Deciding who will manage your practice’s revenue cycle is not an easy decision and should not be rushed. The first question you should be asking is, “Should I manage my billing in-house or outsource?” There is no one-size-fits all answer to this question and it largely depends on your individual practice and staff. Today, we are just going to focus on the benefits of outsourcing your rehab therapy billing.
The front desk is often the face of your practice. They are the first and last people to interact with patients. Because this role is so important to the reputation and success of your practice, you need to have the right person for the job. But how can you know you have chosen the right person? Here are the skills our experts look for in a successful front desk specialist:
Many rehab therapists believe that once they are in-network with an insurance panel, they are an in-network with the insurance indefinitely. This is just one of the common misconceptions of credentialing. The truth is, group and individual providers need to complete recredentialing applications periodically to remain in-network. Let’s take a closer look at recredentialing to avoid unexpected contract termination.
When a healthcare provider gets married and takes their spouses last name, they will update their driver's license, bank accounts, car insurance, etc. With so many crucial areas that need updating, providers might forget to notify the insurance carriers in which their employer participates. Providers must update their professional license and national provider identifier (NPI) with this change, as well as the individual insurance companies.
The Centers for Medicare and Medicaid Services (CMS) implemented new modifiers that could impact your practice, these are the CQ and CO modifiers. If your practice utilizes physical therapy assistants and/or occupational therapy assistants, you will need to know when and how to apply the CQ and/or CO modifier.
To protect Medicare patients from identify theft and illegal use of Medicare benefits, Medicare has replaced the Health Insurance Claim Number (HICN) with Medicare Beneficiary Identifiers (MBI). HICNs were based on member’s SSNs while MBIs are unique and randomly generated.
What is a closed panel?To see a patient who wants to use their "in-network" benefits, you will need to be an “in-network provider”. This means that you have been credentialed and contracted with the patient's insurance company. When an insurance company feels that they have reached the adequate number of providers for a specialty in the area, they will close that panel and no longer issue contracts for new providers/groups. This can be extremely frustrating for a new business owner.
Many healthcare providers are unfamiliar with the credentialing process because they worked in a setting in which it wasn’t required, or their employer handled their enrollment. So, it only makes sense that providers can be intimidated by the amount of work that goes into credentialing when they attempt it for their own practice. We have outlined four ways to streamline credentialing so you can start treating patients as soon as possible.
Rehab billing is difficult to say the least. There are several pitfalls that you need to watch out for in order to “get paid right the first time”. Here are the top 7 most common mistakes you may be making: