Admin Spotlight: An Interview with Lisa Garneau, Billing Specialist

Admin Spotlight: An Interview with Lisa Garneau, Billing Specialist

By Lauren Chapin, LICSW

Welcome to a fresh section of Castlebrook’s Spotlight series where we shine a light on the exceptional work carried out by our administrative staff to ensure the seamless operation of the practice. For the second installment of the admin segment, I sat down with Lisa Garneau, one of Castlebrook’s dedicated billing specialists. Lisa discussed her role at Castlebrook, explained some of the more confusing aspects of insurance, and talked about the biggest fish she has ever caught!
Lauren: Hi Lisa! Thanks for taking the time to chat with me. How long have you been at Castlebrook and what brought you to this position?

Lisa: October was 5 years! As for my background, I used to work for a medical office doing their accounts payable. Their receptionist went on vacation and I filled in for them doing billing on the client end. It wasn’t something I was looking for, but it kind of fell into my lap and I enjoyed it. After working on the medical side of things, I worked for a mental health clinic and knew that’s what I wanted to continue doing. I like the mental health field better than the medical field because I feel like you can help people on a completely different level. 

Lauren:  What are some of the major differences that you notice between the two?

Lisa: In mental health, I see the clients come in on a regular basis versus them only coming in maybe once or twice a year for a physical or a cold in a medical setting. Here, you see a client come in with something that they’re struggling with on a weekly basis and then over time, you see the light come on, they start to smile, they’re not looking at the floor anymore and they make conversation. You don't see that in the medical field. 

Lauren: That’s a great point and something I wouldn’t have thought of! You get to have a relationship with the clients and know people by name without having to always check the chart. 

Lisa: That’s one thing I miss about sitting in the front receptionist office is that I don’t get to see clients as much as I used to! But they all know where my office is so a lot of the regulars will wave when they walk by my office. 

Lauren: So there are a lot of clients that know you and know what you do, for clients that don’t, why may a client be hearing from you? 

Lisa: If it’s a new client, it’s usually because I’m missing some information like their insurance or address in their portal. I don’t typically call clients about balances unless I notice that all of a sudden their bill is coming back as a deductible instead of a copay and it didn’t used to. 

Lauren: For a client that might not know, what’s the difference between a copay and a deductible? 

Lisa: A copay is just a flat rate that gets charged for each session and it’s usually anywhere from $10-$50, or a bit more if an insurance plan designates us as a specialist. A deductible means that they have a threshold of a certain amount of money that they must pay themselves before they meet the deductible and then insurance starts pitching in. 

Lauren: How does a client find out what they will be paying for services if they have a deductible?

Lisa: With a deductible, we charge the contracted rate that is determined by the insurance company for that particular service. So if the insurance company determines that our reimbursement rate is, say, $100 for a session, that’s what the client would be charged until their deductible is met. 

Lauren: How would the client know what would be charged per session by their insurance company if they have a deductible?

Lisa: They just need to ask upon intake and they will be informed of an estimate what their out of pocket costs will be. We say estimate because sometimes we are not given accurate information by the insurance company when we check eligibility and benefits on behalf of our clients.

Lauren: So you may be calling about stuff like that sometimes. Are there other times that you might have phone contact with clients?

Lisa: Sometimes clients might reach out to me if they get charged a no-show or late cancellation fee, which is actually up to the clinician on whether that was charged or not. I encourage clients to speak with their clinicians first if they have a question about it. 

Lauren: In your billing position, besides client contact, what else do you do for the practice?

Lisa: I bill the insurance companies directly for services, and I also reach out to the companies to dispute denials. If there is a denial for whatever reason, I try to be the point of contact with the insurance companies for clients so that they don’t have to deal with the insurance company. Then I would call the client after I already speak to the company. 

Lauren: Everybody needs a Lisa! Speaking to insurance companies can be overwhelming. That's helpful to take the burden off of the client so they can just focus on their wellness. 

Lisa: Yes! I also do the medical records. If we get a medical records request from disability services, an attorney, or the insurance company, for example, I reach out to the clinician and advise them to have a conversation with the client about releasing this information and what that means for them. The information is not released without a conversation with the client and clinician. 

Lauren: That’s helpful to know! While working in the mental health field, or any field really, things can get stressful. How do you like to decompress?

Lisa: It’s tougher for me during the winter months because I’m an outdoorsy person. But during other parts of the year, fishing is my favorite hobby. We spend every weekend out fishing, camping–I love being outside. I always joke that fishing is my church. Last year, I was actually in a fishing tournament for the New England Bass Association and I won! The freshwater bass was just shy of six pounds. The biggest fish I’ve ever caught, however, was a 33-inch striper which took me a half hour to reel in [laughs]. 

Lauren: That’s so fun. To wrap up, if a client sees that you’re calling, why should they not fear calling back billing?

Lisa: We’re always willing to work with them, even if there is an overdue balance that is outstanding. We’re willing to do payment plans and we understand that everybody has unique situations. And we’re human too, sometimes we make mistakes and we don’t want clients to be afraid to call if they see a mistake on our end too.