Billing is one of the most important aspects of running a rehab therapy clinic, aside frompatient care. But it can also be one of the most challenging, especially if you’re working with a billing process that doesn’t suit your clinic.
The right billing method should streamline your workflow, increase your profitability, and free up some much needed bandwidth. Just think, what could you do with some extra time. With that in mind, we’re going to devote the next handful of posts to some billing best practices to help you get your life back.
Our first tip covered auditing your existing process; tip two discussed the need to shop around; tip three explained in-house versus outsourced billing; and tip four detailed the importance of integrated billing. Here’s tip five:
#5: Once you select a plan, establish a comprehensive patient registration process.
Regardless of the billing option that best suits your clinic, there are several things you should know before you treat a patient to ensure your claims are processed quickly and accurately.
Here are ten questions you should be able to answer about each patient:
- What is the patient’s primary and, if applicable, secondary insurance coverage?
- Does the patient’s insurance plan cover PT/OT services?
- Is there a yearly visit limit for PT/OT? If so, how many visits have been used and who do you need to speak with to obtain authorization for additional visits?
- What is the copayment, coinsurance, or deductible that will apply to this service, and what amount of the deductible has been met year-to-date?
- What network is used to price claims for this plan?
- What is the insurance company’s mailing address for paper claim submission, or what is the unique payer ID for electronic claim submission?
- Does the patient’s insurance company require advance notification or plan of treatment be sent to a review company? If so, what information needs included for approval?
- Will the patient need additional information or medical records submitted with each worker’s compensation/liability coverage claim or does the payer prefer a periodic records review?
- What is your timely filing requirement?
- Who should you call for claims follow-up?
When it comes to billing, cash is king. If only raking in that cash was a little more enjoyable and lot less time consuming. With this week’s billing best practices, though, you can at least make sure you select the best darn rake possible for your clinic.
No matter what billing method you choose, make sure it’s one that allows you the time and focus to get back to all the things you want to do—and we’re guessing that doesn’t include claim submissions. It’s time to get your life back.
Make sure to check out part 4 as well!