TPN Event Recap: Clinical Outcomes, Payor Relationships, and Reimbursements

This past March, Hansei Solutions proudly partnered with Trusted Provider Network to identify and provide evidence-based educational opportunities to healthcare providers and their clients. Erin Burke, CEO and founder of Hansei, along with Patrick Dunn, Chief Strategy Officer, had the opportunity to present the online continuing education course titled “Improve Clinical Outcomes, Enhance Payor Relationships, and Expedite Reimbursement.”

This short blog recaps the presentation and breaks down how Hansei Solutions and Trusted Provider Network are helping healthcare providers improve their billing and clinical documentation practices.

What Is TPN.health?

TPN.health, or Trusted Provider Network, is a digital platform that connects behavioral health professionals, treatment facilities, hospitals, and employee wellness programs. TPN.health has grown significantly and is currently recognized as the fastest-growing behavioral health network in the United States. They provide their users with a local community that extends nationwide, connecting them to healthcare providers who adhere to the highest standards of clinical services, ethics, and professional practices.

In light of the COVID-19 pandemic, TPN.health responded by organizing virtual continuing education events on behalf of behavioral health associations across the nation. This proactive step has led them to become the largest virtual conference provider to the behavioral health industry in the country.

Why Hansei Partnered With Trusted Provider Network

TPN.health’s focus on educating and helping providers improve their services closely resemble our own goals at Hansei. We quickly recognized the advantages of partnering, and through our collaboration, we now offer improved solutions that address the growing need for digital continuing education opportunities in behavioral healthcare. Our partnership aims to achieve the following goals:

1. Help healthcare providers improve and strengthen their relationships with insurance companies and patients.
2. Educate and help implement the best clinical documentation methods.
3. Streamline business operations related to billing and compliance to increase efficiency and ensure adherence to regulations.

“We are honored to bring a behavioral health revenue cycle partner like Hansei on board to help open a pathway to reach our goals of improving clinical resources that benefit both the clinician and patient journey.” – Trevor Colhoun, Chief Executive Officer of TPN.health.

“The knowledge we learn as the leader in revenue cycle partnerships needs to be shared with providers everywhere. We are excited to be able to use the TPN platform to further our goal of education and advocacy. As a partner of TPN.health, we are excited to develop a trusted network where clinicians can digitally collaborate, communicate and access resources that benefit all levels of their business.” – Patrick Dunn, Chief Strategy Officer at Hansei Solutions.

About The Presentation

The presentation, “Improve Clinical Outcomes, Enhance Payor Relationships, and Expedite Reimbursement,” was aimed at helping various behavioral specialists and organizations, including counselors, social workers, psychologists, addiction counselors, and marriage and family therapists. The presentation had four discussion points:

Section 1: Strategies to Improve Relationships With Insurance Providers

Erin and Patrick discussed how consistent and thorough documentation helps healthcare providers improve their contract negotiations with payors, emphasizing the importance of including as many details as possible. This will help providers justify their contract rates during the negotiation phase and secure the most cost-effective deals. They also touched on the benefits of consistent communication within a practice and between partners, highlighting how working together to develop new solutions and approaches leads to better outcomes and transparency.

Section 2: Best Billing Practices for Optimizing Reimbursements and Revenue

The next part of the presentation discussed three of the best billing practices that adhere to state and payor guidelines while still providing quality patient care.

1. Documenting Medical Necessity: Properly documenting medical records increases the likelihood of claims being approved and allows for more covered days. This documentation becomes crucial when medical records are requested or when appeals are required.
2. Following Payor Criteria: Adhering to the criteria set by the insurance payor enables billing for specific days and enhances the chances of claims being approved when records are requested. It’s important to consider situations where the state mandates fewer hours of programming than the payor and when a patient’s medical record lacks an “end time” listing.
3. Making Informed Admissions Decisions: When admitting patients, always review their remaining deductible and out-of-pocket expenses for the year to ensure they comply with your facility’s financial terms. It’s also important to understand historical reimbursement and authorization trends specific to each patient’s health insurance policy. Additionally, checking that all necessary forms are signed and completed helps prevent obstacles that can slow or hinder the payment process during the admissions process.

Read more in our eBook: Revenue Cycle Management Services

Section 3: Steps of a Clinical Documentation Audit

Erin and Patrick went over the key steps of a clinical documentation audit and the importance of daily and weekly chart audits. Healthcare providers can avoid the most common denial reasons by:

• Ensuring their documentation is comprehensive, timely, and adheres to laws and guidelines. This includes verifying the appropriate number of billable hours and understanding clinician or clinical supervisor signature requirements.
• Conducting comprehensive patient chart reviews to confirm compliance with payor, state, and national guidelines.
• Ensure that all relevant notes are properly inputted within the designated deadlines and the process for late or missed notes.
• Conducting a final closed chart audit upon patient discharge. This step helps ensure all documentation is complete, accurate, and compliant with regulatory requirements.

Erin also reviewed the importance of proper note-taking and documentation during counseling sessions. It discussed the characteristics of bad notes, such as missing credentials, lack of clinical detail, and incomplete interventions. On the other hand, good notes were described as including session start/end times, ratings of emotions, clear session identification, and complete clinical detail following the industry-standard format.

Section 4: Promoting Public Health

Hansei understands the significance of promoting public health and recognizes the impact that billing practices and clinical documentation have on it. During the final part of the presentation, Erin and Patrick discussed how patient documentation forms the basis for the healthcare provider’s current and future care of that patient. Medical records must contain detailed, complete, and accurate documentation since they can be used as evidence during legal proceedings.

In addition, coded data from patient records serve various purposes, such as providing educational opportunities and supporting research conducted by medical associations, government entities, and other organizations. Based on the data, this research enables projections and provides valuable insights into multiple clinical areas.

Read more: Mental Health Month: Miles For Mental Health

Contact Hansei Solutions

By collaborating with Trusted Provider Network, Hansei Solutions is able to offer innovative solutions that enhance billing practices and provide valuable educational opportunities for healthcare providers. We’re dedicated to driving positive change and empowering providers with the knowledge and tools they need to navigate the evolving medical billing landscape. This also ties into Hansei’s key services, including medical billing, managed care contracting, credentialing, utilization review, and more. Contact us today to schedule a free demo of our medical billing solutions and learn how to grow your practice and improve patient care.