This article outlines the key policies and procedures for client billing, insurance collection, appointment cancellations, and therapist responsibilities.
Client guidelines
Billing your clients
Before a new client is added to your calendar, we ensure that their insurance information has been collected and a credit card has been securely stored on file. We handle the collection of all patient obligations (e.g., copays, coinsurance, and deductibles). Interest-free payment plans are available, upon client request.
Rula recommends that therapists always be transparent about billing their clients through Rula and/or their practice outside of Rula, documenting discussions as they arise.
Client insurance changes
What happens if your client's insurance changes or will no longer be effective at the start of the new year? If you know that your client has new insurance coverage or changes to their insurance, you can assist them by directing them back to the Rula patient portal. There, they can add their new insurance coverage to ensure they are still in network.
If your client updates their insurance and is no longer in network, offering rematch services is an option. Alternatively, if they prefer not to be rematched with another provider, they have the option to self-pay.
Credit card charges
We charge the client's credit card on file within 1-2 days after you submit the billable note. If the client has a known copayment or coinsurance amount, we charge their card before their insurance company processes the claim as well. In some cases, a client's credit card may be charged twice for a single visit. This can happen when we initially charge the card for the known copayment or coinsurance amount. Later, if the insurance company determines that the client owes more money (for example, if the remaining balance is applied to their deductible), we will charge the credit card again to cover the additional amount.
Late cancel and no-show policy
All clients sign Rula's 24-hour Cancellation and No-Show policy during registration (details here).
Once you've determined that the client is a no-show, there are two things you'll need to do to be sure you are paid:
- Complete a Missed Appointment note with the outreach attempts listed above
- Mark the client a no-show from the scheduler
If a clinician enters a no-show as "no charge" due to their clinical discretion, the clinician will not be paid for the missed appointment.
Rula's Support team will manage any disputes or exceptions. Please direct the client to use the AI search bar in the Patient Help Center to get assistance. They can request a live Service Team member at any time. Clinicians are not involved in decision-making around no-show fees once you have entered the Missed Appointment note in the chart. We'll take care of those details to ensure you can focus on the relationship with the client.
Please complete a Missed Appointment note if a client doesn't show up.
Multiple sessions in one week
Providers don't require additional authorization from Rula to provide multiple sessions/week.
If your client requests to see you more than once a week, you can do so if you deem it medically necessary for the client's treatment. Please document the additional session's medical necessity in each note. Insurances only cover one session per day; do not bill back-to-back or multiple sessions on the same day. You can review this article on client charts for more information, Overview of client charts in the Rula provider portal.
Self pay clients
You are welcome to use our billing services for self pay clients. Our self pay rate for clients is $150 for individual sessions and $165 for family/couples sessions. You will be compensated for these visits at your contracted hourly rate.
Questions about charges
If your client has a question about billing, please direct them to use the AI search bar in the Patient Help Center to get assistance. They can request a live Service Team member at any time. Our Support Team will then verify their information and which charge or charges they're talking about. If their issue is resolved, our agents will direct the patient to the Rula patient portal to review their receipts/statements. If further investigation is needed, our agents will escalate to our dedicated Billing Team.
Therapist policies
Billable Notes
The only documentation you need to complete and sign to get paid for a session is the billable note. This includes all billable notes (initial assessment, progress note) and the missed appointment note. Remember, only face-to-face time with your patient is considered billable per insurance carriers. Please review the articles below for more information:
- Documentation requirements to get paid in the provider portal
- Timely Documentation
- Understanding Prefilled Session Times in Clinical Documentation
Treating clients located outside of their home state
Generally speaking, you are only allowed to bill insurance if the client is physically located in the state you are licensed. While we verify their location before ever scheduling them, it is best practice to ask where they are located at the start of every session. Suppose you have a continuity of care issue for a client who has temporarily relocated to another state (e.g., less than 30 days). In that case, therapists are expected to contact the appropriate licensing board in that state to determine if it is permissible to continue to provide services.
CPT and diagnosis codes
Please use the CPT code 90791 in your note for all initial appointments. Please read these article for more information about CPT codes and billing:
Therapist no-show policy
Our goal is to provide world-class support and care for our clients. We collaborate with therapists who contract with Rula to ensure our clients receive life-changing treatment. To confirm this, therapists agree to the following:
- Please arrive on time for their appointments with clients.
- In case of an emergency, reach out to the client directly and promptly to let them know about changes to the schedule.
- Align with the client before making adjustments to the appointment time.
- Provide clients with at least 24 hours notice of a cancellation or rescheduled appointment.
If we hear from a client that a therapist was late or missed their session, we will check in with them. However, after three instances of late cancellations, missed appointments, or tardiness, we will pause sending new clients to that therapist until they have demonstrated the ability to arrive on time and communicate appropriately with clients.
For more information on our no-show policy please review this article, No-Shows & Late Cancellations: Policy Overview and Required Actions.
Utilizing outside platforms to conduct sessions
Providers who work with Rula do so under a Network Access Agreement, which gives them access to the Path CCM network (our network operated under our legal business entity). This network includes our tools and technology—such as our shared Zoom account—but excludes outside platforms, including personal Zoom accounts, doxy.me, and Google Meet.
Because care for Rula clients is hosted within the Path CCM network, all sessions must take place through our Zoom account. Other video platforms can’t be used for Rula sessions, unless there’s a technical issue preventing access.
Updated