How to Set Up Your Intake Series for Mental Health Practices
The intake process is a crucial step in mental health care, setting the stage for a thorough and personalized treatment plan. In today’s blog post, we’ll be discussing how to set up an effective intake series, from the ideal order of sessions to strategies for making both patients and clinicians comfortable with the process. Whether you're working with minors or adults, this guide provides actionable insights to ensure that your intake process is comprehensive, efficient, and centered on patient care.
What Is the Ideal Order for Conducting a Mental Health Intake Series?
The ideal order of the intake process differs for minors and adults.
For Minors
The intake series typically begins with a session involving caregivers, ensuring their involvement from the outset. After that, the clinician meets with the child, sometimes across two separate sessions spaced a week apart. This allows the clinician to observe the child on different days, providing a fuller picture of their mental health. The final session is dedicated to reviewing findings and discussing the treatment plan with both the caregivers and, if the child is 12 or older, the child as well (if appropriate).
For Adults
The intake process is generally shorter and may consist of two sessions. The first session covers the psychiatric assessment and basic intake information, while the second session dives into more detailed topics such as trauma history, family dynamics, and treatment planning.
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In both cases, the clinician ensures a thorough assessment is conducted, gathering all relevant information to create a solid foundation for the patient’s treatment plan.
How Should Mental Health Clinicians Approach Billing for Their Intake Series?
Billing for the intake series can be complex, but using the appropriate codes is essential for proper compensation.
Prescribers typically use the 90792 code, while non-prescribers use 90791. These codes can be billed multiple times during the intake process, but some insurance companies have started limiting how many times they can be billed. For example, one insurance company allows 90792 to be billed only twice for minors and once for adults.
Alternative billing options include Evaluation and Management (E&M) codes (99203 to 99205), which can be billed once for new patient visits. These codes can also be combined with a session extender code (99417) to bill based on time. Clinicians should carefully select the code that offers better reimbursement, as rates can vary.
Common challenges include:
Insurance companies sometimes reimburse intake codes at lower rates than follow-up visits, despite the greater complexity of the intake process.
Proper documentation is essential when combining intake codes with other services, such as psychotherapy or family therapy.
Best practices involve communicating billing expectations early, especially for patients with high-deductible insurance plans. Clinicians should handle office policies and payment details before starting the intake series to avoid confusion later on.
How to Handle Patients Who Only Want a Prescription During Intake
In some cases, patients or their guardians may want to skip the intake series and go straight to a prescriber for a diagnosis or prescription. When this happens, clinicians should clearly communicate the importance of the full intake process.
1. Setting Realistic Expectations
The clinician should explain that mental health diagnoses require time and a team approach. Rushing through the process can lead to inaccurate diagnoses, so it’s important to allow the intake series to play out.
2. Providing Education
Clinicians should emphasize that a thoughtful intake process leads to better treatment outcomes. This approach helps manage patient and guardian anxiety, especially when they expect quick results.
3. Flexibility in Rare Cases
While it's uncommon, there are situations where the diagnosis is clear, and the patient is suffering significantly. In these cases, a prescription may be provided earlier in the process, but this is the exception rather than the rule.
How to Help Patients and Families Feel Comfortable with the Mental Health Intake Process
The intake process can take several weeks, and some patients or their families may feel uneasy about the time commitment. Clinicians can help alleviate these concerns in several ways:
1. Reassuring Them of the Long-Term Benefits
Clinicians should explain that the time spent on the intake series will ultimately lead to better treatment outcomes by providing a comprehensive diagnosis.
2. Managing Expectations
By reminding patients that their issues may have persisted for many months or years, clinicians can frame the few extra weeks required for a thorough intake as beneficial in the long run.
3. Emphasizing Collaboration
Mental health treatment is a team effort. By taking a patient-centered, deliberate approach during the intake, clinicians set the tone for the rest of the treatment.
4. Normalizing the Time Frame
Clinicians should explain that seeing a patient on different days can reveal different aspects of their mental health, making the assessment more accurate.
The Benefits of Conducting Mental Health Intake Sessions a Week Apart
Conducting intake sessions a week apart allows both the clinician and the patient to take the time needed for a thorough assessment. This approach has several benefits:
1. Capturing Fluctuations in Mental Health
By spacing out sessions, clinicians can observe a patient across different days, providing a more balanced and complete picture of their mental health.
2. Reducing Pressure
A week between sessions gives both parties time to process information, reflect on findings, and prepare for the next step in the intake process.
3. Building a Stronger Treatment Plan
The gradual, thorough nature of spaced-out sessions gives the clinician more information, leading to a more tailored and effective treatment plan.
4. Building Rapport and Trust
With time to reflect between sessions, patients may feel more comfortable, leading to better communication and disclosure.
Mental Health Business Moment of the Week
In this week’s business moment, a rare and positive experience occurred during contract negotiations with an insurance company.
Typically, these negotiations happen over email, but this time, a representative from the insurance company scheduled a video call to discuss rates face-to-face. This was highly unusual, as most communications with insurance companies are impersonal and conducted via email or, at best, phone calls.
The video call allowed for a more personal, rational, and productive conversation, signaling hope for a better outcome. While the final decision on rates is still pending, this approach felt like a step forward in fostering better communication between providers and insurance companies.
Setting Up a Successful Intake Series for Your Mental Health Practice
Setting up an effective intake series is essential for ensuring thorough, personalized patient care. By taking the time to follow the right steps, spacing out sessions, and being clear with patients about the process, clinicians can gather the detailed information they need to create strong treatment plans. Additionally, handling billing appropriately and maintaining open communication with patients helps smooth the intake process, benefiting both clinicians and those they serve.
Stay tuned for more insight and stories in next week’s blog post!
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