/rock climbing, obstacle course, ball pit, and dodgeball. The free membership provides unlimited monthly access, with a free slice of pizza every time you attend. The free monthly membership is only available at the Laurel, Maryland location. Other activities include trips to plays, a free tour of Ravens Stadium, and meeting with your mentor at the mall, library, or other public areas. The mentoring program is in person, and the mentor comes to your house to pick your kid up. For clients under the age of 18, it is required to meet monthly at least 3 times a month. The final visit has to be in person at the Laurel office. It is also a requirement that therapy is done at least twice a month. Each person is assigned a Rehabilitation Counselor/Mentor who would meet with them on a regular basis. Is this something that interests you?

Joining a Video Session

With TherapyNotes new update to Telehealth, clients and or their guests are able to join their clinician’s waiting room without logging into a portal account. This is ideal for:

• Couples/Families in separate locations

• Clients who have forgotten their passwords and are running late for their sessions

Here are the instructions in English and Spanish

Prior Authorizations for Medication

Prior authorization (PA) is a process used by health insurance companies to determine if they will cover a prescribed medication or treatment. It’s an extra step that requires the healthcare provider to get approval from the insurance company before a specific medication, service, or treatment can be provided. The goal is to ensure that the prescribed medication is medically necessary and appropriate for the patient based on the insurer’s guidelines.

Psychiatric medications that often require prior authorization (PA) typically fall under categories

that are more expensive, require special clinical justification, or are prescribed for off-label uses.

Prior Authorization Process

1. Nurse Practitioners send the prescription to pharmacy

2. Insurance company reviews the request to determine if the medication meets the criteria for

coverage

3. Pharmacy will send the Prior Authorization form to NP

4. NP receives the form and process

5. NP send completed form to the insurance plan

6. Insurance plan alerts the pharmacy and NP if the medication was approved/denied

Handling clients with prior authorization (PA)

When communicating to clients that a medication requires prior authorization (PA), it's essential to

approach the situation with clarity, empathy, and transparency. Patients may feel frustrated or

confused about this additional step, so it's important to explain the process and manage their

expectations.

- Acknowledge the Situation and Express Empathy

- Explain What Prior Authorization Is

- Outline the Next Steps

- Manage Expectations Regarding Timelines

- Offer Support Throughout the Process

Sample Script

“Hi [Client Name], I wanted to inform you that your insurance company requires prior authorization before they will cover the medication your doctor has prescribed. This means that your Nurse Practitioner will need to submit additional information to your insurer to confirm that the medication is the best option for your condition. It typically takes about 3-5 days for the insurance company to review the request, but there can sometimes be delays. I’ll keep you updated on the status, and if there are any issues, we can explore alternative options. Please don’t hesitate to reach out if you have any questions or concerns.”

Unresponsive Nurse Practitioners

For all matters regarding medication/prior authorizations/prescription refills/pharmacy issues, we should email, call and text the Nurse Practitioners.

**For a faster turnaround time with prior authorizations, please include in your email to the NP that they may call 1-800-932-3918

If it is past the 24 hour window and they remain unresponsive, please escalate the issue to Management. Please see steps to follow here

Processing Client Insurance Form

ALL Client Insurance Forms are to be marked as processed.

1. Click on the “x” highlighted in the screenshot. DO NOT click on “Save 1 New Policy”

2. Select “Mark as Processed” at the bottom of the page.

3. Select “Mark as Processed” again.

Returning Client Process

When a client wants to return to therapy, it’s important to approach the situation with

openness, empathy, and professionalism. Reassuring them that it’s okay to seek support

again can help them feel comfortable re-engaging in the therapeutic process.

CSR Steps for returning client

1) Ensure that client’s information is up to date (email, phone number, address)

2) Verify the client’s insurance is still active, confirm if there are any changes in insurance

and verify and update billing settings accordingly

3) Check for outstanding balance. Client will need to first settle balances before we can

schedule. Consult with the Billing team for advice.

4) Confirm that clients have access to the portal and have completed all pending documents

( ie: Treatment plans, Transition plans etc) Send updated forms if needed.

5) Review Interaction Notes, Therapy Notes for comments or notation if client has been

terminated due to the following reasons

A) No Shows - depending on the severity of their previous infractions , we may be able to

accommodate these clients again as long as client has provided commitment in attendance

compliance. Please consult with management for advice.

B) Billing issues - clients will need to settle outstanding balances. Please consult with

management for advice.

C) Client’s Needs Are Beyond the Scope of Therapy - these clients require a higher level of

care such as hospitalization, crisis intervention or other services that a therapist cannot

provide

D) Inappropriate Behavior or Violations of Boundaries - If a client engages in inappropriate

behavior or violates professional boundaries, such as making sexual advances or threatening

the therapist, immediate termination may be necessary. Safety and professional ethics must

always be prioritized.

Reasons C & D - in most cases, we are no longer able to provide service to these clients and

therefore have to be referred to Psychology Today. Please consult with management if

needed.

6)Match the client with available clinicians and schedule accordingly.

A) For therapy, schedule the next session as an intake if the last intake was more than 6

months ago

B) For medicaid clients, ensure client has completed their OMHC Nurse Practitioner

assessments

7) Assign the new clinician on Clinician’s tab

8) Send an email to the new clinician about adding this client on their caseload

9) Ask the management team to remove the old clinician on clinician's list (if any)

10) Track the returning client on our tracker

11) Document in our Interaction Notes accordingly.

Client Reassignment Process

Client Reassignment Process

There are instances where clients will have to be reassigned to another clinician to continue

services. This process will entail step by step instructions on how to assist clients.

The CSR will ask a few questions to understand the client’s needs and reasons for wanting to

change. This helps us ensure that the reassignment process aligns with the client’s goals and

well-being.

Reasons for reassignments could include:

1) Not a good fit

2) Schedule conflict

3) Insurance Change

4) Current clinician is no longer with the company

Ask Clarifying Questions if needed. If the client’s reasons are unclear, gently ask clarifying

questions to help understand their needs. This can also help in finding a more suitable

therapist for them.

“Can you tell me a bit more about what you’re looking for that might be different in a

therapist or approach?”

Steps for reassignment

1) Ensure that client’s contact information is up to date (email and phone number)

2) Verify the client’s insurance is still active, confirm if there are any changes in insurance

and verify and update billing settings accordingly

3) Confirm that clients have access to the portal and have completed all pending documents

( ie: Treatment plans, Transition plans etc) Send updated forms if needed.

4)Match the client with available clinicians and schedule accordingly.

4.A For therapy, schedule the next session as an intake if the last intake was more than 6

months ago

4.B For medicaid clients, ensure client has completed their OMHC assessments

4) Assign the new clinician on Clinician’s tab

5) Send an email to clinicians involved about the reassignment

6) Ask the management team to remove the old clinician on the clinician's list.

8) Track the reassignment on our tracker

9) Document in our Interaction Notes accordingly.

Handling clients who want to be reassigned to another therapist requires sensitivity,

professionalism, and clear communication. It’s important to respect the client’s needs while

ensuring they feel heard and supported throughout the process

Handling Therapy Referrals from External PRP Agencies

Handling therapy referrals from external PRP (Psychiatric Rehabilitation Program) agencies involves a systematic approach to ensure the referral process is smooth, timely, and thorough.

Below are the steps and considerations for managing these referrals effectively

1)Receive and Review the Referral

Ensure you have all necessary information from the referring agency that the client’s personal information including 1)Full name 2)Contact information (phone number and email) 3) Insurance information 4) Date of Birth

2)Determine Eligibility

Ensure the client meets the criteria for therapy services which mainly includes insurance verification

3) Receive the PRP Agency’s PRP Referral form The PRP Agency will share with us their PRP referral form. This form is what our therapist will fill out if the client qualifies for the program. We will then send the completed form back to the agency to complete the referral.

It is important that the CSR fills out the patient demographic part of the PRP form so the therapist can simply focus on the clinical part to help out the therapist. The CSR may also ask the PRP agency to fill out the demographic part as well. 4)Setting Expectations of our Requirements and Timelines with the PRP Agency

- In most cases, we can schedule the client the same week of the initial contact and the 2nd session the following week. - Our therapists would be able to determine if the client meets qualifying diagnoses for PRP on the therapy intake and our goal is to complete the PRP referral form on the second therapy session. - Our therapist may require the clients to complete some therapy assessment forms to determine eligibility. The forms will be shared on the client’s portal

- The client will need to be seen by our Psychiatric Nurse Practitioner for an assessment as a requirement from Medicaid

5) Initial Client Outreach - Contact the client for an intake call Sample script Hi [Client’s Name], my name is Clarence, and I’m calling from Lartey Wellness Group. I was referred to you by [PRP Agency Name], and I understand you may be looking to engage in therapy services. I’d like to take a few moments to talk about how we can assist you and set you up for services"

6) The intake process - Handle the intake call with client as usual - Upload the blank PRP referral form to the client’s Therapy Notes Documents tab profile - Add an appointment alert on the Intake schedule External PRP clients for therapy: PRP referral form should be completed on the 2nd session

- Notify the assigned therapist that this client is referred to us by an outside PRP agency for therapy and the PRP referral form should be completed on the second session (if the client qualifies). See sample email below

7) Ongoing Communication for Updates and Follow up Regular Updates to PRP Agency: Notify the PRP agency of the client’s scheduled intakes. They will also help in ensuring the client attends their session Follow up with therapists: Ensure that the therapist is able to complete the PRP referral form on the 2nd therapy session (if the client qualifies)

CSR can put tasks on Trello to ensure timely follow up.

Effectively managing therapy referrals from external agencies such as PRP programs is critical for ensuring that clients receive timely, coordinated, and comprehensive care. By streamlining the referral process, fostering communication, and ensuring a focus on the client’s specific needs, you help improve client engagement, reduce gaps in care, and optimize both individual and systemic outcomes. This will also foster good relations with the external agency and promote additional referrals.

Clinicians and Insurances Credentialed with

CareFirst	UHC	Cigna	Medicare
Pauline Jo Adia	Grethel Bradford	Pauline Jo Adia	Jenel Thomas
Grethel Bradford	Quizzina Forney	Tahja-Rae Dickenson	Ifeoluwa Oyefeso
Jennifer Britten	Tia Gross	Quizzina Forney	Chibuzor Igolo
Chelsa Brown	Franklin Lartey	Tia Gross	Chelsa Brown
Quizzina Forney	Patrick Nganga	Jemel Johnson-Smith	Hamida Majili
Tia Gross	Ifeoluwa Oyefeso	Franklin Lartey	Zuwena Iddi
Jemel Johnson-Smith	Laurie Persh	Patrick Nganga	Patrick Nganga
Franklin Lartey	Jon Thomas	Rita Nicholson-Weaver
Patrick Nganga	Sandra Thomas	Oluwatobi Omobo
Rita Nicholson-Weaver	Jennifer Britten	Ifeoluwa Oyefeso
Ifeoluwa Oyefeso	Zuwena Iddi	Laurie Persh
Laurie Persh	Wendy Pitts	Wendy Pitts
Wendy Pitts	Angela Winder	Sandra Thomas
Jalisa Rumph	Lindsey Weller	Jennifer Britten
Jon Thomas	Lois Achu **	Zuwena Iddi
Sandra Thomas	Tahja-Rae Dickenson **	Hamida Majili
Tahja-Rae Dickenson	Rita Nicholson-Weaver **	Jalisa Rumph
Angela Winder	Jalisa Rumph **	Angelique Walker
Hamida Majili	Tyler Morris **	Stacey Kauffman
Zuwena Iddi	Stacey Kauffman **	Chibuzor (Susan) Igolo
Alzariyat Abdalla	** - can accept until further notice	Kayla Edwards (Bond)
Angelique Walker	Chibuzor (Susan) Igolo	Lindsey Weller
Jasmine Ferguson	Kayla Edwards (Bond)
Kayla Edwards (Bond)	Stacey Kauffman
Chibuzor (Susan) Igolo	Lindsey Bryant **
	Cindy Campos Flores **
	Alaina Portser **

REFERRAL SOURCES

Charlie Health IOP

Personalized Intensive Mental Healthcare

Therapy once a week isn’t always enough. Charlie Health’s Intensive Outpatient Program (IOP) combines supported groups, family therapy, and individual therapy into a series of personalized sessions multiple times per week. Our experts use research to address mental health struggles at their roots.

Phone: [phone]

https://www.charliehealth.com/

Bon Ridge Wellness

Trust Bon Ridge Wellness to help you or your loved one manage and overcome life’s challenges. They specialize in providing quality, effective mental health services in Maryland to individuals struggling with emotional distress, such as depression, anxiety, and stress. They accept Medicaid, Medicare and most major insurances. Offers virtual sessions only and caters to 18-68 years old.

Phone: [phone]

https://www.bonridgewellness.com/

IN-PERSON OFFICE INSTRUCTIONS

Access Instructions for the Frederick Office

Frederick Office Address:

5100 Buckeystown Pike # 250, Frederick, MD 21704

Where is the entrance to the second floor?

The newly built professional office building is located on the second floor of the Westview Shopping Complex.

To access:

Go around to the back of the building 5100 on the side of “Five Guys”

You will pass a sign that says “Westview Professional Offices Entrance & Parking”

Once at the back of the building 5100, enter through the double doors with the large green awning. The green awning has the number 5100.

Once inside, take the stairs or elevator to the second floor and enter suite 250.

Please note that the main entrance will require a Fob to access after 5pm on weekdays and all day weekends.

If clients arrive after 5 p.m. on weekdays and all day on weekends, the therapist must meet them in the lobby of the first floor.

Google the number of your therapist:

Tyler Morris: [phone]

Please remember that the therapist may be wrapping up with a client, so they may be 5 minutes late in coming downstairs to escort you or may not be able to pick up your call right away.