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Here’s a great post from Person Centered Tech on the new(ish) HIPAA requirements for online backup services.


I have used FirstBackup.com for years, and they are great.  $49 per year for 2 GB of storage, great customer service based in Iowa, and most importantly …. when my hard drive crashed, the restore process worked and I got all of my backed up date back!

Full disclosure:  if you click on my link, I make a little bit of money, but seriously, I would refer them no matter what!

Do you have a HIPAA security manual? You should!

I know, I know, it’s so easy to get overwhelmed with requirements for HIPAA.  At one point, I had a template to offer for building your own security manual.  Unfortunately, that link is gone.

But, luckily you can still learn why it is crucial to have your own HIPAA security manual, and how to go about it.  Visit Person-Centered Tech, and prepare to be impressed!

How to be HIPAA compliant

Here’s a great post by Mike Langlois, shared by Keely Kolmes, and now here. He makes some great points.


Sometimes it seems like a full-time job to keep up with HIPAA.  On January 25, 2013 the Department of Health and Human Services published its Final Rule, and one of its requirements is that certain changes be made to a “covered entity’s” Notice of Privacy Practices by September 23, 2013.

For a great summary of what is required, take a look at this article by David Jensen, JD, one of the staff attorneys for CAMFT.  It’s very helpful.

The title says it all.  This is not a good idea for so many reasons.  This week I heard a story that will really convince you.

I heard about a therapist, an excellent, conscientious person, who was on her LinkedIn profile, and somehow told it to “find friends” or the equivalent thereof.  So LinkedIn sent “invitations” to everyone on her email list (which means she had to give it her username and password), including a disgruntled client.  This client then reported her to the board, who dismissed the charge.  But the client is also suing her, apparently for malpractice for violating confidentiality.

Although this is the first time I have heard of a complaint, it isn’t the first time I have heard of a therapist making this mistake and accidentally mailing to clients.  How to prevent it?  Don’t put email addresses into online address books.  Use a different type of email client like Thunderbird that only “lives” on your computer, or use a CRM program (Contact Relationship Management) like ACT that again only lives on your computer.

Prevention is the best policy!



CPT code changes — a limited review

CPT codes changed as of January 1, 2013 and I found it a little confusing initially.  However, after talking to some colleagues who deal with getting insurance authorizations, and reading Barbara Griswold’s excellent Special Report (available for purchase on her website), I think I’ve got it figured out for my practice.  I’m just going to share what applies to me, and leave the more comprehensive analyses for other to go over.

I’ve generally only used three codes:  90801 for initial sessions, 90806 for individual 50 minute sessions, and 90847 for family therapy.  Initial sessions are an easy switch.  They are now 90791, Diagnostic evaluaiton (no medical).  90847 remains the same if there is an identified patient but the family or relationship in the room is the focus of treatment.  For sessions that only incidentally involve a family member (such as bringing a parent in for a few minutes), you’d use the code for individual therapy.

And that’s where I got hung up for a while.  The choices are 90834 for a 45 minute session, and 90837 for a 60 minute session.  My mind works in a way that said, “Round upwards”, so I had thought 90837 would be correct.  After reading Barbara Griswold’s report, I learned that 90837 is viewed as the equivalent of the old 90808, an extended session that is likely to be denied or require special authorization.  So, 90834 it is.  It will be interesting to see if the insurance companies use that code change as a change to shave a few dollars from their contracted rate.  Even though I’m not on any panels, that will still impact some of my client’s reimbursements.

In addition to Barbara Griswold’s site, I found some helpful information at Practice Central, and 2 great “crosswalk” charts at  Aetna’s site and http://www.aetna.com/healthcare-professionals/assets/documents/Crosswalk-2013-CPT-4-Coding-Changes.pdf

Back up your data — it’s crucial

After being in practice for 30 years, I am a big fan of being paperless whenever possible. Otherwise, I think I’d be at risk by now of being buried by cartons of old files and other records. But if you’re going to go paperless, you must back up!

First of all, we have a professional responsibility to keep our client records, and that is literally part of the standard of care. Licensing boards don’t want to hear that your hard drive crashed and you lost the patient records. Secondly, for our own peace of mind, we need to know that our data is safe from equipment error. [click to continue…]

I hear this question all the time, and read about it as well. Is a therapy practice some “different sort of animal”‘ or is it a business like any other sort of income- earning endeavor? I have never really understood why people feel the need to frame the question as some sort of “either-or” construct. Certainly a therapy practice is a different sort of business than selling purses, or computers, or building airplane parts, or flipping houses. I don’t think I need to go into detail about how it is different. [click to continue…]

Setting priorities for time and marketing

Starting the Practice Success Tools blog and website has been a fun and also humbling experience. I really love talking to therapists about practice-building and marketing, and I have lots of great ideas for how to build this site so that it can be really helpful. Finding the time to do more on it has been another story. Or, to be completely honest with myself and you, realizing that I have to choose how to spend my time very consciously has been enlightening.

This is true for all of us, and impacts how we build our practices. I am fortunate in that I’ve been in practice a long time in a city that has been very kind to me. So I am busy and that is good, but it’s not so good for this website. I have a very conscious set of priorities in how I focus my time, and often, I “run out of week” before I get to some of the things on my list. On the business side of things, first comes my current clients and current practice administration. Next comes following up on thank-you’s to those who have sent new referrals. Then comes practice development and marketing, which I write about in more detail in the Practice Success Tools newsletter (shameless plug to sign up for our free membership!) [click to continue…]

LinkedIn fun

Yesterday I decided to take a deeper look at LinkedIn for networking purposes. Oh my! I’ve been having so much fun, I’m going to need to rein myself in and get back to my “regular” work at my practice.

Specifically I found the group Links for Shrinks, and from them Facebook Marketing for Mental Health Professionals. These are really interesting groups, with great discussions. We’ll see what transpires from this. It’s an area I’ve been wanting to learn more about. As I learn, I’ll be publishing, here and even more so in the member newsletter. You’ll receive it when you sign up for our free membership. Happy networking!