Content
Introduction
Our mission at Blueprint is to promote the adoption of measurement-informed care as
the new standard of care across all mental healthcare settings.
Why? Because decades of research (not to mention thousands of heartwarming stories) have taught us that clients feel better faster and perceive their care to be higher quality when objective measures are included as part of their care journey.
What's more, we aren't alone in this mission.
Insurance companies are increasingly encouraging - and soon enforcing - the
practice of measurement-informed care in order to ensure that all clients within their
network not only have access to care when needed, but access to the highest quality
of care possible.
In this way, most major insurance companies now recognize this practice as a billable
service, allowing clinics and their staff to get properly compensated for their efforts in
learning, adopting, and integrating data into everyday clinical practice.
The purpose of this guide is to provide easy-to-use resources for clinicians and their
clients to reference related to the billing of assessments on Blueprint.
The Basics of Blueprint Billing
Overview
Each time a client completes an Assessment on Blueprint, a billable event has occurred. Blueprint automatically tracks these billable events and submits insurance claims into your clinic's EHR or billing software on a weekly basis. The claims get tracked, processed, and reimbursed in the same way as other standard claims you are already billing for (e.g., a 45 minute psychotherapy session).
Documentation
Most documentation requirements are fully met within Blueprint's clinician portal. However, depending on your EHR and clinic preferences, assessment-specific notes may also have to be entered into your clients' charts in order to complete the claim submission process. Your clinic leadership will provide you with specific instructions on when and how to complete these notes, if applicable.
Client Cost
Just like other insurance claims, Blueprint assessment claims may result in additional client costs, such as co-pays and deductible payments. While the presence and degree of client costs will vary based on each client's unique insurance plan, it's important to communicate with all clients about the potential for additional costs associated with the use of Blueprint and why these costs are warranted.
Clients without Insurance
In order to ensure that all clients have access to Blueprint's services regardless of coverage, clients who don't have insurance (e.g., cash pay) or who have insurance that doesn't cover Blueprint's claims will not incur any additional charges or fees for the use of Blueprint.
How To Communicate Blueprint Billing To Clients
Communicate the value of Blueprint
Make sure that your client understands the value of Blueprint and why it's important for them to participate in completing regular assessments.
"My goal as your therapist is to make sure I'm staying informed about your symptoms and lived experiences throughout our time working together. Blueprint is an assessment tool that will help me accomplish this goal by sending you online surveys for you to complete outside of our sessions together. In doing so, this information will allow me to provide you with the best possible care and will help me determine if my treatment is working as effectively as it should."Set usage expectations
"You will be receiving reminders to complete your assessments periodically. When this happens, please try your best to complete the assessments as soon as possible so that I can use the information to inform our sessions. If you'd like, you may also use Blueprint's 'check-in' feature to track your mood and related health behaviors for your own benefit, but this is not a requirement."
Obtain informed consent and let your client know about the potential for insurance-related costs such as co-pays and deductible charges and ensure that they are aware of and accept these charges
"Like any billable services, using Blueprint may result in additional fees that your insurance plan doesn't cover, including co-pays and deductible charges. While this may add an additional cost for you, I'm confident that you will find this cost to be warranted given the value that Blueprint adds to our treatment and overall therapeutic relationship. Because of this, I strongly encourage Blueprint to remain a standard part of our care. Would it be alright with you if we moved forward with enrolling you on Blueprint given these potential costs?"
Frequently Asked Questions
What CPT code is used for the claims for Assessments?
The code used for claims for assessments is CPT 96127. This code is used for brief emotional/behavioral assessments with scoring and documentation, completed by a standardized instrument. Insurances that cover this code usually allow somewhere between $6-9 per assessment. Additional codes may apply based on your clinic's billing preferences.
When should Blueprint assessment claims be completed?
Blueprint recommends that clients complete assessments on a day when they do not have a session. Occasionally, insurance payers may not accept a claim for a session and an assessment from the same day.
What will the cost be for my client?
It depends on the client's insurance and how often the clinician assigns assessments. If a client does owe money, it is usually minimal. Insurance companies typically pay between $6-9 per assessment so a client's portion (if they owe one) is usually no more than a couple dollars. Clients may pay a copay, co-insurance, deductible, or nothing.
Are Blueprint's worksheets and daily check-ins billed to insurance?
No. Only the completion of assessments that track a client's outcome (e.g., PHQ-9, GAD-7) are billed to insurance. All therapeutic worksheets, daily check-ins, and symptom tracking modules are freely available for clients and clinicians to use but are not billed to insurance.
What happens if a claim for an assessment is rejected or denied?
If a claim for an assessment is rejected or denied, neither the client nor the clinic will pay anything.
Can clients opt out of using Blueprint?
While the use of Blueprint is strongly encouraged, certain clients with financial hardships or related challenges preventing them from meaningfully engaging with Blueprint may opt-out. Check with your clinic's leadership for specific guidance on when and how to help clients opt out of Blueprint.
We're here for you!
Do you have follow-up questions? We're here and happy to help!
Send us an email at support@blueprint-health.com or use the help messenger in the lower right corner to speak with our Support team. 💪🏼