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How Behavioral Health Programs Should Respond to Requests for Resident Information

Residential treatment options, from independent living programs to intensive wilderness therapy experiences, can help many young people who struggle with substance misuse. Many of these programs fall under the National Association of Therapeutic Schools and Programs. Participants can improve their problem-solving and communication skills and develop healthier living habits, often after traditional therapy models have not been successful.

However, the sensitive nature of these programs can also lead to safety issues for residents. Even the best providers must be prepared to respond to inquiries and investigations.

Reasons for Behavioral Health Safety Investigations

Behavioral health organizations may receive safety inquiries and undergo investigations for numerous reasons.

Licensing agencies may launch a routine investigation as part of a licensing application or renewal.
Payers may request information if they suspect fraud associated with billing.
Former clients or their families may accuse resident programs of mismanagement or abuse.
Data breaches may prompt investigations and audits.

Inquiries may come from licensing agencies, state protection and advocacy systems, payers, attorneys on behalf of client families, or independent organizations. Here’s how to respond.

Receiving a Medical Record Request

Any inquiry is likely to involve a request for client medical records. Before responding, make sure your facility is allowed to disclose records under HIPAA and state laws.

A few rules to follow:

In general, protected health information (PHI) cannot be used or disclosed without consent, except to the individual client.
Additional protections may apply to a mental health professional’s notes recorded during conversation in a counseling session.
If a state law is even stricter than HIPAA, then state law prevails.

Sometimes, you may disclose PHI without consent. These cases are limited and allowed only if there is a “serious and imminent” threat. Always refer to HIPAA and other federal and state laws that apply to your organization.

Responding to a subpoena

Behavioral health organizations under HIPAA law may only release PHI in response to a subpoena if certain conditions are met. The subpoena is accompanied by a court or administrative tribunal order and signed by a judge. The investigator must also provide you with “satisfactory assurance” that it has made “reasonable efforts” to give notice to the individual whose PHI is involved, or to secure an appropriate qualified protective order from the court or tribunal.

If you are subpoenaed, you must address it in some way, no matter what. This may involve contacting the requestor, appearing before a judge, or moving to quash the subpoena.

Declining a Medical Information Request

Your facility may not be able to fulfill all requests for medical information you receive. Be sure you understand the possible consequences if your organization does not disclose requested records.

If you must decline a PHI request in order to comply with federal or state law, do not acknowledge that the client involved was treated at your facility. However, if the request involves an individual who is not, and never has been, a client of your facility, you may say so.

Be sure to maintain and keep records for an appropriate length of time. If your state does not have specific laws for maintaining behavioral health records, consider following the American Psychological Association’s recommendations.

Whether you’re dealing with a routine audit or an unexpected investigation, maintaining appropriate documentation is crucial for behavioral health. The BestNotes EHR solution offers a documentation app that follows to federal, state, and accreditation standards, updating changes automatically, so you can maintain compliant records without anxiety. Contact us today to learn more, or schedule a free demo.

date:  Jun 15, 2021
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Developing a Value Proposition for Your Behavioral Health Business

What do you offer your behavioral health clients? How do you contribute to your community and your field? What makes you different from other providers in your area?

The answers to these questions determine your value proposition. This is an essential part of defining your behavioral health business and guiding many of your decisions.

What’s in a behavioral health value proposition?

Your value proposition should focus on what is unique to your behavioral health business. Some possibilities include:

Newness: You address a particular set of needs that customers were unaware of, or offer something different from what is already available.
Performance: Your organization is results-oriented and focuses on improving existing services.
Customization: You tailor your services to specific needs of individual clients or a client segment.
Design: You can make your service stand out due to design elements, such as a great website or a beautiful, relaxing office space.
Brand/Status: The client finds value in simply using or displaying a specific brand due to the organization’s reputation.
Price: Offer similar value at a lower price to serve a more price-sensitive client base.
Cost Reduction: Your organization helps the customer reduce monetary and other costs.
Risk Reduction: This angle emphasizes how you help clients reduce risk, such as reducing the symptoms of depression that can otherwise put relationships and careers in jeopardy.
Accessibility: Offer services to clients who otherwise may not have access to them, such as operating in an underserved neighborhood.
Convenience/Usability: Make your services easier to use or more convenient for clients, such as virtual therapy options.

How do you determine your value proposition?

Your value proposition won’t include all of those factors. So how do you decide which ones apply to your organization? Start with a little research.

Conduct a stakeholder analysis to determine the audience of your value proposition. Who is affected by your work, has influence over it, or has an interest in your success? This includes clients and payers, but also policymakers and potential partner organizations.
Internally review your organization’s capabilities to determine what you do well, what you are best known for, and what advantages you have over others.
Look at your organization’s strategy and consider what success looks like and how to achieve it. Don’t forget to consider potential risks and weak spots, too.
Gather data that is most valuable to your stakeholders, and what will demonstrate positive outcomes and costs. Consider how your data compares state- or nationwide. This may include health outcomes, how quickly clients are seen, and client engagement.

Once you have the right information, you can begin to create your value proposition. You may want to create both a short “elevator pitch” and a longer value proposition document that incorporates your answers and the data you’ve collected. Write in language targeted toward all relevant audiences.

With an established value proposition, you can articulate the unique value your behavioral health business brings to your market. You can also use it to inform decisions, such as marketing, hiring, and partnerships, that will also contribute to your organization’s success.

BestNotes aims to help behavioral health organizations streamline their operations to help make providers, staff, and clients happier. Our hosted CRM solution saves you from the cost and hassle of developing and supporting your own CRM, so you can increase profits while saving time. Contact us to learn more.

date:  Jun 07, 2021
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How to Create a Business Plan for Your Behavioral Health Practice

When opening your own behavioral health practice, your business plan can make or break your practice. From your clinical approach to your administrative operations, a business plan should guide your decision-making in all aspects of your practice. Here’s how to get started:

Start small and go slow.

Launching your behavioral health practice is exciting, but shouldn’t be rushed. Start creating your business plan with a simple list, or search online for a business plan template to provide a little more structure.

Explore other practices to get some ideas and decide how you may (or may not) want to organize your own practice. Network with other behavioral health professionals, or consider taking local or online business classes or tutorials on different aspects of business ownership.

Plan your general business operations.

No matter the industry, every business plan should include several common elements:

• What products or services you offer
• Your legal structure (sole proprietorship, an LLC, or an S corporation)
• What other employees or partners you may hire
• How you will market your business
• What makes you different from competitors
• Your business goals and how you will measure success
• Obtaining additional financing, if necessary
• How to handle accounting
• What federal, state, or local licensing or permits are required
• What insurance (payroll, liability, etc.) is needed
• Your mission statement

Include the clinical aspect of your business.

Your business plan should also address questions unique to a behavioral health practice, including:

• Who are your clients (including age groups, demographics, or conditions)?
• Will you rent or buy a space, or work out of your home?
• What therapeutic approaches will you use?
• Do you need additional education or training?
• Will you partner or collaborate with other behavioral health providers, social service organizations, or hospitals?
• Will you offer telehealth?
• How will you handle documentation and client data?
• Will you use software solutions, such as accounting or an EHR?
• What will your rates and payment options be? What insurance will you accept?
• Will you join a referral network?
• How will you bill clients? How will you handle late or missed payments?
• What will your scheduling process be like?
• How will you handle a client that is not a good fit?
• Will you work with an accountant or an attorney?

Make your business plan your own.

You can personalize your business plan to address your personal work and productivity style. This part might help guide decisions like:

• Establishing and maintaining boundaries with clients
• When you will take lunch breaks
• Whether you have a mentor you can consult
• How much time you need between client sessions
• How you will stay motivated and disciplined
• How to respond to serious, negative feedback
• How much time you will dedicate to administrative tasks and how much on clinical tasks

The benefit of running your own practice is having the flexibility to change your operations. If you want to change your accounting software, marketing style, or work hours, you can! Your business plan should grow and evolve with you and your practice, so don’t worry about getting it perfect right away.

Your behavioral health business plan should address the type of software you use to make things easier for you. BestNotes EHR and CRM solutions, created for behavioral health and addiction treatment providers, can help you start your practice on the right track. Contact us today to learn more!

date:  Jun 02, 2020
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