Many integrative medicine practices lack the budget, manpower or time to assist patients with resolving billing problems. However, in order to maintain healthy, positive patient relationships, providing this kind of assistance should be prioritized. Use these helpful steps to resolve patient billing issues:
- Ensure You Haven’t Made Any Errors – Patients commonly encounter problems with insurers, but there are many instances in which errors occur from the provider. Identify where your weak points are (these may include denial rates, limited timing, etc.) and ensure they are eliminated quickly.
- Consider Revising Your Process – Another way to reduce patient-billing problems is to assess your current process. Ensure you have a documented billing policy that is followed regularly, and that you don’t skip verify insurance benefits, fail to communicate vital patient information, etc.—these problems may be confusing and frustrating patients.
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- Evaluate Your Outsourcing Options – One of the most important things your patients need is an ally at your practice—someone who can intelligently explain expenses and address special issues as they come about. Consider outsourcing your medical billing to experienced professionals to help verify benefits, maximize revenue and lower claim denial rates.
to learn more about a customized billing solution for your practice today.
Participating with insurance company insurance plans is not always an easy task. Between denied claims, long processing times, payment disputes and more, there is a lot that goes on in addition to insurance credentialing. But, with the help of an initiative by the Council for Affordable Quality Healthcare (CAQH), your credentialing can be a lot simpler and with a lot fewer headaches.
Using CAQH ProView® (formerly the Universal Provider Datasource®)—an all-in-one platform where providers can submit, store, update and access the information they need—payers can easily download participating providers’ information into their systems.
Contact a payer to request its CAQH registration kit and follow their process online, or read more to learn about simplifying insurance credentialing. If you’d like assistance with working with payers, contact an experienced medical billing company to help streamline your practice’s processes.
According to the American Medical Association
, there are many insurance companies that continually underpay providers—most only paying between 86–92% of the rates they’re contracted to.
For holistic practices, this loss can be significant—if not detrimental—to overall revenue, impeding on their potential for scalable growth. However, there is a solution to ending underpayments
for good using these tips:
- Review Contracts and EOBs to See What’s Owed – Review each contract to identify exactly what payers have agreed to pay. Listing out each payer’s contracted rates by CPT code will help prove underpayments as they come up.
- Gather Research – Once contract information is collected, you’ll then want to compile statements and reimbursement data for each payer into another document for a certain range of time (best practice is one to three months). After that time, compare the information to rates in your initial document. Major issues will be easy to identify if payers are coming up short, and if so, it’ll be important to summarize that information into a report.
- Notify the Payer – When you’ve finished compiling your information, showing that underpayments have taken place, notify the payers by requesting a meeting with the individuals who are responsible for negotiating contracts. It’s best to come prepared to share what your reimbursement expectations are, should they agree to pay for their shortcomings. If they do not agree, taking legal action may be an appropriate option at that time.
- Stay Alert – The goal of these tips is for payers to provide more accurate reimbursements. However, if the preparation above doesn’t turn out positively for your practice, it’s a good idea to perform regular payment audits to check for underpayments.
Read more frequently asked questions about holistic insurance billing
like this now! Or, if these steps seem more complicated than what you’re comfortable with, or if you’re unsure of how to appropriately compile this data yourself, you may want to speak with a medical billing expert
to discuss a customized medical billing solution that works best for your holistic practice.