10 Quickest Ways to Lose Out on Insurance Reimbursement

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.

Best Practices in Child Sexual Abuse Summer Series 2010

Best Practices in Child Sexual Abuse: Summer Series

A 5-part training program sponsored by Project Harmony, Metropolitan Child Advocacy Coalition, the 1184 Treatment Teams, and the Nebraska Department of Health and Human Services

Part 1: Reporting and Responding to Child Abuse and Neglect 

is free and available July 23 or Oct 26

To register, click on http://www.nebraskacacs.com/TrainingAndEvents

                 

Friday, July 29

Part 2:         Understanding and Assessing Child Sexual Abuse:

(9:00 a.m. - 12:00 p.m.)

Part 3:         Safety Planning in Sexual Abuse Cases:

(1:00-4:00 p.m.)

Friday, August 27

Part 4:        Treatment, Reconciliation, and Reunification:

(9:00 a.m. –12:00 p.m.)

Part 5:        Resources, Supervision, and Professional Development:

The Ethical Practitioner (includes 3 ethics CEUs):

(1:00-4:00 p.m.)

        

Audience:  

Licensed mental health practitioners, social workers, marriage and family therapists, psychologists, and psychiatrists in Nebraska and Iowa.

Cost:  

Part 1 is free; the remaining courses are $30 each.

Referrals:  

In order to receive referrals from Project Harmony Child Protection Center, licensed mental health practitioners will need to complete the entire series in any order.

To download a registration form, click here.

Using Michael Port's Book Yourself Solid 4-Part System

A few months back, I had the opportunity to participate in a call with Michael Port, author of Book Yourself Solid.

I like his 4-Part Sales Formula -- and recommend therapists use these principles in talks with prospective clients.

Question #1: What is your goal? What do you want out of therapy?
- Once you feel certain you know what they want to accomplish (and what their timeframe is), ask:

Question #2: How will you know when you've accomplished your goal? What results will you see? What feelings will you have?
- Once you feel like the prospective client has articulated these outcomes, ask:

Question #3: Would you like someone to help you accomplish this goal?
- If they say "No," wish them the best of luck and keep in touch with them.
- If they say, "Yes," then ask:

Question #4: Would you like that person to be me? Because, you know, you are my ideal client.
- When they say, "What do you mean?" respond with, "Because you are someone with whom I can do my best work, because you are ..." (and then list the qualities that make them who they are.)


For more information, read his book:

Have a Therapy Directory Listing, But No Website?

Do you have a Therapy Directory listing, but no website? 

If you're not ready for a full-fledged website, you can create a simple, one-page website by registering your vanity domain name and pointing it to your Therapy Directory profile.

Want help making this happen? For just $15, I'll register the custom domain name of your choice and redirect it to your Therapy Directory profile. 

To purchase this service, click here.

You can then use the domain name on all of your materials -- letterhead, business card, articles, brochures, and more. And, in the future, if you decide to develop a full website, you can simply point the domain name to the new website.

Here's an example of how this works:

http://www.debshaddy.com

Do You Make These Common Mistakes In Your Therapy DirectoryProfile?

Do you have a profile on The Therapy Directory? Are you making these common mistakes that are keeping you from getting more clients from your profile?

• Using I/me/my language instead of you (client) language. Prospective clients want to know how you can solve their problem, not what kind of degree or license you have or where you went to school.

• Talking in "psycho-babble." Pretend you don't have a graduate degree -- instead, put yourself in the shoes of a prospective client and explain how you can help him or her in a way that he or she can easily understood.

• Your profile has one or more typos. There is no excuse for errors in your profile. Copy-and-paste your narrative into a word processing program and run a spell-check. Double-check that your phone number is correct, and that your name is spelled correctly!

• Not including your photo. You can almost double the number of clicks your profile receives if you include a photo (but it has to be the right photo).

• Being too broad in your narrative description. The most effective profiles identify a specific issues -- or a category of problems -- that a prospective client might be experiencing.

• Trying to promote an entire practice with your profile -- not just you. If your Therapy Directory profile uses your practice name instead of your name, or your narrative references other therapists, you are diluting your impact and missing a possible opportunity to connect with prospective clients.

• Not setting yourself apart from other therapists. What makes you different from other therapists? (Your education? Your training? Your ability to speak Spanish?) Many therapists "look" alike online. Find ways to differentiate yourself ("Omaha's only therapist who...")

• Wasting the space you've been given. You only get 200 words in your Therapy Directory narrative -- so make the most of them! Don't waste valuable space on unnecessary information.

• Limiting your geographic scope. You can include up to three cities/zip codes in your profile (your own zip code, plus two additional ones), which allows your profile to appear in search results outside of your specific zip code. If you're not using this feature, you may be missing out on prospective clients from nearby areas.

• Providing a broken link to your website. The number one goal of your Therapy Directory profile is to attract prospective clients. Many prospects will want to check out your website, if you have one. So make sure the link on your Therapy Directory profile is working once your profile is live.

If your profile has one or more of these mistakes, you're missing out on clients! Call Bridget at (402) 393-4600 for a free evaluation of your Psychology Today Therapy Directory profile.

Billing Questions Teleseminar #1

The first Billing Questions Teleseminar was held on Wednesday, June 9, 2010.
Download the .mp3 audio file here.

Our guest was Deb Winsor of W-Tech Solutions. Deb has a bachelor's degree in business administration from the University of Nebraska-Lincoln. She worked in a hospital setting for more than five years before joining an extremely well-known insurance company here in Omaha (whose name we won't mention) where she has worked for the past 11 years. Deb has experience with Medicare, Medicaid, managed Medicaid, PPO insurance, Tricare, and numerous other health insurance companies. Her company, W-Tech Solutions, provides billing services to mental health therapists.

Questions asked included:

• Question: "I billed a claim in error for Jane Smith and I should have billed the claim for her daughter Mary Smith. Do I send in a new claim for Mary? How can the insurance company help me with this error on my part?"

Deb's answer: When in doubt, call the insurance company and ask how they'd like it handled. Some insurance companies have the capability of "moving money" from one member of the family to another family. If the insurance company cannot or will not do this for you, ask if you should refund the money for Jane Smith and then bill a new, clean claim for Mary. The better you follow the instructions for that insurance company, the faster your error will be resolved.

• Question: Is it important to fill out box 10 a.b.c. on the 1500 form? Could you answer this questions -- and what is box 10?

Deb's answer: Box 10 relates to information that may affect the payment of the claim by this insurance carrier. 

Box 10a: Select Yes to check if the patient's condition is related to employment. [This alerts the insurance company if this claim may be related to a Workmen's Compensation claim.]

Box 10b: Select Yes to check if the condition is related to an auto accident and enter the state. [This alerts the insurance company if this claim may be related to a car accident.]

Box 10c: Select Yes to check if the patient's condition is related to another accident.

The insurance company may return your claim for this information. This, in turn, holds up your payment. The better you fill out the 1500, the easier it is for the insurance company to process your claim. A claim with no errors is called a clean claim. Clean claims mean faster reimbursement for you.

If you use an accident-related code, you need to make sure it's not related to any other type of claim (Workmen's Compensation or automobile accident).

• Question: "My client has Medicaid. Is there a way to verify his benefits?"

Deb's answer: Medicaid is a payor of last resort. Make sure there is no other insurance that might be primary to Medicaid. Then, verify Medicaid eligibility. You can verify Medicaid eligibility five ways:

1. Ask to see the client's monthly Nebraska Medicaid Card or Nebraska Health Connection ID document. Make a copy for your records.
2. Call the automated Nebraska Medicaid Eligibility System (NMES line). In Lincoln, call (402) 471-9580 or (800) 642-6092 outside Lincoln.
3. Work with your electronic data interchange (EDI) clearinghouse to set up electronic Health Care Eligibility Benefit Inquiry.
4. Access client eligibility through the Internet.
5. Call the Medicaid Inquiry Line at (877) 255-3092 or (402) 471-9128. You can find more information on the state's website.

You can use the NMES line to look at authorized sessions -- but make sure you do it well before the expiration date.

• Question: "All the information needed to process the claim is on the bill I give to my client. Do I have to submit my charges on an insurance claim form?"

Deb's answer: The easiest answer is a question. How quickly do you want to get paid? You could submit your charges on a nice letterhead statement. The insurance company might accept it. But they might not. And if they don't, your pretty piece of paper will be returned to you with questions from the insurance company. Or worse. If you are a contracted provider for the insurance company, your contract may state that you must bill on a HCFA 1500 form. In that case, you won't get paid without one.

The easier you make it for the insurance company to process your claim -- i.e., with correct spellings of names, correct demographic information, and most importantly, correct insurance information with proper authorizations, the faster you will get reimbursement.

• Question: "What are some of the most common reasons claims are denied?"

Deb's answer: A common reason is that there is no tax identification number, which makes it difficult to identify the therapist, especially if the provider has a common last name. You should be using a federal tax identification number instead of your personal social security number. Call the insurance company's Provider Relations number -- they can help you get this set up.

Bonus tip: Insurance companies can use three different types of codes for billing -- Revenue Ruling Codes, CPT Codes, and HCPCS codes. It pays to ask the insurance company which codes they use.

You can contact Deb at W-Tech Solutions at (402) 415-5338 or e-mail w-tech_billing@cox.net if you have any billing questions or if you're interested in working with her. W-Tech Solutions allows therapists to focus on the billing aspect of your business so you can focus on your clients.

This call was sponsored by W-Tech Solutions, Inc. and The Therapy Directory, powered by Psychology Today. Get a free 90-day trial of The Therapy Directory using this link.

The next Billing Questions Teleseminar will be Wednesday, July 14 from 3 to 3:45 p.m.

Simple, Affordable, Professional Websites

Do you have a website for your practice?

If not, have you thought about one, but were put off by the hassle? (Finding someone to help you create it, coming up with content, the huge upfront cost, etc.?)

Most therapists I work with on their marketing and practice development efforts tell me they don't have a website because it's too hard to get started, or they don't want to pay $1,000 or $1,500 up front, plus the cost of website hosting and monthly or quarterly update charges. I understand!!

But what if you could create your own website for your practice in just 15 minutes, with no upfront cost? (Look for the promotional code below to see how you can get your first month free...)

A few months ago, I was looking for an affordable solution for therapists who want a website, but they want to be able to update it themselves -- adding information about new services, or groups they offer, or providing new, timely articles and resources for clients. Many therapists find a website can attract new clients, help develop relationships with referral sources -- and even make you money while you sleep, through the sale of information products like books, workbooks, CDs, and DVDs (your own, or others!)

I found a great therapy -- TherapySites -- that offers an affordable, easy-to-use solution that allows you to:

• Get your practice online quickly -- your new website can be up in a matter of just 15-20 minutes.
• Accept client payments securely online (you can accept credit card payments without needing your own merchant account!)
• Sell your products -- or products produced by other therapists -- such as books, workbooks, CDs, DVDs -- online.
• Get your intake paperwork to clients so they can fill it out before the first session, saving them -- and YOU! -- time.

Best of all, your website will look good and be easy to navigate. Unlike some low-cost websites, TherapySites sites look good too -- featuring high quality design templates and photo images, your website will look like a professional designed site -- at a fraction of the cost.

If you have even basic computer skills (say, enough to use Microsoft Word, or Facebook), you can create your own website. It's really easy.

It's also extremely affordable. Pay as you go -- no contracts, no upfront fees, no long-term commitments. For just $59 a month, you get:

• A website designed to showcase your therapy practice.
• A custom domain name (www.yourname.com)
• A custom e-mail address that matches your domain name -- that you can use on its own or have forward to any existing e-mail account you already have.
• Unlimited pages of content, including audio and video, at no extra charge.
• Online search functionality -- your website will be indexed by search engines so you can be found by prospective clients who are searching for a therapist. TherapySites works GREAT with Psychology Today's Therapy Directory to drive clients to your site...)
• Access to website statistics through Google Analytics so you can see how many visitors are coming to your site, and what pages they're visiting.

Recently, I became an Authorized Agent for TherapySites (just like I'm an Authorized Agent for The Therapy Directory). Through my affiliation with them, I can offer you the opportunity to try TherapySites for FREE for ONE MONTH so you can see if TherapySites works for you (a $59 value).

Simply visit this link:
http://www.therapysites.com

In the upper right-hand corner, you can watch the Video Tour or click the GET STARTED button. You'll be able to create your site right away. If you like what you see, you'll be offered the chance to BUY THIS SITE NOW -- when you do, enter promo code "PromoIBC" to get your FREE month to try it for yourself.


Be sure to enter this code when asked, so you'll get your first month free.