DB Management & Associates, Inc

DB Management & Associates, Inc DB Management & Associates, Inc We are a nationwide billing and consultation service for behavioral health providers and other ancillary professionals.

Our primary specialty is behavioral health and we stay abreast of the ever changing and complex environment of reimbursement.

07/31/2025

I just got a Medicare bulletin and I can't believe the first sentence in the second paragraph and why it is necessary to state that. It's almost like they are trying to infuriate those folks that resent people of color getting any care. I am not sure why this was put this way. It seemed totally biased but read for yourself. check out CMS.Gov for your latest bulletins.

04/28/2025

Due to all the chaos in Washington and uncertainty to our Healthcare systems I have received the following documentation from one of the larger Plans in Virginia

Dear Provider Partner,
As we all know, this is a particularly challenging time across the healthcare industry with multiple trends and uncertainties impacting our organization. We must make strategic decisions so that we can continue delivering on our mission.

For many healthcare organizations, the Medicare Advantage Prescription Drug (MAPD) product is no longer financially sustainable in the current environment. Industry-wide headwinds and market dynamics, including reimbursement trends and regulatory changes, are leading many insurers to reassess their participation in Medicare Advantage.

With that in mind, Sentara Health Plans will no longer offer our MAPD plans in Virginia at the end of this plan year, which ends on December 31, 2025.
• Members enrolled in an MAPD plan for 2025 will keep their coverage through the end of the year. We will not enroll any new members effective January 1, 2026.
• This does not impact Sentara Health Plans Medicare Advantage Dual Eligible Special Needs Plan (D-SNP), commercial, individual, or Medicaid lines of business.
• We are evaluating our Medicare Advantage Chronic Special Needs Plan (C-SNP) programs for continuation in 2026 but have not made a final decision.
• This change does not affect the insurance plans accepted by Sentara hospitals and medical professionals.

So due to the budget cuts that are anticipated by this Administration some of our most vulnerable citizens are going to lose coverage for pharmaceuticals. This will be a big blow to those dually enrolled in Medicare/Medicaid.

07/16/2024

23 years and still going. Most small business fails in 5 years they say but everytime one door closes another opens and here I am still going after 23 years.

09/14/2023

Medicare just announced that Marriage and Family Therapist and Mental Health Counselors can begin to submit applications on or around 11/01/2023 for an effective date of 01/01/2024. Once the new fee schedules are finalized for the coming year.,

07/14/2023

Expanding the Behavioral Health Workforce

We need the help of every behavioral health practitioner to meet the behavioral health needs of every person with Medicare. Marriage and Family Therapists and Mental Health Counselors provide essential services, such as psychotherapy and group therapy — but to date, they could not enroll as Medicare providers. Following Congressional action, CMS is proposing procedures to allow Marriage and Family Therapists and Mental Health Counselors (including Addiction Counselors who meet all the requirements to be a Mental Health Counselor) to enroll as Medicare providers, which means that the more than approximately 400,000 Marriage and Family Therapists and Mental Health Counselors would now be able to independently treat people with Medicare and be paid directly.
Finally the announcement we have all been waiting for.

07/14/2023

Did you know this was coming down the pike? Currently, Medicare covers and pays for various of behavioral health services, including inpatient psychiatric hospitalizations, partial hospitalizations services, and outpatient therapeutic services. However, there is a current gap in coverage when people with Medicare require levels of services more frequent than individual outpatient therapy visits, but less intensive than a partial hospitalization program. The CY 2024 OPPS and ASC Payment System Proposed Rule includes proposals to implement provisions of the Consolidated Appropriations Act, 2023 that created a new benefit category for Intensive Outpatient Program services. CMS is proposing to establish payment and program requirements for the benefit across various settings, including hospital outpatient departments, Community Mental Health Centers, Federally Qualified Health Centers, and Rural Health Clinics effective January 1, 2024. CMS is also proposing to establish payment for intensive outpatient program services provided by Opioid Treatment Programs (OTPs) effective January 1, 2024, and is clarifying that these intensive behavioral health services are available for individuals with mental health conditions and for individuals with substance use disorders.

06/10/2022

It occurs to me that states that did not expand Medicaid are the states that have poor behavioral health services available or funded. In a recent email that I just received from dhhs.nc.gov they are providing all the reasons that Medicaid should be expanded in all states. The recent increase in mass shootings is a clear case for Medicaid expansion.
Expanding Medicaid would ensure access to affordable health insurance coverage for more than 600,000 North Carolinians. It would also increase access to health care— including mental health and substance use services— across the state, particularly in rural communities.

Medicaid expansion would save lives, increase access to mental health treatment, help working families, build a healthier workforce, protect veterans and their families, and boost rural health care. Read a NCDHHS newsletter article for more on the reasons why Medicaid expansion would benefit North Carolina.

However, some states make it nearly impossible for providers to enroll in the Medicaid program while others make provider enrollment relatively easy. Then they complicate it by having the MCO feature that confuses providers as to who and where they are supposed to bill once they get enrolled. We have been doing provider enrollment applications and working through the everchanging world of enrollment. With Medicaid enrollment each state has it’s own individual set up and what they want in a Virginia application is different from the items they want in Nevada. It would be so much easier on all if they conformed to one set of rules as to what they want and need across the nation. This is what frustrates providers and some will just not bother because they went through the process of getting licensed and having the necessary insurance etc… and all the bells and whistles they needed to be a practicing provider only to be told that there is yet another hoop for them to crawl through in order to be enrolled and/or reimbursed. It is pretty maddening to say the least.
Medicare enrollment in recent years has become standard and works in all 50 states the same way but not Medicaid. Medicaid is only partially funded by federal government but then each state has to raise revenue to fund the rest not covered by federal. Federal government dictates the minimum standards a state must provide to pull down their money while the state must fund any other enhancements to the benefit. That is why each state’s Medicaid is different and eligibility for Medicaid is different. Then comes the managed care organizations that get into the mix and you are on a merry go round to say the least. I could go on but I digress. The reason I put this out there is concerning behavioral health services and how the expansion of Medicaid benefits might help to improve a state’s ability to help it’s citizens. just saying we need one set of rules for the entire country not just each state doing it's own thing. It makes it so much tougher for behavioral health providers to do the very valued work that they need to do when it is different depending on who is running your state. Behavioral Health is healthcare. Just saying.

03/08/2022

If you provide psychiatric and psychotherapy services to Medicare beneficiaries, are you familiar with the requirements for documenting the medical records? ...

12/03/2021

New Medicare Part B rates introduced. The new Part B deductible for 2022 is 233.00 . They raised the Part B premium which is the amount that comes out of SS checks to 170.10 negating the COLA increase they are giving to most SS recipients which is the norm. We will have the new Medicare Schedules available by the end of the month.

Address

Whitsett, NC
27377

Telephone

+18778919352

Website

Alerts

Be the first to know and let us send you an email when DB Management & Associates, Inc posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Business

Send a message to DB Management & Associates, Inc:

Shortcuts

Share