Be Prepared! Why Payer Changes Can Upend Billing Practices If You’re Not Ready

Change is always right around the corner, whether we like it or not. In the case of insurance companies, they’re not even waiting for said corner to spring changes on you; they’re perfectly content to hit you midstride with the latest guidance or requirement updates. What makes changes from payers especially tricky to track is that there are so many of them, they’re often not clearly announced in a way that’s easy to find, and they often put insurance companies out of step with one another. 

The challenge for rehab therapy clinics is to try and stay on top of these changes as best they can before they result in denials and delays, which often feels like a losing battle. So how do practices keep pace as updates seem to come through at a record pace? 

Appoint a point person. 

You want everyone in your clinic to be on the same page, but you probably figured out long ago that it’s highly impractical to expect every member of your staff to keep up with every bit of information coming in, not to mention inefficient. And chances are that you’ve probably delegated primary responsibility for certain functions to someone on your team. Payer updates are another example of an essential bit of information that should fall to one person, with the goal that regular training and internal dissemination of those changes can keep the rest of the practice up to speed. And while you might think it impractical to expect a staff member with other responsibilities to spend hours digging around online for updates, there’s usually an easier way.  

Get updates in your inbox.

The number and rate of payer changes might not be ideal, but at least there are conveniences afforded by modern technology when it comes to staying up to date. You certainly are well-acquainted with the most frequent payers you’re dealing with, and most of those payers offer you the option to sign up for email updates that’ll keep you abreast of changes. (I’m signed up for a few myself. Please don’t judge me too harshly.) Or if a particular payer doesn’t do email blasts, or you’d prefer to keep your inbox clear of yet another mass email, they’ll have a newsroom on their site where all the latest updates are published that can be checked on a regular cadence.   

Keep a record of payer changes.

It’s hard to keep documentation and billing requirements straight even when payers aren’t making regular tweaks, so constant changes probably require a single source of truth. While your designated payer update rep might be able to hold every change in their mind, a documented record of each update gives everyone something to fall back upon. A digital doc that everyone has access to is one approach, or, hey, physical media is making a comeback: a binder with printouts of the latest from your favorite payers ensures you have access to that info even when the wi-fi is down.       

Set up payer alerts.

Maybe the easiest way to remember something is to have someone else remember it for me, or to at least offer reminders. And that’s what billing software can do for you, once you set it up. WebPT, as one example pulled from thin air, allows you to set up customizable payer alerts that are tailored to each payer to make sure you’re meeting their specific requirements, whether that’s coding, documentation elements, or provider sign-off.  

Team up with billing experts who keep track for you.  

If you’re looking to simplify the entirety of your billing process, you can also make the choice to work with an outside RCM team to handle the hard work for you. Granted, not every clinic leader will take to the idea of having an essential part of their operation outside their four walls, but hiring a crack RCM team has its benefits. They come with tons of experience in billing, including keeping up with those irksome payer changes, and they have the tools and talent to help clinics collect more of what they’re owed while taking stress off of overworked billing staff.    

If you’re curious whether rehab-focused RCM support makes sense for your clinic, take a quick gander at what WebPT RCM Services has to offer.