What patient referrals can be expected?
Based upon your list of preferred clients and your state licensing, referral opportunities will occur. In some contracts Cogtrium is acting as a sub-network for inclusion in a larger health plan’s network. In these cases referrals will come from being a preferred provider in the larger network plan. For contracts where Cogtrium is providing direct access to Cogtrium providers to groups such as school districts and employers, referrals are made on the basis of your interest, acceptance of fee schedule, skill, licensing, and availability.
How does telehealth work with the Network?
Almost all services delivered by the Network are through telehealth. This is the reason for offering the Platform at such low cost and allowing use on a provider’s non-network patients. We firmly believe that more experience a provider has with the Platform and delivery of services through telehealth the better the quality of the services to patients will be.
What are the fee schedules?
Each Network contract with a payer contains a fee schedule. To receive patient referrals from the payer you must opt in to that particular fee schedule. You only accept the fee schedules you choose that meet your personal needs.
How much is paid in the fee schedules?
This varies by payer contract. For example, a prison outsourcing psychological and psychiatric services to the Network would have a fixed fee based on ICD10 and CPT codes. Each psychologist, psychiatrist and counselor participating in the telehealth services would accept the fee schedule in advance of receiving patients. School districts are usually subject to IDEA legislation reimbursement generally complies with local Medicaid schedules. Employers and other payers vary according to negotiations with each payer.
You have to opt in to a fee schedule to receive referrals from that source You are always in control of what fee schedules and patients you will accept.
How does the Cogtrium school district initiative work?
School districts under the federal IDEA mandate are required to provide to students services related to cognitive disorders and other conditions. These include speech and language, occupational therapy, autism, ADHD, etc. The primary providers include psychologists, counselors, SLPs, OTs, etc. School districts often lack necessary internal staff to fulfill all of the need. Often a district may not have available staff that can do certain assessments or create treatment plans. The Cogtrium solution is offered as a turnkey Platform to assist in improving the service level to students. The fee schedule is set in the Network contract with each district and are usually similar across each state and track local Medicaid rates. A provider by accepting the fee schedule can then receive assignments and schedules.
How am I paid?
For some contracts providers are paid by the ultimate payer. For example, a network contract with a Blue Cross payer the payments come from Blue Cross with the Network running interference to make sure the amounts are right and timely. For many contracts such as school districts where a purchase order type mechanism is included, payment can be completed as soon as the service is done, and provider approval of the service is complete. We also have direct deposit available which means actual time between service completion and payment can be 2 to 3 days.
What equipment to I need?
No special equipment is required, just a device with internet access, a speaker, and web cam. Most laptops and current systems work. See our support pages for recommended items.