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What is the Cascadia Behavioral Health reimbursement rate for CPT code 90837, and what action did Ben Carter take on March 26, 2024, regarding this rate?

Gold answer

$105.75. On March 26, 2024, Ben Carter sent a formal inquiry to Janice Lee at Cascadia Behavioral Health regarding this rate.

Filesystem View raw JSON
Input
363k
Output
5k
Steps
1
Tools
10
Latency
1.2m
Cost
$4.51
#1 Ran rg -n "Cascadia Behavioral Health|90837|Ben Carter|March 26|2024-03-26|03/26/2024" agent_memory 590,547 chars
Command command_execution 
rg -n "Cascadia Behavioral Health|90837|Ben Carter|March 26|2024-03-26|03/26/2024" agent_memory
Result 2 lines 
agent_memory/ce_reading/2024-02-12_pdx_telehealth_summit_notes.md:124:This was super relevant for my practice. Working with couples remotely presents unique challenges. This session was led by a couple named Sarah and Ben Carter, who run a practice focused on tech-enhanced therapy.
agent_memory/ce_reading/2024-02-13_email_telehealth_summit_takeaways.md:12:Secondly, there was a significant focus on…
#1 Ran rg -n "March 26|Mar(ch)? 26|2024-03-26|03/26/2024|Cascadia Behavioral Health|CBH|90837|rate" agent_memory/admin/billing agent_memory/memory/… 322,659 chars
Command command_execution 
rg -n "March 26|Mar(ch)? 26|2024-03-26|03/26/2024|Cascadia Behavioral Health|CBH|90837|rate" agent_memory/admin/billing agent_memory/memory/reference
Result 4 lines 
agent_memory/memory/reference/billing_codes_and_policies_guide.md:21:    *   3.2. Secondary Payer: Cascadia Behavioral Health (CBH)
agent_memory/memory/reference/billing_codes_and_policies_guide.md:23:        *   3.2.2. CBH Specific Quirks & Notes
agent_memory/memory/reference/billing_codes_and_policies_guide.md:24:        *   3.2.3. CBH Appeal Process Overview
agent_memory/memory/reference/billin…
#1 Ran rg --files agent_memory/admin/billing agent_memory/memory/reference 2,993 chars
Command command_execution 
rg --files agent_memory/admin/billing agent_memory/memory/reference
Result 6 lines 
agent_memory/memory/reference/emergency_protocols.md
agent_memory/memory/reference/billing_codes_and_policies_guide.md
agent_memory/memory/reference/practice_policies_and_procedures.md
agent_memory/memory/reference/hipaa_compliance_guide.md
agent_memory/admin/billing/insurance_correspondence/2024-03-26_cbh_rate_negotiation_inquiry.md
agent_memory/admin/billing/insurance_correspondence/2024-02-05_a…
#1 Ran nl -ba agent_memory/admin/billing/insurance_correspondence/2024-03-26_cbh_rate_negotiation_inquiry.md | sed -n '1,220p' 21,095 chars
Command command_execution 
nl -ba agent_memory/admin/billing/insurance_correspondence/2024-03-26_cbh_rate_negotiation_inquiry.md | sed -n '1,220p'
Result 10 lines 
     1	From: ben.carter@cypressgrovecounseling.com
     2	To: j.lee@cascadiabh.com
     3	Date: Tue, 26 Mar 2024 10:15:32 -0700
     4	Subject: Inquiry Regarding Reimbursement Rate Negotiation - Cypress Grove Counseling
     5	
     6	Dear Ms. Lee,
     7	
     8	I hope this email finds you well.
     9	
    10	My name is Ben Carter, and I am the Administrative & Billing Coordinator at Cypress Gro…
#1 Ran nl -ba agent_memory/memory/reference/billing_codes_and_policies_guide.md | sed -n '136,162p' 3,144 chars
Command command_execution 
nl -ba agent_memory/memory/reference/billing_codes_and_policies_guide.md | sed -n '136,162p'
Result 5 lines 
   136	    *   Attach all supporting documentation.
   137	5.  **Submit Appeal:** Submit the appeal letter and documentation according to PHA's instructions, typically via their provider portal or mail. Keep a copy of everything submitted.
   138	6.  **Follow Up:** Track the appeal status and follow up proactively if no response is received within the stated timeframe.
   139	
   140	**Case Study …
#1 Ran nl -ba agent_memory/admin/billing/insurance_correspondence/2024-04-02_cbh_rate_inquiry_response.md | sed -n '1,160p' 9,663 chars
Command command_execution 
nl -ba agent_memory/admin/billing/insurance_correspondence/2024-04-02_cbh_rate_inquiry_response.md | sed -n '1,160p'
Result 10 lines 
     1	From: ben.carter@cypressgrovecounseling.com
     2	To: j.lee@cascadiabh.com
     3	Date: Tue, 26 Mar 2024 10:15:32 -0700
     4	Subject: CBH Rate Negotiation Inquiry
     5	
     6	Dear Janice Lee,
     7	
     8	This email serves as a formal inquiry regarding the process for negotiating an increase in reimbursement rates with Cascadia Behavioral Health.
     9	
    10	Cypress Grove Counsel…
#1 Ran /bin/zsh -lc "rg -n \"fin_cbh_reimbursement|CBH.*90837|90837.*CBH|Cascadia.*90837|\\"'$155|'"\\"'$125|'"\\"'$130" agent_memory' 27,875 chars
Command command_execution 
/bin/zsh -lc "rg -n \"fin_cbh_reimbursement|CBH.*90837|90837.*CBH|Cascadia.*90837|\\"'$155|'"\\"'$125|'"\\"'$130" agent_memory'
Result 2 lines 
agent_memory/memory/reference/billing_codes_and_policies_guide.md:158:*   **`fin_cbh_reimbursement`**: This specific reference is to the overall reimbursement structure from CBH, which we've been discussing as potentially needing renegotiation due to rates being consistently below market averages and impacting practice profitability. (See `f498` for related discussion thread).
agent_memory/memory/…
#1 Ran nl -ba agent_memory/staff/notes/2024-03-26_email_cbh_reimbursement_strategy.md | sed -n '1,30p;235,290p' 11,165 chars
Command command_execution 
nl -ba agent_memory/staff/notes/2024-03-26_email_cbh_reimbursement_strategy.md | sed -n '1,30p;235,290p'
Result 8 lines 
     1	From: ben.carter@cypressgrovecounseling.com
     2	To: ananya.sharma@cypressgrovecounseling.com, maria.flores@cypressgrovecounseling.com
     3	Date: Tue, 26 Mar 2024 09:15:37 -0700
     4	Subject: Q1 Reimbursement Rates - Cascadia Behavioral Health (CBH) Analysis
     5	
     6	Team,
     7	
     8	I've compiled the Q1 reimbursement data, and I wanted to flag a concerning trend regarding C…
#1 Ran nl -ba agent_memory/staff/notes/2024-03-25_email_q1_billing_summary_issues.md | sed -n '1,40p;150,165p' 6,839 chars
Command command_execution 
nl -ba agent_memory/staff/notes/2024-03-25_email_q1_billing_summary_issues.md | sed -n '1,40p;150,165p'
Result 11 lines 
     1	From: ben.carter@cypressgrovecounseling.com
     2	To: ananya.sharma@cypressgrovecounseling.com
     3	Cc: sami.jones@cypressgrovecounseling.com
     4	Date: Mon, 25 Mar 2024 10:15:32 -0700
     5	Subject: Q1 2024 Billing Summary and Cascadia Reimbursement Concern
     6	
     7	Hi Ananya and Sami,
     8	
     9	Hope you're both having a productive start to the week.
    10	
    11	Just wa…
#1 Ran nl -ba agent_memory/admin/billing/insurance_correspondence/2024-04-10_incorrect_payment_notice.md | sed -n '1,20p;120,132p;325,333p' 6,488 chars
Command command_execution 
nl -ba agent_memory/admin/billing/insurance_correspondence/2024-04-10_incorrect_payment_notice.md | sed -n '1,20p;120,132p;325,333p'
Result 8 lines 
     1	From: ben.carter@cypressgrovecounseling.com
     2	To: maria.flores@cypressgrovecounseling.com
     3	Date: Wed, 10 Apr 2024 09:17:23 -0700
     4	Subject: Issue with CBH EOP - Client J.P. (DOB 08/15/1995)
     5	
     6	Hi Maria,
     7	
     8	Hope you're having a decent week. Mine's been a bit of a blur, trying to get through this mountain of EOPs. It's that time of the month again, you …
Answer
The CBH reimbursement rate Ben flagged for CPT `90837` was **$105.75 average reimbursement in Q1 2024**. He noted this was below the expected contracted amount, which was closer to **$130.00**. Source: [2024-03-26_email_cbh_reimbursement_strategy.md](/Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/fs/dp_009/agent_memory/staff/notes/2024-03-26_email_cbh_reimbursement_strategy.md:10). On **March 26, 2024**, Ben Carter emailed Cascadia Behavioral Health to **init…
Judge: covers all asked facts
SMFS Won View raw JSON
Input
280k
Output
4k
Steps
1
Tools
9
Latency
1.4m
Cost
$3.49
#1 Ran cat /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/profile.md 6,350 chars
Command command_execution 
cat /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/profile.md
Result 9 lines 
# Memory Profile
# This file is auto-generated from your memories.
# It is not editable. To update, modify the source files
# that contain this information.

## Core Knowledge
- Dr. Ananya Sharma is the founder and a Senior Licensed Psychologist at Cypress Grove Counseling in Portland, OR.
- Maria Flores is a Licensed Clinical Social Worker (LCSW) at Cypress Grove Counseling in Portland, OR.
- Sam…
#1 Ran smfs grep "Cascadia Behavioral Health reimbursement rate CPT code 90837 Ben Carter March 26 2024" /Users/prasanna/Documents/supermemoryai/su… 8,515 chars
Command command_execution 
smfs grep "Cascadia Behavioral Health reimbursement rate CPT code 90837 Ben Carter March 26 2024" /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/
Result 5 lines 
/memory/reference/billing_codes_and_policies_guide.md:Ben Carter manages the billing operations at Cypress Grove Counseling and maintains the internal billing and reimbursement guide.

# supermemory semantic search — 10 results for "Cascadia Behavioral Health reimbursement rate CPT code 90837 Ben Carter March 26 2024"
# searches by meaning across files in this container. usage:
#   grep "natural l…
#1 Ran sed -n '1,80p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/admin/billing/ins… 7,413 chars
Command command_execution 
sed -n '1,80p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/admin/billing/insurance_correspondence/2024-03-26_cbh_rate_negotiation_inquiry.md
Result 10 lines 
From: ben.carter@cypressgrovecounseling.com
To: j.lee@cascadiabh.com
Date: Tue, 26 Mar 2024 10:15:32 -0700
Subject: Inquiry Regarding Reimbursement Rate Negotiation - Cypress Grove Counseling

Dear Ms. Lee,

I hope this email finds you well.

My name is Ben Carter, and I am the Administrative & Billing Coordinator at Cypress Grove Counseling, located in Portland, Oregon (loc_office_cgc). We have b…
#1 Ran sed -n '1,80p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/staff/notes/2024-… 7,028 chars
Command command_execution 
sed -n '1,80p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/staff/notes/2024-03-25_email_q1_billing_summary_issues.md
Result 11 lines 
From: ben.carter@cypressgrovecounseling.com
To: ananya.sharma@cypressgrovecounseling.com
Cc: sami.jones@cypressgrovecounseling.com
Date: Mon, 25 Mar 2024 10:15:32 -0700
Subject: Q1 2024 Billing Summary and Cascadia Reimbursement Concern

Hi Ananya and Sami,

Hope you're both having a productive start to the week.

Just wanted to let you know that the Q1 2024 billing summary report is now complete …
#1 Ran sed -n '180,215p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/admin/billing/… 3,274 chars
Command command_execution 
sed -n '180,215p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/admin/billing/insurance_correspondence/2024-03-26_cbh_rate_negotiation_inquiry.md
Result 2 lines 
---
Confidentiality Notice: This email message, including any attachments, is for the sole use of the intended recipient and may contain information that is privileged, confidential, and exempt from disclosure. If you are not the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this commu…
#1 Ran smfs grep "CBH Cascadia CPT 90837 reimbursement rate 105.75 155.00 contract rate" /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scr… 8,903 chars
Command command_execution 
smfs grep "CBH Cascadia CPT 90837 reimbursement rate 105.75 155.00 contract rate" /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/
Result 7 lines 
# supermemory semantic search — 10 results for "CBH Cascadia CPT 90837 reimbursement rate 105.75 155.00 contract rate"
# searches by meaning across files in this container. usage:
#   grep "natural language query"          search all files
#   grep "query" path/to/dir/              search within directory
# output: <filepath>:<line_start>-<line_end>:<chunk> (chunk text is verbatim from the file)

…
#1 Ran sed -n '150,180p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/staff/notes/20… 3,244 chars
Command command_execution 
sed -n '150,180p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/staff/notes/2024-03-25_email_q1_billing_summary_issues.md
Result 8 lines 
To: ananya.sharma@cypressgrovecounseling.com
Cc: sami.jones@cypressgrovecounseling.com
Date: Tue, 26 Mar 2024 14:30:15 -0700
Subject: Follow-up: Q1 2024 Billing Summary & CBH Reimbursement Discussion

Hi Ananya and Sami,

Just wrapping up our meeting. Thanks for taking the time to go over the Q1 billing summary and discuss the Cascadia Behavioral Health reimbursement situation. I've updated the sh…
#1 Ran sed -n '1,70p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/staff/notes/2024-… 7,216 chars
Command command_execution 
sed -n '1,70p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/staff/notes/2024-03-26_email_cbh_reimbursement_strategy.md
Result 8 lines 
From: ben.carter@cypressgrovecounseling.com
To: ananya.sharma@cypressgrovecounseling.com, maria.flores@cypressgrovecounseling.com
Date: Tue, 26 Mar 2024 09:15:37 -0700
Subject: Q1 Reimbursement Rates - Cascadia Behavioral Health (CBH) Analysis

Team,

I've compiled the Q1 reimbursement data, and I wanted to flag a concerning trend regarding Cascadia Behavioral Health (CBH). As you know, we contrac…
#1 Ran sed -n '228,250p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/staff/notes/20… 2,885 chars
Command command_execution 
sed -n '228,250p' /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/staff/notes/2024-03-26_email_cbh_reimbursement_strategy.md
Result 3 lines 
| CPT Code  | Description                     | Q2 2023  | Q3 2023  | Q4 2023  | Q1 2024  | Contracted Rate (Est.) | % Difference (Q1 vs Contract) |
| :-------- | :------------------------------ | :------- | :------- | :------- | :------- | :--------------------- | :---------------------------- |
| **90837** | 60 min Individual Therapy       | $115.50  | $112.25  | $110.80  | $105.75  | ~$130.00  …
Answer
CBH’s Q1 2024 average reimbursement rate for CPT code `90837` was **$105.75**. Ben noted it should have been closer to the contracted rate of about **$130.00**. On **March 26, 2024**, Ben Carter contacted Cascadia Behavioral Health to **initiate a formal discussion about adjusting/negotiating the reimbursement rate**, with the review focused on CPT `90837`. Sources: [CBH analysis](/Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_009/agent_memory/staff/…
Judge: covers all asked facts