Lisa Wheeler  November 3, 2014Asheville, NC
From Eagala Networking FB PAGE
Hi EAGALA members,
I wanted to share a couple of things:

1) please try and avoid the use of the term “Equine Therapy”. We practice mental health using the Equine Assisted Psychotherapy model. Specifically we use the EAGALA Model. 
In the reimbursement world “Equine Therapy” is a very specific code for Hippotherapy and Therapeutic Riding: S8940. This is generally NOT reimbursed.
However, the work we do: mental health–is reimbursable using the appropriate MH billing codes.
If you are elsewhere in the world similar language may exist.
2) please consider, regardless of the country you live in, joining the Network Group Compliance and Insurance. I regularly post info on staying on compliance and getting the work we do reimbursed (and FYI—it is!!) 
I admit–boring stuff–like watching paint dry on wall more exciting than compliance and insurance. BUT its necessary and I do try and make it meaningful and a little fun…Also, as I get valuable information from any country, I try and get it up as soon as possible.
Thanks for your time!
Lisa Wheeler, MS Ed, PA-C, Director of Compliance and Insurance for EAGALA
https://www.facebook.com/groups/eagala/permalink/10153019375815750/    Brenda Hunter Feb 5, 2015  Wow! Great dialog! Generally speaking, the greatest legal and ethical concerns in this matter is “double dipping.” One cannot be an insurance in-network provider and charge a rate other than contracted by the insurance provider. Given this rate typically is quite minimal, it serves as a barrier in providing EAGALA model EAP as it doesn’t cover the costs of the services. Hence, several EAGALA model providers chose to not be part of an insurance network and require the clients to do self-pay and then submit for reimbursement from their insurance for services received from out-of-network providers, to as least get some level of reimbursement. That’s the best system as it stands right now. EAGALA is working toward trying to get the insurance companies to recognize EAGALA model EAP as a specific model of therapy that requires higher levels of reimbursement, but we just are not there yet. So in the meantime, this is the best solution.

Comments are closed.