Joe Feldman | Navigating Insurance Denials: Changing the System for Mental Health | TPOT 361
The Practice of Therapy Podcast with Gordon Brewer
Release Date: 12/16/2024
Joe Feldman | Navigating Insurance Denials: Changing the System for Mental Health | TPOT 361
The Practice of Therapy Podcast with Gordon Brewer
Medical necessity—a term that seems straightforward—often becomes a complex hurdle in the world of healthcare, especially in mental health. Joe Feldman, founder of Cover My Mental Health, sheds light on the disconnect between clinical care and legal frameworks, and shares how his nonprofit empowers patients and clinicians to navigate these challenges effectively. What is Medical Necessity? Contrary to what many assume, "medical necessity" is not a clinical term; it’s a legal one. As Feldman explains, most healthcare professionals are trained in safe, effective care aligned with ethical...
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The Challenges of Private Practice | TPOT 360
The Practice of Therapy Podcast with Gordon Brewer
Starting and running a private practice is a journey filled with challenges, growth opportunities, and the potential for both professional and personal fulfillment. Gordon Brewer, a seasoned mental health professional and founder of The Practice of Therapy, reflects on his journey into private practice, sharing insights that are both inspiring and practical for current and aspiring private practitioners. The Journey to Autonomy Gordon began his private practice journey in 2006 after gaining extensive experience working in nonprofit agencies. While he credits his nonprofit work for providing...
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Keith Kurlander | The Power and Potential of Psychedelic Therapy in Private Practice | TPOT 359
The Practice of Therapy Podcast with Gordon Brewer
In this episode of The Practice of Therapy Podcast, Keith Kurlander opens up about growing his therapy practice in Boulder, Colorado, navigating high competition and high demand. From door-knocking to diving into the digital world with paid advertising, Keith shares how embracing online marketing and specializing in sought-after areas helped him stand out in a crowded field. He also offers strategies for new and growing practitioners, from networking basics to expanding into group practices. Plus, Keith dives deep into the future of psychedelic therapy, exploring its transformative potential...
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Nicole McCance | Systemizing: Setting Your Private Practice Up for Success | TPOT 358
The Practice of Therapy Podcast with Gordon Brewer
In this episode of The Practice of Therapy podcast, host Gordon Brewer talks with Nicole McCance, who shares her insights on scaling a therapy practice through effective systems and strategic hiring. Nicole emphasizes the importance of systemizing processes before bringing new hires on board, helping therapists avoid the overwhelm of constant questions and task management. She reveals that many therapists dive into hiring without setting up essential workflows, which can quickly turn them into “chief question answerers” rather than effective leaders. Nicole discusses the power of...
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Crystal Adams-Scott | Connecting Communities: The Power of Intentional Kindness | TPOT 357
The Practice of Therapy Podcast with Gordon Brewer
Crystal Adams-Scott shares the powerful story behind Hope Unite, a movement born from her and her son’s act of kindness. Driven by the message “You matter,” which she believes could have saved her husband’s life, Crystal discusses how simple cards adorned with a purple rose serve as reminders of worth and invitations to spread kindness. With volunteers distributing these cards across the U.S. and beyond, the initiative not only promotes kindness but also connects individuals in crisis to vital resources like the National Suicide Prevention hotline. Crystal emphasizes the...
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Sanjana Sathya | Simplifying Payments from Clients With Superbills | TPOT 356
The Practice of Therapy Podcast with Gordon Brewer
Navigating the world of therapy payments can be a maze for both therapists and clients, especially when insurance and out-of-network benefits come into play. Sanjana from Thrizer breaks down how their platform simplifies this process and how it helps make therapy more accessible for clients while ensuring clinicians get paid their full rate. Resources Mentioned In This Episode Start your free trial and enjoy waived credit card fees for your first $2,500 in charges: Meet Sanjana Sathya Sanjana is a co-founder at Thrizer. She is passionate about helping people access quality and...
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Tiffany Duffing | The Road to Growth: Building a Purpose-Driven Private Practice | TPOT 355
The Practice of Therapy Podcast with Gordon Brewer
In this episode of The Practice of Therapy Podcast, Tiffany dives deep into the intricate relationship between anxiety and gut-brain interactions. She explains how anxiety can affect the gut in ways that aren’t always obvious, with some people experiencing clear GI issues, while others may have subtle gut disturbances without noticeable anxiety. Through relatable examples, Tiffany illustrates how thoughts, self-talk, and physical symptoms are interconnected, highlighting the bidirectional communication between the brain and the gut. Beyond the science, Tiffany also shares key insights for...
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Encore: Jenn Fredette | The Private Practice Guide To Copywriting | TPOT 354
The Practice of Therapy Podcast with Gordon Brewer
Do you need help with your private practice website? Jenn Fredette joins us to discuss the transformative power of strong copywriting and how it can elevate your online presence. When it comes to crafting compelling copy for your website, having a clear niche is crucial. By defining your niche, you can tailor your message to resonate deeply with your ideal client, making your marketing efforts more effective and targeted. Jenn Fredette, an expert in copywriting for private practices, shares valuable insights on refining your website’s copy to attract and engage the clients who are the...
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Encore: Mike Michalowicz | Revolutionizing Hiring Practices in Private Practice | TPOT 353
The Practice of Therapy Podcast with Gordon Brewer
In this episode of the Practice of Therapy Podcast, Mike Michalowicz dives into a transformative approach to the hiring process: recruiting workshops. Traditional interviews, as it turns out, have proven less effective than anticipated, with a mere 10% of candidates hired through this method turning out to be great performers within organizations. This often results in mishires and mismatches that hinder a company’s growth. We explore how recruiting workshops can revolutionize talent acquisition, elevate organizational success, and foster a paradigm shift in hiring, emphasizing unproven...
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Encore: Kati Morton | Using YouTube and Social Media to Leverage Mental Health Information | TPOT 352
The Practice of Therapy Podcast with Gordon Brewer
In this episode of The Practice of Therapy podcast, Gordon Brewer welcomes Kati Morton, a licensed therapist and YouTube sensation whose channel has become a sanctuary for many seeking mental health support. Kati’s journey is unique; she has not only provided education through her videos but also built a thriving online community. Her dedication to fostering a safe and supportive space has allowed individuals to feel connected and seen, even when traditional therapy may feel isolating. Listen in as Kati shares the behind-the-scenes of her YouTube channel, how she balances her online presence...
info_outlineMedical necessity—a term that seems straightforward—often becomes a complex hurdle in the world of healthcare, especially in mental health. Joe Feldman, founder of Cover My Mental Health, sheds light on the disconnect between clinical care and legal frameworks, and shares how his nonprofit empowers patients and clinicians to navigate these challenges effectively.
What is Medical Necessity?
Contrary to what many assume, "medical necessity" is not a clinical term; it’s a legal one. As Feldman explains, most healthcare professionals are trained in safe, effective care aligned with ethical standards, not in decoding the legal intricacies of medical necessity. This disconnect often leads to insurance denials, leaving patients stranded without the care they need.
Feldman highlights a key concern: insurance companies often deny claims for higher levels of care, such as intensive outpatient programs or residential treatment, by deeming them “not medically necessary.” This decision-making process frequently prioritizes cost-cutting over patient well-being.
Resources Mentioned In This Episode
- Read the full show notes here
- Use the promo code "GORDON" to get 2 months of Therapy Notes free
- Start Consulting with Gordon
- The PsychCraft Network
- The Practice of Therapy Community
- Mental Health Wear TN
- Full Focus Planner
- Cover MY Mental Health
Meet Joe Feldman
Cover My Mental Health President and Founder Joe Feldman began advocating for access to mental health care after overcoming denials for his daughter’s residential care, including with a successful federal lawsuit.
Feldman developed Cover My Mental Health based on his own success overcoming insurance obstacles, with input from leading litigators, appeals experts, clinicians, insurance regulators, and former insurance industry insiders.
His advocacy work has included policy-driven discussions with legislators and regulators, a board role with The Kennedy Forum Illinois, presentations to parent groups, and publication of actionable guidance, such as a 2021 article in the Journal of Psychiatric Practice on medical necessity letters.
Feldman also serves on the board of Thresholds, a Chicago-based firm providing support to those living with mental illness, and Acadian Kitchens, a for-profit seasonings business in Louisiana.