Wiki Merging Behavioral Health with Medical Practice

[sarahsule]

Hello All,

I have a multi-part question. I am assisting a practice with credentialing. This practice group has a tax ID and a group NPI. Originally this group was only behavioral health ( therapists, social workers etc), there was no rx services and no medical procedures, just talk therapy. NOW, they are expanding to offer Primary Care & Psychiatric Medication Management and have recently hired MDs, PAs, APRNs and MHNPs that must also be credentialed under the group.

Question 1: Do I need separate credentialing contracts for the Group NPI/Tax ID now that care is expanding? Does this vary payer to payer?

Question 1: Historically, as a therapy group they have used SimplePractice for their practice management system (EHR, ERA, EFT, Billing etc. etc.), SimplePractice is not robust enough for the new Primary Care/Medication Management and they will need a new Practice management system. Is it possible to let all the therapists continue to use SimplePractice while just the medical practitioners use the New more robust system? Can a single Group NPI/Tax ID carry more that one practice management system and bill from both? The therapy providers LOVE simple practice and don't want to migrate, and the more robust medical practice manamgement systems are more expensive per provider, when only the medical staff need those more robust functions. If we cannot use the same Tax ID/Group NPI for both systems, is it possible to create a new group/tak ID for just the medical providers?

We a bit lost, so any advice on merging this behavioral health practice with its new Primary Care & Psychiatric Medication Management branch is greatly appreciated! Thank you all!

 

[ntreber]

I recomend that you contact your payors as most have seperate contracts for Primary care and Mental health. Some also have seperate Claims addresses. I work for an FQHc and we have primary care and mental health sevcies and have one group NPI / Tax ID.

 

[Troykall1]

Hi, We are a HIV support integrated care clinic with medical, dental and behavioral health. I also do credentialing and we just added behavioral health to billing, before they were 100% grant funded. I would check with your state first, in Colorado we have to have a separate NPI for each specialty and location. So we have 4 locations and 3 specialties so we have 12 clinical NPI. We have one Tax id. Your BH contracts are most likely with a BH carve out like carelon, contact them and see who you need to contract with for medical. If it is like Anthem, Aetna and Kaiser you can just add your new providers to your contract.
EMR. We use two, softdent and Athena. BH and medical are on one and dental the other. We had to make our own macros and adjust the system a bit to accommodate BH but it is working. If you can use one system I would, having two is a challenge. Our Anthem and Aetna checks come for all three programs into one system and we have to work the dental out of one and then post them to the other. You got this, just move forward as if you are adding new providers (you are) and a new specialty (you are) communicate with your payors and you will be up and running in no time.