Just on the off chance that anyone comes accross this and needs this information, let me save you what amounted to about 3 hours of research. There is apparently no easily accessible place online where all this vital information is availible together.
If you are considering a mental health private practice, there are some logistics to consider before jumping in. Amongst these of course is how to obtain financial reimbursement for services. In order to be paid for your hard work in private practice you essentially need three numbers. These numbers can take up to 3 months to apply and be approved for so this should be a FIRST STEP in working towards a private practice. Why won't anybody tell you this!? I got the information through extensive phone calls to insurance companies, grilling other professionals, emailing professional organizations and career centers and lots of googling. Ladies and gentlemen, the research shows:
For private practice billing and insurance reimbursement you basically need three separate numbers:
In order to bill in private practice on sliding scale or fee for service (without in insurance reimbursement) you need to apply for a small business id at:
http://www.irs.gov/businesses/small/article/0,,id=98350,00.html
In order to bill for state (Medicare or Medicaid) reimbursement, you need an NPI#. More information available at:
https://nppes.cms.hhs.gov/NPPES/Welcome.do
In order to bill private insurance companies, you need a CAQH# which in turn each individual private insurance company has to approve for reimbursement (i.e. once you have the CAQH, you use it to apply one at a time to private insurance companies you want to use for reimbursement- you would do this online at each private insurance company’s website). More information available at:
http://caqh.org/ucd_health_participating.php
Just in case this spares some other poor soul all the frustration and confusion of obtaining BASIC information. Geez.
Wednesday, October 12, 2011
Monday, June 27, 2011
Feeling Put-Upon
GRRRRRRRR DEFinately feeling a certain kind of way today. Feeling very much PUT UPON by others.
Ever ask yourself (albeit selfishly) "why don't I ever spend any time doing what I want? Why am I constantly doing things that make me unhappy that others want me to do!?" FEELING that way today!!$%#!
AMONGST the people making me feel put upon are people I spend the most blood sweat and tears trying to help, make right or reconcile with. I don't understand, and I believe I forever won't, why people PURPOSELY make things EXCEEDINGLY difficult FOR THEMSELVES. KNOWINGLY. When the options are A-relax, or B- get crazy; they opt for B EVERY TIME.
Ever have something come along and just take the wind out of your sails? Suddenly everything gets 100% harder. Depression and the death of a pt will do that to you. Add to that this exasperation and exhaustion of being put upon and try to stay afloat. Try to keep your social life afloat. Your personal life. Your family life. EX-AS-PER-ATED. Just plain ANGRY!!!??$?$$$@@@!!!!
So here is my personal recommendation, world. Next time you have options to either, A-relax, or B- get crazy, go against the gut and choose A. Sit down with a nice cold beverage and inhale, exhale; inhale, exhale....
HONESTLY!!!!!
Ever ask yourself (albeit selfishly) "why don't I ever spend any time doing what I want? Why am I constantly doing things that make me unhappy that others want me to do!?" FEELING that way today!!$%#!
AMONGST the people making me feel put upon are people I spend the most blood sweat and tears trying to help, make right or reconcile with. I don't understand, and I believe I forever won't, why people PURPOSELY make things EXCEEDINGLY difficult FOR THEMSELVES. KNOWINGLY. When the options are A-relax, or B- get crazy; they opt for B EVERY TIME.
Ever have something come along and just take the wind out of your sails? Suddenly everything gets 100% harder. Depression and the death of a pt will do that to you. Add to that this exasperation and exhaustion of being put upon and try to stay afloat. Try to keep your social life afloat. Your personal life. Your family life. EX-AS-PER-ATED. Just plain ANGRY!!!??$?$$$@@@!!!!
So here is my personal recommendation, world. Next time you have options to either, A-relax, or B- get crazy, go against the gut and choose A. Sit down with a nice cold beverage and inhale, exhale; inhale, exhale....
HONESTLY!!!!!
Tuesday, March 8, 2011
Thank God for Running and Puppies
I have been thinking often at work what things in life the women I work with who are chemical dependent replace with drugs. When do we get our natural "high"? What are they missing or giving up for the chemical fix? I don't mean lifestyle. That's a given. I mean what are our moments of natural high that they instead strive to acheive with drugs?
I think I am in another cycle of my depression. God knows I have lived with my old friend long enough to know the disease well. Once symptoms fearful and desperate, now I recognize the lack of energy, motivation and enjoyment as like trying to run through water, slowing me down. I cuddle up with a good book more, I enjoy long hot showers, I pull out my puzzle books and buy my favorite doughnuts. I excuse myself to hunker down as long as I am fulfilling (somehow!) my other basic responsibilities.
I got to work today at 630am. I had so much to do and was getting so behind, as every waking moment at work I have a patient in my office, paperwork tends to just pile up and wait. This morning, sitting on my butterfly rug on my floor pillow with a laptop and my files and papers across the floor, I forced myself through typing and typing and typing of notes, records, documentation. Since I came in so early, I left at 4pm instead of the usual 430pm (a whole half hour-yippee!!) This meant I would get home before the sun went down. To me this means one and only one thing: I get to run around my lake before dark.
Anyone who has been depressed for any reason can tell you that depression is crippling. It overtakes you so you literally can barely do anything except curl up and wait it out, hoping you do nothing destructive. Often it gets so bad that your mind becomes paralyzed for thought and you cannot keep a single thing in your spiraling mind. Its like trying to tread water in a whirlpool. Your best saving grace, other than medications I suppose, is to have a couple coping mechanisms that you can always turn to, that always work. Of these I have just one.
When my mind is paralyzed and my body depressed, I know only to do one thing. Lace up my running shoes, flick on my ipod, and start running. Though metaphorical and healthy, the literal focusing on nothing but physical sensation and breathing calms and centers my soul. Doing this outside with the sky over my head is my zen: there is nothing like it in all this world. When I am running I have nothing in my mind but calm focus and simple purpose to keep moving forward. Working through the physical pain of my muscles and lungs cures some of the emotional ache, and the simplicity of the exercise (just breathe and keep moving) grounds and centers me. Eventually, the endorphins get pumping and my measly, tiny amounts of dopamine and seratonin get their lazy butts to work. I smile. I feel happy.
Today when I was running around my lake feeling my muscles work up a hill and straining to keep my breath even with my stride I thought, "this is the first time I have felt happy all day." It is not necessarily that my depression makes me miserable all day anymore. I have learned to cope beyond that point. However, no matter what I try, running is the only thing that brings back the "happy." Otherwise, it's just numbness, spiraling and paralysis. It is my natural high. My addiction, I suppose, for my body and mind crave it now and want nothing else for relief of the depression.
Well, almost nothing else. I have to make a little plug for my sweet sweet puppy. Though I could go on about the therapeutic benefits of animals, suffice it to say that there is something very special about never having to go through anything alone. No matter how mopey or grumpy I feel, I always have a little white bundle of fur at my side who couldn't be more thrilled in the world to be there.
Thank you, God, for my beautiful runs and my little puppy.
I think I am in another cycle of my depression. God knows I have lived with my old friend long enough to know the disease well. Once symptoms fearful and desperate, now I recognize the lack of energy, motivation and enjoyment as like trying to run through water, slowing me down. I cuddle up with a good book more, I enjoy long hot showers, I pull out my puzzle books and buy my favorite doughnuts. I excuse myself to hunker down as long as I am fulfilling (somehow!) my other basic responsibilities.
I got to work today at 630am. I had so much to do and was getting so behind, as every waking moment at work I have a patient in my office, paperwork tends to just pile up and wait. This morning, sitting on my butterfly rug on my floor pillow with a laptop and my files and papers across the floor, I forced myself through typing and typing and typing of notes, records, documentation. Since I came in so early, I left at 4pm instead of the usual 430pm (a whole half hour-yippee!!) This meant I would get home before the sun went down. To me this means one and only one thing: I get to run around my lake before dark.
Anyone who has been depressed for any reason can tell you that depression is crippling. It overtakes you so you literally can barely do anything except curl up and wait it out, hoping you do nothing destructive. Often it gets so bad that your mind becomes paralyzed for thought and you cannot keep a single thing in your spiraling mind. Its like trying to tread water in a whirlpool. Your best saving grace, other than medications I suppose, is to have a couple coping mechanisms that you can always turn to, that always work. Of these I have just one.
When my mind is paralyzed and my body depressed, I know only to do one thing. Lace up my running shoes, flick on my ipod, and start running. Though metaphorical and healthy, the literal focusing on nothing but physical sensation and breathing calms and centers my soul. Doing this outside with the sky over my head is my zen: there is nothing like it in all this world. When I am running I have nothing in my mind but calm focus and simple purpose to keep moving forward. Working through the physical pain of my muscles and lungs cures some of the emotional ache, and the simplicity of the exercise (just breathe and keep moving) grounds and centers me. Eventually, the endorphins get pumping and my measly, tiny amounts of dopamine and seratonin get their lazy butts to work. I smile. I feel happy.
Today when I was running around my lake feeling my muscles work up a hill and straining to keep my breath even with my stride I thought, "this is the first time I have felt happy all day." It is not necessarily that my depression makes me miserable all day anymore. I have learned to cope beyond that point. However, no matter what I try, running is the only thing that brings back the "happy." Otherwise, it's just numbness, spiraling and paralysis. It is my natural high. My addiction, I suppose, for my body and mind crave it now and want nothing else for relief of the depression.
Well, almost nothing else. I have to make a little plug for my sweet sweet puppy. Though I could go on about the therapeutic benefits of animals, suffice it to say that there is something very special about never having to go through anything alone. No matter how mopey or grumpy I feel, I always have a little white bundle of fur at my side who couldn't be more thrilled in the world to be there.
Thank you, God, for my beautiful runs and my little puppy.
Wednesday, February 9, 2011
My Afternoon off...
Every now and again I get burnt out at work. The patients I have come in cycles- new ones at the beginning of their pregnancy with all their needs and new problems, then these same patients after delivery with the CPS involvement and custody issues. At the peaks of these two cyles, I tend to have my moments of burn-out. Having just finished a CPS/delivery wave, now I am in the new patients, new problems wave. Also, one of the six therapists left, leaving five of us to manage all the patients. My caseload is new, and it is rising.
There are various causes of exhaustion on different days. On Mondays, I have two hours of back-to-back art therapy group that I plan and run. It may sound easy, but it is its own version of chaotic managing needy and unruly patients, keeping a topic relevant to them, following rules like sedation protocols, and making sure my supplies don't disappear. Tuesday, I was feeling emotinoally exhausted; just sad. Sad for the women trying so hard to kick addiction with the odds and a terrible life history up against them. Sad from patient after patient sitting in my office crying and crying. Sad from seeing some women so far gone into their addiction that their prognisis as poor on a good day. Sad sad SAD.
Today I am a mixture of the two. After a patient, a group, clinical rounds and methadone rounds this morning, I asked my supervisor for permission to retreat home for the rest of the afternoon. To relax? Nope. To do three weeks of case notes I have fallen behind on and can't get done at the office because of constant other things to do.
SO here is my afternoon off to recalibrate and recuperate from work: millions of work case notes. SIGH. At least Zorro is here and he doesn't shoot dope, nod out, eat benzos or smoke crack. Or grass. Or snort. Or take pills. You get the idea.
There are various causes of exhaustion on different days. On Mondays, I have two hours of back-to-back art therapy group that I plan and run. It may sound easy, but it is its own version of chaotic managing needy and unruly patients, keeping a topic relevant to them, following rules like sedation protocols, and making sure my supplies don't disappear. Tuesday, I was feeling emotinoally exhausted; just sad. Sad for the women trying so hard to kick addiction with the odds and a terrible life history up against them. Sad from patient after patient sitting in my office crying and crying. Sad from seeing some women so far gone into their addiction that their prognisis as poor on a good day. Sad sad SAD.
Today I am a mixture of the two. After a patient, a group, clinical rounds and methadone rounds this morning, I asked my supervisor for permission to retreat home for the rest of the afternoon. To relax? Nope. To do three weeks of case notes I have fallen behind on and can't get done at the office because of constant other things to do.
SO here is my afternoon off to recalibrate and recuperate from work: millions of work case notes. SIGH. At least Zorro is here and he doesn't shoot dope, nod out, eat benzos or smoke crack. Or grass. Or snort. Or take pills. You get the idea.
Monday, February 7, 2011
The Color Test
| Click'>http://www.colorquiz.com/cgi-bin/results.cgi?do=print_blog&picked1=1,5,4,2,3,0,7,6&picked2=1,5,2,4,3,7,6,0&sex=f&blog_name=Cindy">Click here to read the rest of the results. |
Thursday, January 27, 2011
Doing laundry
Though I had amibivalent feelings about the snow day when I woke up this morning and saw my little Accent would not make it on the snowy roads to Bayview, I ultimately decided none of my patients would make it in through the snow either and to enjoy the rare break (though pto paid for) of a snow day.
I remember in grad school writing a post in a spare moment grabbed in a coffee shop between two jobs and my classes, where I fantasized about having a day off to do laundry and be domestic. This morning as I looked around my cluttered and very lived-in apartment, with it's piles of laundry, mountains of dishes, carpet in much need of vacuuming, tables in need of dusting, bathrooms of scrubbing, and peices of my daily life scattered all around, I felt some much needed sympathy for myself and how much I give of myself at my job. Though always worrying I am never doing enough, I give every iota of emotional and cerebral energy I have every day to my women. Evienced by everything askew in my apartment, I get home and barely have the energy to wolf down some take out, pack tomorrow's lunch and crack open a book before I fall asleep.
Today with the clean white snow on the ground trapping me inside with my puppy, I took out some chicken to thaw for dinner, set some water to boil for tea and enjoyed a breakfast that wasn't just a travel mug and a granola bar on the road. I did some sketching and drawing over a liesurely breakfast, put on some sweats and began to tackle the disarray of my apartment. How liesurely and therapuetic it felt! To engage myself in something where the outcome simply reflected the energy invested: I cleaned and my apartment got cleaner. Imagine that principle simply demonstrated to the frustrated therapist! Sigh. What a reward. Though I still have chicken to marinate, and laundry to fold and put away as the tired washer and dryer finishing shaking them clean(-ish), I am so enjoying the relative predictability and reliability of my simple apartment and finally fulfilling some domestic responsibilities.
While I'm on this- I was thinking the other day how in my flurry of hard work to establish myself as an independent adult in the past few years, working several jobs at a time, taking classes, trying to license and ever move up the job ladder, I haven't had time for much else other than this thought: "Cindy, you MUST succeed!" Having come to a relatively comfortable place after all that, the next phases of my life are much on my mind. Maybe one of the biggest questions on a single woman my age's mind in this day and age is the "to work, or not to work" while having a family question. For me it is not so much a question of desire (of course I want to stay home!) but of necessity. Though I have molded my career from what I may have dreamed to become to what will come closest to that and best accomodate a family life, the question of how it will all balane out causes me angst. I'm sure any therapist, friend or mother would tell me that is a healthy thing. SIGH. The double shift...
On a lighter tangent, I often joke with my friends and my sweet boyfriend that my doggy (an eternal puppy in my mind) is my practice baby. Though I am in my mommy prime and my hormones scream "BABIES BABIES BABIES!" (not lessened by working with only pregnant women all dasy) I am luckily able to staunch much of the urge by being a puppy-mom. Go ahead, make fun, tell me he's just a dog, but I'll tell you what, he's a damn happy one, and he gives me more psychological stability and therapy than many wasted dollars and hours historically have. That said, here is my lighter tangent. A list of ways being a puppy-mom is preparing me to be a real mom:
1) As soon as I put his toys away, they are IMMEDIATELY strewn accross the apartment again, even if they are toys he hasn't touched in ages.
2) Because of number one, I am skilled at vacuuming around toys (usually)
3) I have to plan my trips ahead and find babysitters if I will be away for too long
4) He has more toys and clothes than he will ever use
5) I have the vet on speed dial
6) Sometimes he really doesn't want to do something and gives me attitude
7) I have to accept that some things about this little monster will never change
8) Whenever he wants ANYTHING, its, "Hey mom! Hey Mom! Hey Mom!!"
9) He decides to make noise RIGHT at the best part of the show or movie I'm watching
10) If he's sick or having nightmares, or needs anything, I dont sleep
11) Those little eyes get me every time
12) To him, me getting comfortable and settled on the couch is an indication that it is time to take him outside
13) I have to discipline him for things he does that I also think are kinda cute
14) I have to watch what I say around him so he doesn't get the wrong idea ("walk"? "treat"?)
15) I have to make sure he is properly sociallized with other good puppies
16) I could go on, but most importantly he is my little buddy and we love each other
Thanks for reading my ramblings on a satisfyingly restful day!
I remember in grad school writing a post in a spare moment grabbed in a coffee shop between two jobs and my classes, where I fantasized about having a day off to do laundry and be domestic. This morning as I looked around my cluttered and very lived-in apartment, with it's piles of laundry, mountains of dishes, carpet in much need of vacuuming, tables in need of dusting, bathrooms of scrubbing, and peices of my daily life scattered all around, I felt some much needed sympathy for myself and how much I give of myself at my job. Though always worrying I am never doing enough, I give every iota of emotional and cerebral energy I have every day to my women. Evienced by everything askew in my apartment, I get home and barely have the energy to wolf down some take out, pack tomorrow's lunch and crack open a book before I fall asleep.
Today with the clean white snow on the ground trapping me inside with my puppy, I took out some chicken to thaw for dinner, set some water to boil for tea and enjoyed a breakfast that wasn't just a travel mug and a granola bar on the road. I did some sketching and drawing over a liesurely breakfast, put on some sweats and began to tackle the disarray of my apartment. How liesurely and therapuetic it felt! To engage myself in something where the outcome simply reflected the energy invested: I cleaned and my apartment got cleaner. Imagine that principle simply demonstrated to the frustrated therapist! Sigh. What a reward. Though I still have chicken to marinate, and laundry to fold and put away as the tired washer and dryer finishing shaking them clean(-ish), I am so enjoying the relative predictability and reliability of my simple apartment and finally fulfilling some domestic responsibilities.
While I'm on this- I was thinking the other day how in my flurry of hard work to establish myself as an independent adult in the past few years, working several jobs at a time, taking classes, trying to license and ever move up the job ladder, I haven't had time for much else other than this thought: "Cindy, you MUST succeed!" Having come to a relatively comfortable place after all that, the next phases of my life are much on my mind. Maybe one of the biggest questions on a single woman my age's mind in this day and age is the "to work, or not to work" while having a family question. For me it is not so much a question of desire (of course I want to stay home!) but of necessity. Though I have molded my career from what I may have dreamed to become to what will come closest to that and best accomodate a family life, the question of how it will all balane out causes me angst. I'm sure any therapist, friend or mother would tell me that is a healthy thing. SIGH. The double shift...
On a lighter tangent, I often joke with my friends and my sweet boyfriend that my doggy (an eternal puppy in my mind) is my practice baby. Though I am in my mommy prime and my hormones scream "BABIES BABIES BABIES!" (not lessened by working with only pregnant women all dasy) I am luckily able to staunch much of the urge by being a puppy-mom. Go ahead, make fun, tell me he's just a dog, but I'll tell you what, he's a damn happy one, and he gives me more psychological stability and therapy than many wasted dollars and hours historically have. That said, here is my lighter tangent. A list of ways being a puppy-mom is preparing me to be a real mom:
1) As soon as I put his toys away, they are IMMEDIATELY strewn accross the apartment again, even if they are toys he hasn't touched in ages.
2) Because of number one, I am skilled at vacuuming around toys (usually)
3) I have to plan my trips ahead and find babysitters if I will be away for too long
4) He has more toys and clothes than he will ever use
5) I have the vet on speed dial
6) Sometimes he really doesn't want to do something and gives me attitude
7) I have to accept that some things about this little monster will never change
8) Whenever he wants ANYTHING, its, "Hey mom! Hey Mom! Hey Mom!!"
9) He decides to make noise RIGHT at the best part of the show or movie I'm watching
10) If he's sick or having nightmares, or needs anything, I dont sleep
11) Those little eyes get me every time
12) To him, me getting comfortable and settled on the couch is an indication that it is time to take him outside
13) I have to discipline him for things he does that I also think are kinda cute
14) I have to watch what I say around him so he doesn't get the wrong idea ("walk"? "treat"?)
15) I have to make sure he is properly sociallized with other good puppies
16) I could go on, but most importantly he is my little buddy and we love each other
Thanks for reading my ramblings on a satisfyingly restful day!
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