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. Clinician Spotlight: An Interview with Julie Massi, LMHCLauren Chapin, LICSW
Welcome to Clinician Spotlight, a series where I sit down with some of our wonderful therapists for a cozy conversation about work, mental health, and many life tidbits in between. This month, I had the opportunity to get to know Castlebrook’s newest addition to the team, Julie Massi. She and I chatted over Zoom where she discussed her journey to Castlebrook, why she values the mental health profession, and how the recorder is not just the squeaky instrument you played in elementary school. ******** Lauren: Hi! Thanks for taking the time to sit down with me. It’s a pleasure to have you on board! Why did you originally get into the mental health field? Julie: This is actually a career change for me! I worked for a number of years in financial services jobs with some great people. I started to explore volunteer work in my off hours and one of those positions was as overnight staff at a women’s shelter. I noticed that I really looked forward to the part of my night when the guests would come home to talk about their days, goals, and plans. I enjoyed listening, having a conversation, and being supportive and encouraging. So I started thinking, “What if I had a job where this is what I could be doing all day? That sounds really great, I think I’d like to do that.” That’s what led me to consider getting into counseling professionally. Lauren: That’s a wonderful story. What ultimately brought you to Castlebrook? Julie: I always saw myself in a group practice setting because collaboration and teamwork are really important to me. I never wanted to be an island, so to speak. I appreciated how open and transparent Kerrie [the director] was throughout the hiring process and also appreciated the focus on making sure that clinicians are operating at our best so that we can do what’s best for our clients. Lauren: Absolutely. Do you see any crossover, or skill sharing, between the corporate world and counseling? Julie: Yes! Analytical skills definitely apply as well as communication skills. Taking in and processing lots of information to put together the story of where we are and where we want to go, understanding and factoring in the other person’s perspective when we need to work together, and having to face challenging results at times. That’s been helpful to take into therapy as I want both the client and myself to feel like it’s going in a good direction and that their needs are being met. Lauren: I can see the similarities for sure. Where did you end up doing an internship after graduate school? Julie: I did my internship in residential programs at a local community mental health agency. The setting was different from outpatient, but the work can be very similar. I had a lot of encouragement, freedom, and support to approach the meetings like counseling in their homes, and I often found us reinforcing skills that clients were working on and picking up threads that they might not have gotten to during their in-office therapy sessions. I enjoyed it so much. I returned there after graduation to get some experience in their crisis stabilization service for people transitioning out of hospitalization. I got to understand how hard it is to ask for help or to trust that the person sitting there asking you all these questions is there to help. Particularly in situations where you don’t know how this information might be used or what will happen next. It taught me to be transparent and open about why I’m doing what I’m doing–I want people to be informed about the process. Lauren: That’s a tough balance to strike between assessing risk and maintaining trust and transparency. Julie: Definitely. I always focused my questions on understanding where the person is at, what they are going through, and making sure that I`m not overreacting or underreacting to what I'm seeing and hearing. I also learned to focus on creating a comfortable environment and showing up as my genuine self, to try to set people at ease and let them know that I’m there for the right reasons. Lauren: Does that translate into your style of how you approach therapy? Julie: I definitely gravitate towards the modalities of therapy that are person-centered. I want to make sure as much as possible that the person's needs, preferences, and rights are being respected. Part of that means that people might make decisions that I would not have made for them, but sometimes people need to try something out and see how it goes, and if it doesn't go the way that they hoped, that’s the opportunity to try something different. There is a bit of risk and uncertainty associated with that, but it’s important for therapy to be a place where clients have a sense of agency. Lauren: That makes sense. What might you tell somebody who is nervous about beginning therapy? Julie: It might sound cliche, but it does take courage to take those first steps toward getting support, and I don’t think that's something that should be taken for granted. There is a whole process that could have happened before a person is sitting in front of me. Opening up comes at your own pace. The therapist has a responsibility to prove to you that they’re going to be helpful, and if it feels like it’s taking a while for that to become clear, it’s so helpful to bring that up with the therapist to talk through together, even if that seems easier said than done. Lauren: What’s your favorite thing about being a therapist? Julie: There are a bunch of things. Just the fact that people let me into their lives in this way is pretty amazing and meaningful to me. I really like getting to know so many different people, getting to see their strengths, and how they’ve already brought themselves through some really challenging, difficult situations. I love moments when a skill I suggest works out really well and I get to hear about it in the next session, or when a client lets me know that I have really understood where they are coming from on a deeper level. Lauren: So part of therapy and the mental health field is taking care of yourself. What do you do outside of work to recharge? Julie: One thing that I’m really glad I got to return to doing post-lockdown is my early music group. We play recorders, not the squeaky plastic ones from elementary school, but real wooden ones [laughs]. We perform music mostly from the Renaissance or early classical periods at museum events, holiday festivals, and things like that. Lauren: How cool! What’s one last thing you’d like to leave us with? Julie: A quote that I like, I can’t remember who said it, is that we grow in spirals. I think of it like stretching out a slinky. if you look at it from the side you can see the spiral traveling up, but if you look at it from the top, you just see a circle. A lot of times in life we’re going through situations that we feel like we’ve been through before and we can’t believe that, “Here I am, at the same point of the circle, just going around and around.” But if we’re growing, we’re actually moving up the spiral of the slinky. Even if you’re coming across a situation that feels familiar, if you have skills and insights you didn’t have before, it’s not the same situation. It’s a time to put all of that knowledge to use for a better outcome. Finding Gratitude: 30 Small Joys to Appreciate When You're Drawing a BlankLauren Chapin, LICSW
Gratitude can be a bit tricky, especially when times are tough. When you're experiencing things like burnout, loss, or a struggle with mental health, finding the silver lining can be frustrating. However, appreciating and acknowledging the positives doesn't always have to revolve around big life domains such as family, health, or basic needs. It can be the little things, the ones we often overlook in our daily lives. Here are 30 things that I personally feel grateful for. Try out some of these ideas to find things that inspire gratitude in small ways!
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Mission Statement
Castlebrook Counseling Services, Inc. is a group of private practice clinicians with a shared goal of strengthening our community by providing therapy and clinical support designed for children, adults, and families to successfully meet life’s challenges.