PINEAPPLE SUPPORT PROVIDER NETWORK POLICIES AND PROCEDURES
Providers must complete a Provider Intake to be considered for the Pineapple Support Provider Network.
At the time of completion of the Provider Intake, providers must be fully licensed by the State Board of Examiners for the profession(s) in which they are licensed and must submit proof of licensure along with the Provider Intake form.
Providers must maintain and provide proof of that professional licensure on an annual basis.
Providers must maintain professional liability insurance at all times and provide Pineapple Support with proof of current insurance prior to admission to the network and again on an annual basis.
Providers must sign and return via email the Pineapple Counseling and Psychiatry Provider Agreement at the time of admission to the Pineapple Support Provider Network and at the time of any major change in Pineapple Support Policies and Procedures.
Providers must have an email account at which they may receive information, notices and requests from Pineapple Support staff that may include client identifying information, in the form of client’s initials and Pineapple ID number.
Providers must have access to the internet in order to conduct online video therapy and download forms and other important information from the Providers page on the Pineapple Support website (www.pineapplesupport.org).
Providers must agree to utilize Apricot, the client information systems utilized for the benefit of both Provider (prompt and accurate payment) and Pineapple Support (real time data entry, timely authorization and re-enrollment).
Providers understand that they are independent contractors and in no way employees of the Pineapple Support Foundation.
Authorization and Referral Process
Referrals to authorized Pineapple Support Providers are made based on multiple criteria, including but not limited to, a client’s specific request regarding location, gender of provider, provider’s experience with specific issues or problems of concern to a client, philosophical or spiritual preference of a client, current provider caseloads and provider availability.
While Pineapple Support makes no guarantee as to the number of referrals a provider may receive, Pineapple Support expects each new provider to build up to a caseload of no fewer than two (2) Pineapple Support clients.
Providers will instruct clients to contact Pineapple Support when their authorization for services is approaching expiration.
Providers understand that they should not engage in a new service with a client until an authorization for the new service has been created.
Pineapple Support Clinical Staff will begin outreach to clients a minimum of 15 days prior to expiration of authorization for services. Pineapple Support Clinical Staff will make two separate attempts to reach client for reauthorization.
Pineapple Support Clinical Staff will ensure that all clients agree to a release of information for any and all Pineapple Support Providers involved in their care.
Providers agree to respond to all contacts and inquires by authorized Pineapple Support clients, including initial requests for appointments, on the same day if at all possible, but at all times within 24 hours during the regular business week. If the contact or inquiry occurs during a weekend or holiday, a response is required before close of business on the first business day following the weekend or holiday.
Providers agree to respond to all contacts and inquiries from Pineapple Support Staff (via telephone, email or text) on the same day if at all possible, but at all times within 24 hours during regular business week. If the contact or inquiry occurs during a weekend or holiday, a response is required before close of business on the first business day following the weekend or holiday. Persistent failure to respond to outreach by Pineapple Support staff will be grounds for termination from the Network.
Providers agree to identify clients in email correspondence only by the use of the client’s initials and Pineapple Support ID Number. At no time should a client’s full name be used in an email correspondence.
Providers agree to either email Pineapple Support staff directly or post a note to record when pertinent information regarding a client needs to be shared with Pineapple Support Clinical Staff.
Providers will immediately notify Pineapple Support Clinical Staff of their inability to take any new Pineapple Support clients by either putting themselves in “Active/On Hold” status in Apricot or by emailing the Clinical Director.
Providers will notify Pineapple Support Clinical Staff if they have received an Authorization for Services and the referenced client does not call to schedule an appointment within two weeks of the initial authorization.
Providers will notify Pineapple Support Clinical Staff if they have not communicated with a client in over 30 days.
Upon being informed by a provider that a client has not been in contact with them for over 30 days, Pineapple Support Clinical Staff will conduct wellness checks.
When there is important information to impart to Providers, Pineapple Support Clinical Staff will email all providers with the new information. Such information includes, but is not limited to, policy changes, request for event volunteering and Provider Network Meeting reminders and minutes.
Providers agree to discuss the client’s co-pay per session and the provider’s practice policies regarding payment of co-pays and missed and/or cancelled appointment fees.
Providers will collect the authorized co-pay amount from the client at the initial session and every session thereafter, unless other arrangements have been made with Pineapple Support Clinical Staff.
Providers should be aware that Pineapple Support is not responsible for any missed appointment fees or unpaid co-pays, even if the missed appointment is the initial intake. Therefore, providers should follow their own practice policies with regards to payment.
Providers will have all Pineapple Support clients agree to their practice release of information, allowing the provider to speak with Pineapple Support Clinical Staff and any other Pineapple Support Providers involved in the client’s care.
Pineapple Support Clinical Staff will support all practice policies of Pineapple Support Providers.
Co-Pays and Claim Forms
Providers are required to submit claims within 60 days of the date of service. A claim should be submitted for each session provided, even if the Pineapple Support rate is $0, which would only happen when the client’s co-pay is equal to the full Pineapple Support rate for the service provided. This is done so that Pineapple Support has the ability to track utilization of services.
Providers understand that any claims submitted after 60 days from the date of service will not be paid.
Providers will verify their license on each submitted Provider Claim Form.
Providers will verify their insurance status on each submitted Provider Claim Form.
Providers understand that they will not be reimbursed for services provided to a client without a VALID Authorization for Services.
Providers understand that they will not be reimbursed for continued services beyond the expiration date of the Authorization for Services. (please see #3 in the Authorization and Referral section).
Providers may contact Pineapple Support Case Manager regarding questions about claim forms or other billing procedures +1 305 776 0440.
Pineapple Support will compensate providers according to the Apricot Claim Form or invoice with prior approval from Pineapple Support Clinical Director.
Pineapple Support will compensate providers on the remaining balance minus the client’s co-pay. Providers are responsible for collecting the co-pay from the client at each session. Co-pays are assessed individually, so please refer to each client’s Authorization for Services.
Pineapple Support will not pay for any missed or cancelled appointments. At the provider’s discretion and in accordance with the provider’s established practice policy, as discussed with the client during the initial session, providers may bill the Pineapple Support client for the entire cost of a missed or cancelled appointment at the applicable Pineapple Support rate.
Pineapple Support does not reimburse at a higher rate for any extended sessions, beyond the usual and customary session rate.
On Hold Status
Providers may decline to accept new referrals by being placed on “Active/On Hold” status in Apricot. Providers may do this by changing their status in their Provider Intake in Apricot or by emailing the Pineapple Support Clinical Director.
A provider may remain in “Active/On Hold” status for a maximum of 6 months. If a provider needs to be in “Active/On Hold” status longer than 6 months, they will need approval from Pineapple Support Clinical Director to remain as a Pineapple Support Provider.
Providers agree to abide by all applicable codes of ethics of their profession.
Providers agree to abide by current privacy laws, respect the confidentiality of Pineapple Support clients and maintain appropriate professional boundaries with clients at all times, including in the use of electronic communications and social media.
Providers will provide the same quality of care offered to all clients through the use of evidence based practices, based on clinical judgment and scope of practice (as allowed by state and federal law for specific education, experience and competency) to achieve the best outcomes.
Providers will share any concerns and grievances with Pineapple Support Clinicians and/or the Clinical Director and expect reasonable efforts and actions to achieve resolution.
Pineapple Support Staff will use the following process when a grievance has been presented about a Pineapple Support Provider:
Pineapple Support will contact the provider to obtain the provider’s version of events.
If the grievance is reportable, Pineapple Support Clinical Staff will encourage the complaining client to file a formal complaint with the appropriate licensing board of the provider. If the client is unwilling to do so, Pineapple Support Clinical Staff will file the complaint.
If complaints continue, recommendations will be sought through peer review with the Pineapple Support Clinical Advisory Panel.
Pineapple Support reserves the right to place the provider on “Active/On Hold” status while the complaint is being investigated.
If the issue is malpractice or clearly violates ethical practice standards, Pineapple Support reserves the right to terminate the provider immediately and reassign clients as necessary.
Termination of Services with Clients
When the provider and client agree to terminate their relationship, the provider will complete the termination portion of the Provider Service Summary within 30 days of final session.
If the client disengages for any reason for more than 60 days without notice to Pineapple Support or the provider, the provider will complete the termination portion of the Provider Service Summary immediately.
Providers will adhere to the ethical standards of their discipline and licensing board when terminating a client, ensuring that the client is notified in writing, provided with referrals where appropriate, and, where, appropriate, offering the client 30 days of continued treatment during transition to another provider.
Providers will clearly document reasons for termination and efforts made to notify the client.
If a client should contact the provider to schedule an appointment after termination, providers will refer client to Pineapple Support for reauthorization.
Termination from Pineapple Support Provider Network
Providers may discontinue their relationship with Pineapple Support at any time, without explanation, by notifying Pineapple Support Clinical Staff via email, mail or phone.
Providers agree that they will notify Pineapple Support Clinical Staff of their intention to leave the Network a minimum of 30 days prior to the desired date of termination.
Providers will refer all Pineapple Support clients back to Pineapple Support Clinical Staff for an updated assessment and new referral to a Pineapple Support Provider, if needed.
Pineapple Support may discontinue the relationship with a Provider for failure to adhere to these Policies and Procedures or if a grievance has been filed on the provider that is considered malpractice, clearly violates ethical practice standards or is a part of a pattern with the provider.