Collaborate on Sickness Billing Format for Client for Corporations with Ease Using airSlate SignNow

Sickness billing format for client for corporations

whether you're a seasoned behavioral health professional that just opened a private practice or a biller that just landed your first job at a facility you have to figure out how to bill insurance companies for counseling services unfortunately caring for clients is only half of the responsibilities you have on your plate the other half is dealing with and reporting to insurance companies so that you get paid for your services if you don't lock down a solid process for billing within your organization you'll have no choice but to eventually close your doors for good so the solution to what i'm saying is easy then right come up with a process for billing with your staff implement it and you can sleep well at night assuming that all your organization's revenue is in good shape it's not that easy two statistics help paint the dismal picture that is billing insurance companies first eighty percent of medical bills contain errors in other words even if you spend weeks with your team perfecting the billing process for your organization the industry averages aren't on your side second insurance claim denial rates are well over 11 so even if there aren't any errors on the medical bills that you send your patients their insurance companies still might not compensate you on the back end yes i've painted a grim picture but there's still hope hi everyone i'm albert from etactics and today i'm going to give you five steps on how to bill insurance companies for counseling now before we get started make sure that you subscribe to our youtube channel by clicking the button below and also hit that alert bell icon so that when we post new and helpful content you'll get notified [Music] the first step is the credentialing process billing can't happen without credentialing basically insurance companies came up with this process of credentialing to ensure that you're qualified for their panels to put it more simply they want to make sure that they can trust you once you're credentialed with an insurance company they'll likely list you and or your company on their website although each insurance's credentialing process is different there are preliminary steps that you should take to ensure you're prepared before the specifics first acquire a tax id for your organization that's separate from your social security number second seek and obtain malpractice insurance use the separate tax id received in step one third obtain a national provider identification or npi number fourth ensure that you're licensed in the state that you're providing service fifth understand your nucc grouping sixth if you're going to be a medicare or medicaid provider look up and know your taxonomy code seventh apply for a dea number if you plan on prescribing clients eight finalize the location and address of your private practice ninth familiarize yourself with caqh.org and create an account tenth and finally conduct research and make a list of insurance organizations now that preliminary process is essentially all of the information that's required for your ca qh application you see caqh is so important because it's an industry accepted database that many insurance companies use as their credentialing database of course once you create a user and submit it to the ca caqh database you need to keep the information updated it's especially important to ensure that you update the information within this database when your license and or malpractice insurance renews every year the second step to billing insurance companies for counseling is credential applications the application and contracting phase of the insurance credentialing process looks like this first before contacting any organization determine whether your credentialing as a group or an individual second if you have multiple locations have the addresses ready to provide third contact each of the insurance companies on your list and ask for their provider relations department fourth ask the provider relations department for a credentialing application and fifth review the credentialing application before signing understand things like documentation and claim submission requirements appeals processes reimbursable diagnosis codes modifier codes and timely filing limits sixth once signed keep a record of the contract in a safe place and seventh once credentialed the insurance organization will give you access to the provider portion of its website eight visit that website create a login familiarize yourself with the website ninth add all of the contact information to the master list that you created earlier and although i've only listed nine steps to the credentialing process it's important to understand that you can't finish it in a day in some cases this process could take months depending on the organization you're working with i haven't even mentioned the fact that some require you to have at least three years of licensure before accepting your application you're also bound to run into a scenario where an insurance company you're trying to credential with isn't accepting new providers at the moment if you run into this situation retry every six months until there's availability the third step is understanding cpt codes that your counseling organization uses often once you're credentialed with an insurance organization and you're on its panel you'll receive detailed billing information and requirements you need to keep these requirements in mind for every client session that you provide outside of credentialing billing insurance companies for counseling can't happen without current procedure terminology cpt codes in the mental health world cpt codes break down by procedure and by the length of time of the session for counseling there are a handful of cpt codes you'll most commonly use 90791 which is exclusive to the first appointment held with a client 90832 for 16 to 37 minute sessions 90834 for 38 to 52 minute sessions and 90837 for sessions lasting longer than 53 minutes and it isn't out of the ordinary for insurance organizations to include cpt codes in billing guides unfortunately though the codes provided within these guides might not be up to date since this happens it's best to ensure that you have the current cpt manual provided by the american medical association if you don't keep track of the right cpt code a lot of negative consequences could happen first it leads to delays in payment second the insurance organization may audit you finally the insurance organization might remove you from its panel the fourth step i have for you is claim submission after getting credentialed and recording information during the client visit for cpt code purposes it's time for claim submission if you're a private practice you're going to either send claims via paper cms 1500 form or digitally through your clearinghouse via ansi 837p format most modern insurance organizations don't accept paper forms anymore as such that's why you'll need a secure digital means to send them that's where your clearinghouse partner comes into play claim submission is such a long process it deserves its own entire separate video but basically it involves your team collecting specific patient information during sessions submitting patient claims on a clearinghouse level to ensure that it's accurate then submitting claims to insurance payers the fifth and final step to billing insurance companies for counseling deals with post submission and appeals this step starts with claim status once you submit your claim you're done and you can forget about it until you hear back from the insurance payer just kidding it takes insurance providers a bit of time before they accept or deny a claim once accepted the insurance organization will either send you a check via mail or through an electronic funds transfer eft for the claim of course if payment comes via an eft it will just appear in your organization's bank account with no real explanation so then how do you keep track of the claims that got accepted and resulted in payment from the insurance provider claim status your clearinghouse or pm system if it's integrated should have the ability to provide you with real-time updates as to the status of your claims thus checking the status of what you submitted and having historical data about your claims should happen regularly after claim status you move into appealing denied claims unfortunately the payers you submit your claims to aren't always going to accept everything when they don't accept your submission it's called a denial you don't receive any payment on denied claims however insurance organizations allow you to resubmit denials appealing is the accepted term for the process of fixing errors within denials and resubmitting them the appealing process should also exist within your clearinghouse it should be able to provide you with the denial reason codes and point out exactly where errors within your claims exist billing insurance companies for counseling is the same process as the ones used across the entire mental health industry the only thing that changes throughout is the patient information cpt code used insurance organization you're submitting claims to and its submission requirements i know what you're thinking he practically just identified everything so basically everything about billing changes for every patient every time yes there are a lot of details that change however your clearinghouse is there to help you get through the intricacies involved with billing insurance companies every step of the way if you'd like to learn more about billing insurance companies for counseling reach out to e-tactics and you've already made it this far into the video so you might as well like share and comment below