Documentation & Payer Friction -Therapist Research

SECTION 1 - About Your Practice

Owner / operator (clinician who runs the practice)

Through a managed network (Headway, Alma, Grow Therapy, etc.)

Out-of-network (I provide superbills; clients file themselves)

Medicaid (or a Medicaid managed-care plan)

The platform built into my network (Headway / Alma / Grow)

Standardized measures used routinely (e.g., PHQ-9, GAD-7, PCL-5)

I'm honestly not sure what specifically satisfies payers

A medical records request or audit from a payer

A claim recouped / clawed back after it was already paid

A 90837 session downcoded to a shorter code (e.g., 90834) or denied for "level of care"

I proactively billed a shorter code than the session warranted to avoid scrutiny (sometimes called "self-downcoding")

A prior-authorization hassle for ongoing therapy