Client, Patient, or Name: Which to Use in Mental Health Documentation?“What is the proper way to refer to a client when writing my notes? Do I use their first name, or do I refer to them as ‘client’ or ‘patient,’ which is their role in our relationship?” I get this question a lot and am fond … [Read more...] about Client, Patient, or Name: Which to Use in Mental Health Documentation?
Question & Answer: Intake Summary
Question & Answer: How do I write an Intake Summary without violating client confidentiality?QUESTIONI'm struggling with how to effectively document in a manner that satisfies "medical necessity" requirements while also protecting the privacy of my clients. I understand how to keep progress … [Read more...] about Question & Answer: Intake Summary
Mental Health Documentation for Worker’s Compensation
Mental Health Documentation for Worker’s CompensationA therapist recently asked me how to document for a Worker’s Compensation claim. Some companies will accept a summary of treatment. Most will want the client’s full record. That will include the Diagnostic Assessment, Treatment Plan, … [Read more...] about Mental Health Documentation for Worker’s Compensation
Overview of Creating and Integrating Forms into Simple Practice
[Beth Rontal ] Welcome everyone for my first live Facebook. So we're very happy to have you here. I am Beth Rontal, the Documentation Wizard and LICSW. And I am welcoming Frances Harvey from My Solution Services. And we're gonna give an overview of how to customize, create, and integrate your … [Read more...] about Overview of Creating and Integrating Forms into Simple Practice
I’d Rather Clean the Toilet than Write Progress Notes: Making Peace With An Essential Task
Q: I love being a therapist, but I hate writing progress notes and sometimes can’t bring myself to do it. I know it’s risky not to write them. Is there a way to make this task less onerous?A: Every therapist knows that avoiding progress notes puts their practice in jeopardy. But of the thousands of … [Read more...] about I’d Rather Clean the Toilet than Write Progress Notes: Making Peace With An Essential Task
How to Document Changes in Treatment During Covid-19 Without Writing Another Plan
Private practice therapists are expected to write a new treatment plan once a year. What happens when your well thought out plan gets thrown to the wind before it's time for an update? This scenario may be happening right now since the sudden outbreak of the Covid-19 pandemic. Problems, goals, and … [Read more...] about How to Document Changes in Treatment During Covid-19 Without Writing Another Plan
How to Document for Tele-Mental Health During the Covid-19 Pandemic
Adjusting to TelehealthWe’re all trying to adjust to a new way of living and providing mental health services. I’m going to help you navigate the needs for tele-mental health documentation during the Corona virus pandemic. Most insurance companies are now finally on board with offering tele-mental … [Read more...] about How to Document for Tele-Mental Health During the Covid-19 Pandemic
Can Mental Health Providers Charge For Phone Calls?
Like most answers I give regarding being a mental health therapist and having a private practice, “yes” and “no.” WHY SHOULD MENTAL HEALTH PROFESSIONALS CHARGE FOR PHONE CALLS?Phone calls can take a lot of time and time is what we’re paid for.If you don’t charge for these phone calls, you are … [Read more...] about Can Mental Health Providers Charge For Phone Calls?
Are Discharge Summaries Mandatory?
Do you need to write a discharge summary as a mental health provider?Yes and no.Confusing? Definitely. That’s because the standards are not consistent from one insurance company to the next.Here’s what I can tell you:Discharge Summaries for Medicaid Medicaid requires discharge summaries for … [Read more...] about Are Discharge Summaries Mandatory?