Behavioral Health Provider Experiences with Third-Party Payers

Demographics

Question Title

1. In which areas of mental health practice do you hold credentials? (Select all that apply) (Required.)

Chemical Dependency

Counseling

Marriage and Family Therapy

Psychiatry

Psychology

Social Work

Other (please specify)

Question Title

2. Are you dually licensed (ex. LSW, LICDC)? If so, please share which credential you most often use to bill.

Question Title

3. Which category best encompasses your license type? (Please select one) (Required.)

Independently licensed

Dependently licensed

Trainee license (Student/Intern/Resident)

Non-licensed

Other (please specify)

Question Title

4. Which answer best describes your position within your practice? (Required.)

Owner of private practice (solo)

Owner of small group practice (2-5 clinicians)

Owner of large group practice (6+ clinicians)

Employee of group practice (non-community mental health)

Employee of a community mental health agency or hospital

Employee of a correctional institution

Employee of a school district

Other (please specify)

Question Title

5. Which statement is most true for your practice? (Required.)

My practice currently bills third-party payers for counseling or medication management services.

My practice does not and has never billed third party payers for counseling or medication management services.

My practice has billed third-party payers in the past, but have since stopped.

Unsure

Question Title

* 1. In which areas of mental health practice do you hold credentials? (Select all that apply) (Required.)

Question Title

* 2. Are you dually licensed (ex. LSW, LICDC)? If so, please share which credential you most often use to bill.

Question Title

* 3. Which category best encompasses your license type? (Please select one) (Required.)

Question Title

* 4. Which answer best describes your position within your practice? (Required.)

Question Title

* 5. Which statement is most true for your practice? (Required.)

1. In which areas of mental health practice do you hold credentials? (Select all that apply) (Required.)

2. Are you dually licensed (ex. LSW, LICDC)? If so, please share which credential you most often use to bill.

3. Which category best encompasses your license type? (Please select one) (Required.)

4. Which answer best describes your position within your practice? (Required.)

5. Which statement is most true for your practice? (Required.)