When I was a boy, one of the ways that I kept secrets was through coded messages. Now as a counselor, I have to send coded messages every day to insurance companies in order to send very private bills for my services. One of the many secrets that were kept from me in graduate school was that a lot of counseling is paid for by insurance companies who require one code for the diagnosis being treated, and a different kind of code for the type of service provided for that diagnosis. HIPAA is a law that requires we keep the secrets of our clients, as well as follow the rules for how we communicate their codes with their insurance company and their primary care physician. As a child, the penalty for breaking a secret in a coded message was usually breaking a friendship, but as counselors, if we break the secrets in the codes of our clients, HIPAA requires that we go to jail and pay a minimum of $250,000 in fines. This clear message threatening us should motivate all counselors to be carefully trained to send and receive their coded messages.
Diagnostic codes to bill for counseling sessions are available online and from books published annually in order to stay up-to-date. The procedure codes for what is done in counseling sessions with clients is also available online and from annual publications. If you are interested in a successful private practice, then you need to learn the codes and how to send coded messages with your bills. There are billing services that can help you, as well as coaches who have learned from their own mistakes about how to prevent you from making mistakes with your coded messages.
One of the reasons we call it private practice is because we need to continue growing and practicing to get better at sending our coded messages to the insurance companies, which try to find reasons to deny our claims so that they can retain the premiums paid to them by our clients. They actually look for excuses to deny the codes and deny paying the claims. A physician friend of mine calls those people at the insurance companies “box checkers” because they search through our coded messages to find excuses to check off a box that will deny the claim being paid to us.
Here is an easy coded message for you using the letters of the alphabet and the first 26 numbers:
7 5 20 8 5 12 16 23 9 20 8 3 15 4 5 19 19 15 25 15 21 3 1 14 8 5 12 16 3 12 9 5 14 20 19
Dr. Ray Smith integrates theology and psychology as an ordained Presbyterian minister as well as a licensed mental health counselor and an adjunct professor of counselors in Spokane, Washington.