Welcome to Edward Coyle's blog home at PsychPsyte.com.

August 7, 2010. Deja vu all over again!
I've been struggling to understand and respond to the new changes in our state Medicaid/SoonerCare reimbursement process. I've seen this before of course and I suspect that we will all see it again in some form. Essentially as I understand it, the state of Oklahoma has contracted with a third-party managed care company to oversee the behavioral health component of our state Medicaid program. In part this is a sensible effort to reign in increasing costs to the program. Unfortunately, just as almost every managed care scheme I've seen over the years, the most apparent results of its implementation will be reduced access to care for clients, and increased burdens in terms of nonsensical paper/edata shuffling for providers. I have no doubt that the program will indeed reduce unnecessary services, including duplication of psychological testing for children in DHS custody, who have often undergone multiple assessments as they move from one facility or foster family to another. My biggest complaint so far, though, is that the system was put into place with almost no warning for many behavioral health providers. One evening I simply started getting denials as I tried to submit my claims on the very easy-to-use web portal run by the state Health Care Authority. I eventually learned from my friend Dr. Steve Sternlof that the new system was in place and that no claims would be paid until providers went through a rather complicated prior authorization process for each patient, new or existing. I must admit that I have not successfully completed the process, so my information may not be complete, but according to Dr. Steve, once you have obtained prior authorization through the third-party webportal, you still have to print out and FAX!!! a paper copy to the same company that you submitted the edata to in order for the treatment to be approved. Once they have processed this paper confirmation, you can go back to the reliable state-portal and bill as before. Once again, it seems that a good intention, that is the attempt to increase outcome information and to organize mental health treatment according to some standardized guidelines, has turned into yet another pain in the neck for patients and providers. A lot of the trouble could have been avoided, however, if the implementation had been carried out with actual notification to providers beforehand. I hereby predict that there will be some significant changes to the system within the next few months, perhaps bringing it closer to what it should have been before rolling it out. I'll let you know more about my adventures with it as we proceed.

August 3rd, 2010.  The Inner Workings and Purpose of PsychPsyte.com from the Horse's Mouth:
  Here is where I'll talk about my practice, my software development and any other topical concerns.  I've been working pretty hard over the past year to make PsychPsyte.com something of both use and interest to both mental health professionals as well as the general public.  Because I am doing this almost completely on my own, I sometimes end up getting a little discouraged about my lack of progress in completing projects for the site and promoting it as a commercial venture.  A lot of times I consider collaborating or even simply hiring a contractor to do some of the more difficult coding and organization tasks.  Every time, though, I end up believing that this would add more complexity without providing much benefit.  I keep telling myself I will be at the point of adding some part-time staff "in a little bit."  But, that time still hasn't come.  I'll post here as I have time and interest.  I'll be setting up an XML commenting function shortly so you can comment directly on these posts like any self-respecting blog.  Until then, if you want to add something, email your comment to admin@psychpsyte.com and I'll post it if it passes my personal judgment.  Thanks for reading and if you have any requests for particular content, let me know.