91 Getting Paid for the Work You Do: Financing Mental Health Care with Dr. Jon Price and Dr. Jenna Vallejo

https://302.buzz/PM-WhatAreYourThoughts

Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, we are joined by Dr. Jon Price and Dr. Jenna Vallejo.

Jon Price, MD FAAP, is a Dublin, OH general pediatrician who has been in primary care and pediatric urgent care. He is co-chair of the Ohio Pediatric Council, a dialog group linking pediatricians and insurance plans looking for win/win solutions to improve health care access and coverage for children and attain the financial means for pediatric practices to provide excellent care. He is a member of AAP committees dedicated to child health financing policies and advocacy with public and private health insurance payers. (COCHF,PAAC)

Jenna is the Chief Operating Officer of Potomac Pediatrics in Rockville, MD. She is a healthcare executive that utilizes innovative ideas to revolutionize the patient experience. For the past few years, she has focused on building an integrative mental health model in primary care pediatrics that is accessible & affordable for patients and financially viable for the practice. Jenna is passionate about striving to offer more expansive pediatric services that can be tailored to the patient to optimize patient outcomes while reducing overall medical expenses for families and the healthcare system. Jenna previously served in the United States Navy as a Hospital Corpsman, as well as worked in family practice and urgent care nursing roles. Her clinical experience combined with her healthcare leadership expertise allows her to approach challenges from the patient experience viewpoint and the practices need to achieve financial success.

Join us today as we talk about the importance of insurance credentialing and how physicians should be paid for the extra work that we do.

Key Highlights:

[00:01 - 15:41] The Struggles of Child Poverty in America

• Eligibility of Medicaid and Chip for children in the United States.
• The states have agreed to not disenroll any patients until the government declares that the public health emergency from Covid19 is over.
• · Jon talks about how employers can provide health insurance for their employees
• They discuss how Medicaid and Chip differ, how the program works, and how it might change in the future.
• There is a lot of confusion about how to code for mental health services, and payers are looking at those who are using more upper-level codes
• Pediatricians need to get creative to cover mental health costs

[15:41- 32:14] Mental Health Staff Urge Insurance Companies to Do Better

• How insurance companies could be doing better in terms of reimbursing mental health professionals, and stresses the importance of insurance credentialing
• How care plans for children with mental health issues can be complicated to manage
• After a child leaves the doctor's office, they are still often linked to the child's care and may be called upon to assist in the future.
• How to get paid for your phone calls and portal...