Maintaining Licensure

Providers must maintain State licensure without lapses. They must also obtain necessary Continuing Education as required by the applicable State licensing board. 

Compliance with State and Federal Laws

Providers must adhere to State and Federal regulations regarding confidentiality (Health Insurance Portability and Accountability Act of 1996 [HIPAA], and CFR-42 Part 2), the management/storage of Protected Health Information (PHI) as well as charting and billing standards. Providers must also follow laws regarding mandated reporting and duty to warn standards. Any potential violations of law need to be disclosed to Foundations’ leadership in a timely manner regardless of accidental or intentional action. 

Protecting Client Confidentiality

In accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), providers maintain the responsibility to maintain client confidentiality with regard to Private Health Information (PHI). PHI includes and is not limited to: Clients’ names, dates of birth, phone numbers, addresses, email addresses, diagnoses as well as any other potentially-identifying information. Providers will: 

• Refrain from discussing or disclosing PHI to any entity outside of Foundations Family Support without prior written approval from the client (See Releases of Information and Records Requests). 

• Abstain from sharing, sending, or leaving client chart information visible. 

• Refrain from using personal communication devices and platforms to communicate with clients. 

• Maintain use of HIPAA-compliant communication with clients using SimplePractice Secure Messaging, Foundations’ HIPAA-compliant email, and/or using provided HIPAA-compliant phone services via Phone.com. 

• When using email to multiple clients, providers must use the Blind Carbon Copy (BCC) email feature or can request that Foundations’ contact consumers on their behalf. 

In the event of any potential leak of PHI outside anyone authorized to view the PHI, please report immediately to Foundations’ at: support@foundationsfamilysupport.com

Honest Disclosure of Background Investigations/Convictions 

Providers must submit to a background check upon hire and annually thereafter. Providers are required to report/disclose any investigations, charges, and/or convictions past and present to Foundations' leadership immediately. 

Ethical Practices 

Foundations’ providers adhere to American Counseling Association (ACA) Code of Ethics as well as National Association of Social Workers (NASW) Code of Ethics. These codes include and are not limited to the following:

• Foremost preventing harm to consumers

• Working in the best interest of our consumers

• Maintaining ethical boundaries in helping relationships

• Refraining from dual relationships 

• Practicing with honesty and integrity

• Truthful documentation and billing

• Protection of consumer privacy

• Working collaboratively with the team and other providers

• Advocating for the best interests of consumers

• Consulting and staffing ethical dilemmas 

Being a Healthy Helper

Providers at Foundations are encouraged to practice ongoing self-care and when needed, obtain personal counseling to address the prevention of vicarious trauma and burnout. Foundations leadership values provider’s use of healthy boundaries, taking vacation, taking days off, spending quality time with friends and family and community, and setting healthy work-place boundaries. Providers are empowered to make healthy choices for self as well as to model these choices for consumers. 

Updating Foundations on Changes

Providers must update Foundations with any changes related to:

• Address, phone number, personal email addresses

• Banking/direct deposit information 

• Ability to perform counseling

• Licensing status

• Other sources of income

• Any information regarding safety that may impact colleagues and consumers 

Accurate Time Tracking

Providers must track hours worked under the following guidelines:

• No more than 40 hours per week worked unless prior authorized

• May include work-related training/self study within a typical Monday through Friday 9am to 5pm work day with prior approval

• Hours may be flexed with provider discretion while not going over 40 hours per week

• Provider may choose to leave office/work early at provider discretion using either accrued PTO (with prior approval) or time without pay

• Providers need to inform Foundations leadership if time tracking errors are made in a timely manner

• Maintain a 65% or better productivity rate on monthly average

Insurance Fraud Prevention

Providers must use correct billing codes and times for services rendered and agree to seek training/consultation when unsure what billing codes are appropriate. Providers can find up-to-date billing code standards on Foundations’ staff website. Correct service status (Show, Canceled, Late-Canceled, No-show) must be indicated prior to the end of day. 

Scheduling and Consumer Care

Providers are responsible for maintaining up-to-date calendar availability. Providers are responsible for scheduling consumers, marking cancellations and no-shows, and contacting consumers when calling out sick when needed. Providers may choose to reach out to Foundations leadership for support with this as needed as well. Providers are responsible for the timely and ethical care of consumers assigned to their caseloads and must timely and accurately document all consumer interactions within 24 hours of interaction. Providers are responsible for safety and risk assessment of consumers on assigned caseloads as well and must refer to high levels of care should assessed consumer risk/safety exceed the abilities for services at the outpatient level of care. Providers must be available to meet with consumers at a frequency that is clinically appropriate and will refer clients to other providers or community resources when clinically indicated. Collect and maintain accurate client demographics, contact information, insurance/billing information, and to timely discuss balances due with their clients. Providers taking more than two weeks consecutive vacation will need to staff this with Foundations leadership and coordinate appropriate backfill support for consumers. 

Being a Good Steward of Technology and Office Space

Providers will maintain a working smartphone with a passcode enabled. Providers must use all Foundations-supplied office technology in ways that prevent damage and do not violate State and Federal Law. Providers may be charged for broken/damaged office equipment unless damage is obtained through unsafe consumer behavior. Providers work collaboratively to help keep office spaces and common spaces clean/sanitized as an effort to prevent janitorial costs. These savings are passed onto provider compensation.

Foundations will work to maintain healthy, clean, and functioning office spaces that are supplied with basic office supplies and working technology. Foundations maintains HIPAA-compliant email and telephone systems as well as an updated website. 

Provider Advocacy

Foundations’ leadership will advocate for the health and safety of our providers. Leadership will encourage healthy boundaries with work and home-life. Leadership will also stand with providers as a support regarding and not limited to:

• Distressing consumer and/or community interactions

• Dissatisfied consumer interaction

• The compensation of services 

• Legal and/ethical disputes

Timely and Adequate Consultation/Supervision

Foundations will strive to make available quality and qualified supervision and consultation to support the pursuit of licensure, ongoing learning objectives, ethical decision-making, community resources and referrals, and/or crisis support. 

Foundations’ Duties

• Maintenance of Liability Insurance

• Timely and Accurate Billing 

• Reasonable Safety of Consumers and Providers 

Performance Reviews

Strengths-based performance reviews will be conducted by Foundations leadership annually during the month of June each year. Employees are assessed on the following strengths:

• Collaborative Mindset and Teamwork

• Ethical Practice 

• Healthy Boundaries with Work/Personal Life Balance

• Timely Documentation

These reviews should be completed collaboratively when possible and will incorporate feedback from both leadership and employees. 

Action Plans and Termination 

Providers failing to adhere to items listed under Employee Responsibilities and/or with Performance Reviews indicating significant areas of growth may be placed on an Action Plan and/or be terminated from employment with Foundations. Any behavior deemed by Foundations Leadership to be egregiously unethical, unprofessional, in violation of “Who We Are” and/or illegal will result in immediate termination of employment. 

Action Plans

An Action Plan (Correction Plan) must state the unmet Employee Responsibilities (need for growth), provide a plan for how a provider will come into compliance with the applicable Responsibilities, identify a timeline for the completion of this plan and/or when this will be re-assessed. The Action Plan must also include the employee’s strengths and how these will be supportive in their coming into compliance. These plans must be signed by both the employee and by Foundations Leadership. Failure to meet compliance with Action Plans may result in termination of employment. 

Ensuring Client Safety

Foundations manages HIPAA compliance across our systems to maintain confidentiality of clients. Foundations also processes and addresses client grievances and concerns to protect client safety in services. Additionally, Foundations works to maintain safe and healing office environments.

SimplePractice 

Foundations’ Providers use SimplePractice Electronic Medical Records (EMR) services for cloud-based scheduling, documentation, and billing. 

To login: https://secure.simplepractice.com/

Client Portal: https://foundationsfamilysupport.com/client-portal

Google Workspace

Foundations contracts with Google Workspace services for HIPAA-compliant email services, document creation and storage, and data collection. 

Included Services:

• Document/Word Processing: https://docs.google.com/

• Spreadsheets: https://sheets.google.com/

• Form/Data collection/Storage: https://drive.google.com/

• Email https://www.gmail.com/

• Calendar: https://calendar.google.com/

• Video Conferencing: https://meet.google.com/

Phone.com 

Phone.com provides a cloud-based and HIPAA-compliant phone management and voicemail/fax solution. 

Included Services:

• Calling from smartphone/computer

• Faxes

• Voicemail

Tips for managing new client intakes:

• Ensure your calendar and availability are up-to-date

• Communicate with administration on openings for new clients

• Inform administration on the populations you want to see

• Letting administration know when a client is not a good fit

New Clients

All new clients are considered "Prospective Clients” pending the completion of consent documents and intake paperwork. These will be displayed on the “Inquires page.” Foundations administration processes these daily to help ensure that consent paperwork is completed and that intake paperwork is in process of being completed prior to being assigned to a provider with openings, or added to a provider’s waitlist. 

Once a client is added to a provider’s caseload either as active or as waitlisted, the provider may review these intake documents and determine if this is a good fit. If this is not a good fit, the provider will inform administration and the chart will be reassigned. If the client is a good fit, a provider can move forward with seeing this client as scheduled or reaching out to schedule an intake appointment. 

Providers are welcome to review the inquires page and inform administration on a willingness to accept a client and/or a reason why they would not accept the client (perhaps due to ethical issues such as a potential dual relationship or other conflict of interest). However, providers will find the most information after a client has been added to their caseload or the waitlist.

Clients are added to a provider’s caseload or waitlist based on a number of factors. Priority is experience and willingness to work with a particular population and/or to treat a specific concern. Secondary is the location and the times available that work with the client as well as the provider. New providers to the practice can opt for an expedited process for building a caseload in a more timely manner also ensuring that client engagement is higher. 

Primary CPT 

Can bill for only one per day:

90791 (Intake Assessment): Can be billed once a year per provider and covers updates to assessments and enrolling one in services.

90837 (Individual Psychotherapy, 53+ minutes).

90834 (Individual Psychotherapy, 38-52 minutes).

90832 (Individual Psychotherapy, 16-37 minutes).

90847 (Family Therapy, With Client Present).

90846 (Family Therapy, Without Client Present).

Use 95 Modifier for telehealth appointments.

Use 59 Modifier on any Family Therapy session that takes place on the same day as an Individual Psychotherapy session for a client.

Add-on CPT (In conjunction with primary)

90785 (Interactive Complexity): Use with any Individual Psychotherapy service that requires any additional equipment and/or the use of an interpreter. These include: Art Therapy, Play Therapy, EMDR, Drama Therapy, etc. (Cannot be used with Family Therapy sessions).

99354 (Prolonged Service): Use with any 90837 Individual Psychotherapy that goes 30 minutes over the initial time.

99355 (Prolonged Service Extended): Use with any 90837 Individual Psychotherapy with 99354 Prolonged Service for every hour over the first Prolonged Service of 30 minutes.

Use 95 Modifier on each for telehealth appointments.

Use 59 Modifier on any Family Therapy session that takes place on the same day as an Individual Psychotherapy session for a client.

Modifiers need to be added to each CPT code used. 

Providers add assessments, including for Intake Assessments, within the client chart by clicking “New> Other Document” and then from the drop-down menu, choose the assessment desired. 

These include:

• Intake Assessment

• Diagnostic Tools/Screeners

• Safety Plans

• More

Sending Assessments and Documents in the Portal

In the client chart, click on the “Files” tab. Then, choose “Actions> Share with client.”

Clinicians are responsible for maintaining all charting. It is best practice at Foundations to utilize collaborative documentation in sessions. Charting must be completed by the provider within 24 hours of service interaction. This is mandated by state law. 

It is the clinician’s responsibility to confirm that the following are in the chart:

• Signed consents to treat (Informed Consent)

  • Must be signed by the client if age 13 or over, signed by parent if age 12 or younger

  • Must be signed by client on or after turning 13 years of age

• Billing consent

• Any required Release of Information (ROI) for all collateral parties

• Any court-ordered documents and/or parenting plan documents 

• Any collateral documentation to support treatment

Appointment Status

Providers need to review and update appointment statuses prior to the end of the day to ensure proper billing. The default status is “Show” and means that the client attended this service and will be billed and/or have insurance billed. A “Canceled” Status means that a client canceled this session more than 24 hours in advance OR a therapist canceled this session at any time. Clients nor their insurance will be billed for a canceled session. “Late Cancel” means that a client reached out to cancel a session in less than 24 hours notice. The default charge for this is listed in the session tab and must be changed to $100 (commercial plans) or $0 (Medicaid plans) by the provider for accurate invoices being sent to consumers. This is the same for a “No-show” status wherein a client failed to attend the scheduled appointment and did not notify the provider. Providers must then change the fee to $100 (commercial plans) or $0 (Medicaid plans) to accurately charge proper fee. 

Intakes:

• Ensure billing code is 90791 (Intake)

• Confirm Self-Pay or Insurance Billing — Edit this in client chart under “Edit Client Info/Billing” 

If client DID complete online forms: Ask if they would like to have paper copies of consent documents (Privacy Practices, Informed Consent, and Practice Policies) and review the content of these. Have them sign the one-page Consent Form initialing that they have received these documents (to be scanned into their chart). Confirm address/phone number, birth date etc. Ask to see the insurance card and confirm the ID was entered correctly. 

Create an Intake Assessment form: From within the consumer chart. Copy/paste client responses from the self-report intake form  into Intake Assessment form and expound on clinical symptoms to justify any diagnoses provided—consider that these may be released to outside organizations. Add information such as gender identity, sexual orientation, religion/faith, age, race/ethnicity, disability, etc. within the reason for treatment. 

Add Progress Note for the Intake Service:

Description: document that you have reviewed consents, credentials, no-show policies, and confidentiality/mandated reporting. Document any ROIs signed. Document any safety concerns. Document any diagnosis provided.

Impression: How did they seem? Affect? Dress? Orientation? 

Plan: What are next steps in the process

Add a diagnosis to the intake progress note: This will automatically generate and prompt the creation of a Treatment Plan. This does not need to be completed in the intake session. 

Create Mental Status Exam: This is located in the chart; “Add New> Mental Status Exam.” 

If client DID NOT complete online forms: Review Paper Copies of Privacy Policies, Informed Consent, and Practice Policies and provide client these in physical form to take home. Ask that they initial and sign the one-page consent form (to be scanned into chart). Obtain Demographics (Birthdate, Address, Phone Number, Sex, and Ethnicity) and Insurance information. Verify name in the chart and name on insurance card and on photo ID. 

Create an Intake Assessment form: From within the consumer chart. Assess clinical symptoms to justify any diagnoses provided using client voice—consider that these may be released to outside organizations. Add information such as gender identity, sexual orientation, religion/faith, age, race/ethnicity, disability, etc. within the reason for treatment. 

Add Progress Note for the Intake Service:

Description: document that you have reviewed consents, credentials, no-show policies, and confidentiality/mandated reporting. Document any ROIs signed. Document any safety concerns. Document any diagnosis provided.

Impression: How did they seem? Affect? Dress? Orientation? 

Plan: What are next steps in the process

Add a diagnosis to the intake progress note: This will automatically generate and prompt the creation of a Treatment Plan. This does not need to be completed in the intake session. Though, a diagnosis is required before we can bill insurance.

Create Mental Status Exam: This is located in the chart; “Add New> Mental Status Exam.” 

Diagnosis and Treatment Plans are automatically initiated when a diagnosis is assigned to the Intake session. They can also be added within the chart: New> Diagnosis and Treatment Plan. Make sure to add previous diagnoses even if they are the same. Insurance claims will only pull diagnoses from the most recent treatment plan. No more than four diagnoses per client.

Create a “Basic Treatment Plan.” 

Set an Objective that is Simple, Measurable, Attainable, (in behavioral terms) Realistic, and Time Oriented. 

“Currently, {NAME} reports confidence in managing distress at a “__” on a scale of 0-10 with 10 being high confidence. Over the next 6 months or less, {NAME} would like this to increase to a “__” on the same scale. {NAME} will know that they are making progress when, “{ACTION/DOING STATEMENT}.” Progress toward this goal will be assessed by {NAME} report and will be considered met when it has been sustained for {TIMEFRAME}.”

For interventions, be sure to cover:

• When/where and how often services will take place and for what purpose 

• What Therapist will provide explaining any terms that are used in simple language

• What the client will do

• How often the plan will be reviewed and/or updated

• Who all will be involved in the client care (community supports)

• Which client strengths will work toward the goal. 

Treatment plan gets saved, printed, and then the client signs this (to be scanned into the chart).

• Offer client a copy of this plan

• Document in the note that the treatment plan was created, signed, and if client accepted/declined a copy.

• Treatment Plans are reviewed/updated every 6 months

Updating Diagnosis and Treatment Plans:

• Create New Diagnosis and Treatment Plan

• Click “Create from previous one”

• Make any updates needed

• Note previous goal and progress made from this

• Print/sign/scan into file

Make sure to add previous diagnoses even if they are the same. Insurance claims will only pull diagnoses from the most recent treatment plan. No more than four diagnoses per client.

Clinicians are responsible for maintaining all charting. It is best practice at Foundations to utilize collaborative documentation in sessions.

Each billable service must include a progress note and are completed within 24 hours of service. Providers Should use the standardized Progress Note template available in the dropdown menu. The option to add a note will automatically become available directly from the provider’s calendar as well as from within the consumer’s chart at or after the time the session has begun. To add a progress note to a future session, this can be accessed from the calendar, clicking on the appointment, and choosing “Add Note.” 

Progress notes must Include:

• Accurate number of minutes of session duration 

• When/where the session took place

• Where the client was located and where the provider was located for telehealth sessions

• How the consumer appeared/presented in the session

• Clinical activities that occurred AND how they are connected to the Diagnosis and Treatment Plan

• Any changes/updates to treatment plans

• Any documents/assessments that were completed/signed (ROIs, Consents, Measures, Safety Plans, etc)

• The impression of progress made toward treatment plan goal(s) and/or motivational stage of change

• Any potential risk factors present

• Plans for next sessions

Services described in the progress note must match the billing code entered on the drop down CPT code list on the calendar view.

Consumers who are no longer enrolled due to completion of treatment goals, transfers of care, choosing to end services against medical advice, and/or not engaging with Foundations for more than three consecutive weeks require a Discharge. 

To add a Discharge: Within the consumer’s chart, click New>Assessment, then in the drop-down menu, be sure to select Discharge. 

Chart the following information:

• Reason for counseling and the goals set forth in the therapeutic episode

• Progress observed by counselor as well as consumer report using consumer words

• The reason for discharge

• Any recommendations for future supports

Save and sign this assessment. 

To finalize the discharge: WIthin the consumer’s chart, click Edit. Then, change the drop-down indicating “Active” to “Inactive.” Then click “Save.” 

All requests for records need to be: 1) In writing 2) signed by the authorized requestor and/or 3) have a signed ROI in place authorizing these to be released. Consumers are able to request records by either speaking with their counselor and completing the Records Release form in the client portal, or by signing the paper document, or can do so themselves by downloading the form and following directions online. 

All records requests need to be reviewed and processed by Foundations’ leadership and with permission of providers when available. These may be subject to a fee to consumers.

Providers must be trained in using telehealth prior to engaging in telehealth therapy. Telehealth must include synchronized video and audio sessions to qualify for insurance billing. This means that telephone and/or email communication is not billable. Consumers seeking telehealth therapy must sign a telehealth consent as well. Telehealth is built into the SimplePractice EMR and is secure and HIPAA-compliant. 

A client’s chart may be set to the telehealth “Video Office” by default by changing this setting within the client’s chart: “Chart >Edit >Location> Video Office.” In doing so, it is important that email appointment reminders be enabled. SimplePractice will then email a client a unique link to join this session 10 minutes prior to the beginning of each session. 

An appointment may be changed to telehealth individually as well by accessing the appointment via the calendar view and changing the location to “Video Office.” At this time, it is important that the provider then “Share Link” via email reminder from the appointment dialogue box as well. 

For any sessions using telehealth, the modifier “95” must be included in the first of the four text boxes located under the CPT billing code drop-down box. 

There are free apps available for iPhone and Android smartphones that can be downloaded from the respective App Store and Play Store. 

To refer a consumer for medication management or to another provider, a provider must write this as an intervention in the treatment plan. Next, add a task for admin to reach out for scheduling:

1. Navigate to "Tasks" on the left hand side of the SimplePractice window

2. Create New Task

3. Add a description to let admin know what type of request this is and assign it to Trevor Liebing

   4) Assign the Client that is being referred 
   

Prescriber will schedule with consumer for Psychiatric Assessment. Prescriber will confirm that Medication Management is listed in the Treatment Plan. This assessment is located in SimplePractice within the consumer’s chart by clicking New>Assessments>drop down>Psychiatric Assessment. This intake will also be noted in a progress note. Appropriate prescribing will then be administered through e-prescribing services. 

NOTE: As prescribers are being included in the network, only self-pay services are available. This means that prescribers will need to include a Good Faith Estimate for all consumers (See more in Billing and Invoicing Consumers).

Medications are managed in the chart within the “Medications” tab.

Clients in Emotional Crisis

• Attempt to safety-plan with client and document that crisis contacts have been provided 

• Obtain a verbal/written commitment to personal safety: Document this in the chart AND/OR:

• Cancel upcoming appointments for the rest of the day

• Contacting Crisis Line: 988 

• Provide your location

• Use your personal cell number for call back if possible

• Inform Trevor Liebing (Personal Cell: 509-990-4574) Texting is best/quickest

• If the client is under the care of a guardian, the guardian may be instructed to take the client to Emergency if safe to do so; offering to meet them there

• If the client is an adult or is alone, it is best to attempt to keep the client in the office until crisis personnel can attend

• Document concurrently in client chart or as soon as possible 

• Meet client for warm transfer at Emergency Department if possible 

IF THE SITUATION IS NOT SAFE AND YOU ARE FEELING AT RISK FOR PHYSICAL HARM:

• Leave this situation immediately

• Contact 911 from your personal cell

• Avoid using your car

• Contact Trevor Liebing (personal cell: 509-990-4574) by calling/texting

Clients Expressing Homicidal Thoughts/Intent:

• Collect information on intended victim(s) and/or any foreseeable victim(s) ONLY IF SAFE TO DO SO

  • Name

  • Location

  • Contact information

• Attempt to gain commitment to safety and safety plan with client

• Do NOT attempt to keep client in the office

• Notify Police by calling 911

• Notify intended victim(s)

• Document these interactions in client chart ASAP

• Inform Trevor Liebing (personal cell: 509-990-4574) call/text

Any abuse of a minor, past or present/ongoing, MUST be reported to Child Protective Services, and/or law enforcement. Information should be first-hand knowledge/experienced by the client. Third-hand knowledge may not need to be reported based on staffing/consulting with a supervisor.

CURRENT/RECENT ABUSE PHYSICAL, SEXUAL, AND/OR NEGLECT OF A PERSON UNDER THE AGE OF 18:

• If alleged abuse is occurring within the family

  • Contact CPS: 1-800-557-9671

• If alleged abuse is occurring outside the family

  • Contact Law Enforcement: 911 or

  • CrimeCheck: 509-456-2233

• Depending on the situation, it may be best to inform the family that a report will be made. It may be best to make a report(s) with family present as well.

• Document all details, in clinical terms, using client voice as much as possible. Document that report has been made including name of intake caller.

PAST ABUSE PHYSICAL, SEXUAL, AND/OR NEGLECT OF A PERSON STILL UNDER THE AGE OF 18:

• Same as above

• Note that if abuse has taken place outside this local area, you will need to report the alleged abuse to authorities with jurisdiction over where alleged abuse had occurred.

• Document these interactions and staff with other providers

PAST ABUSE PHYSICAL, SEXUAL, AND/OR NEGLECT OF A PERSON WHO IS CURRENTLY OVER THE AGE OF 18:

• Does the alleged abuser still have contact with children or other vulnerable populations?

  • If YES- proceed with reporting protocol

  • If NO- place report with participation/willingness of client

• Document these interactions and staff with other providers

Tips for a smoother process:

• Reviewing correct spelling of client names

• Having the correct birthdate

• Accurate and timely updates to insurance information 

• Using authorized diagnosis codes

• Having up-to-date payment card on file

• Discussing with clients what it means to have a co-pay, coinsurance, or a deductible on the plan

• Being sure to change all no-show and late-cancel appointments to $0 for medicaid coverage or $100 for commercial coverage

After a client has been seen and when the required information is available in the chart, a claim for insurance is created and submitted. This happens daily at Foundations. After a claim has been processed by the payer, that claim is either returned with an EOB with a payment or an explanation of why payment is denied. Most payers are automatically updated within SimplePractice and reflect the status as they arrive and some are entered manually. Foundations bills for services at a much higher amount that is returned by payers. The remaining unpaid amount is considered a write-off. Outstanding claims as well as write-offs will display in SimplePractice as an “Insurance Balance.” If a client has a copay, coinsurance, or deductible, the EOB will state this and the amount required to be billed to the client. This amount will be displayed as “Client Balance.” If the client has a secondary insurance plan, the provider will submit a Helpdesk ticket to alert Foundations that these will need to be processed. Secondary claims are then submitted to the secondary payer along with the original claim as well as the returned EOB from the primary payer. All payments received by insurance payers as well as by clients within a pay period will be processed for commission after the close of the pay period. 

A paid claim means that all or part of the claim has been paid by an insurance payer. The write-off will still be calculated and added to the "Insurance Balance.” Most claims are paid within two weeks of the service date with some payers taking up to forty days or more.

A denied claim may mean that the client is responsible for paying for services at the contracted rate if there is a deductible, or a reduced sliding scale rate if they do not have insurance coverage at the time of service. Other possible reasons for a denial can be: incorrect information in the chart, ineligible diagnosis code, or insurance payer error. Denied claims that are not going to a client’s deductible are processed, corrected, and resubmitted weekly. 

Sliding Scale

Clients without insurance coverage or who are paying out of pocket are automatically enrolled in sliding scale with a reduced fee of $100 per session.

Good Faith Estimate

In line with the No Surprises Act, any self-pay or out-of-network services need to include a Good Faith Estimate. This will include the fee for service as determined by Sliding Scale as well as the approximate number of services estimated to address consumer’s treatment goals. 

These are added in the consumer’s chart by clicking New>Good Faith Estimate

Client balances are amounts that are due to Foundations through means of self-pay, insurance copays, coinsurance fees, deductibles, records request fees, and/or late-cancel or no-show fees. 

These can be paid online by clients by logging into the client portal at www.foundationsfamilysupport.com

Clients with large insurance deductibles may benefit from applying for a payment plan. For a payment plan, we must have a valid payment card entered into the application at www.foudationsfamilysupport.com/payments 

Payment plans are then processed each month charging the amount agreed to by the client to their payment card. 

Clients with a balance of $300 or more are not able to continue services with Foundations until a plan is in place to pay the balance. Administration will inform the provider of this balance and the need to either pause client care or plan for a discharge. 

Pay periods begin at the 1st of each month through the 15th of each month and then from the 16th through the last day of the month. Payroll is then processed on the following business day. Commission is a set percentage due to providers that is paid out after the close of each pay period twice a month. This is calculated as the commission percentage of all payment returns within the allotted pay period.  

Tips on calculating your commission:

• Most accurate after the close of the pay period

• In SimplePractice, navigate to the “Analytics” page

• Select “Custom” for the time frame

• Choose the dates of the pay period (1st through the 15th OR 16th through the last day of the month)

• The amount displayed is the total revenue for billing within this period

• Your commission will be the percentage of that amount

From the staff webpage, employees have access to important links and document downloads. This is accessible: www.foundationsfamilysupport.com/staff

Employee Documents and Links:

• Direct Deposit (Document)

• Timesheet (Logging Time) 

• Internal Referral

• Virtual Staff Meeting(s)

• Employee Handbook

Employees are empowered to track their working time and log this twice monthly. Hours are logged on the 15th and the last calendar day of each month by the end of day. Employees are to honestly track working hours within a typical 40-hour work week including but not limited to:

• Working with clients

• Documentation

• Phone calls

• Supervision/consultation

• Approved Training(s)/Study

Timesheets are accessed via the Foundations' Staff page resources. 

Time not qualified for pay:

• Personal calls/web use

• Leaving office earlier than typical

• Arriving to office later than typical 

• Non-approved training/study

• Non-approved consultation

• Hours more than 40 per week without authorization 

Paid Time Off accrued over time with approximately 2-4 paid weeks full-time employees per year. PTO is paid out based on the previous 90 days commission rate per hour and is not eligible to be paid out to employees leaving Foundations. 

Taking/Requesting Time Off

When requesting Paid Time Off (PTO), contact a supervisor minimum one week in advance prior to planned PTO for approval. PTO may be denied by leadership. Enter all approved PTO on the Employee Timesheet.

It is a primary principle within Foundations to pay therapists the most that can be afforded in an effort to elevate the profession and to reward the hard work and dedication of employees. Compensations are hourly with built-in flexibility allowing choice with taking PTO/Sick Leave or choosing Time Off without pay. 

Full-time Licensed

• 55% Commission

• PTO

• Sick Time

• 401K and Matching

• Dental

• Vision

• Health

Full Time Associate 

• 50% Commission

• PTO

• Sick Time

• 401K and Matching

• Dental

• Vision

• Health

Part-Time Licensed 

• 50% Commission

• PTO

• Sick Time

• 401k and Matching

Part-Time Associate

• 50% commission

• PTO

• Sick Time

• 401k and Matching