courtesy of Kim French, Summit-Edge
1. Not getting on enough insurance panels: The more panels you’re on, the easier it will be to attract clients.
2. Not getting enough information upfront: Insurance billing is information driven. Make sure you collect all necessary information from the family. Then, verify this information with the insurance company.
3. Not getting and following the authorization: Always see if an authorization is needed. If it is, make sure you get it documented. Then, stick the authorization letter in your clinical file, and make sure you follow it carefully.
4. Not billing enough: Billing less than the maximum allowed is throwing money out the window. Use the Blue Cross/Blue Shield allowable rates as a guide in making sure you’re billing enough.
5. Not billing correctly: Insurance companies are very fussy about the claims. Make sure you’re dotting the “i”s and crossing the “t”s.
6. Not billing timely: More and more insurance companies are requiring that the billing be completed very quickly -- 60 to 90 days is not unusual. Given the complexity of insurance billing, these new time requirements will be costly for providers. The billing process will need to move very quickly.
7. Not reviewing the EOBs: The EOBs will tell you whether or not everything is getting paid according to plan. If something goes wrong, the EOB or denial will sound the first alarm.
8. Not responding to insurance company requests: If the insurance company asks for information from you, or from the family, make sure it gets that information. They won’t ask twice.
9. Not following up: It is very easy for an insurance company to ignore or deny a claim. So, a powerful follow-up system is essential to keeping the claims in process. If you don’t have it, the insurance companies will wear you down.
10. Not paying attention to what’s going on: Know what panels you’re on. Know what diagnoses and procedures get scrutinized. Know what the Medicaid procedures are.
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