How You Can Avoid Common Costly Mental Health Billing Errors
Mental health practitioners often grapple with common billing issues. Insurers might deny claims due to perceived duplicates. DSM-5 and ICD-10 code disparities can complicate billing. Partial payments for patient care activities occur, adding administrative work. Providers might discover patients are out-of-network only after claim submission. ClinicMind offers solutions: billing for diagnostic assessments and office visits on separate days, expertise in DSM-5 and ICD-10 code conversions, and the benefit of outsourcing billing to address these challenges.
4 Factors That May Affect the Cost of Chiropractic Care
When back and neck pain affects your quality of life, you may consider visiting a chiropractic clinic to resolve it. While this type of treatment can greatly improve some spine and neck issues, you may have concerns about the cost if you do not have medical insurance or if your plan does not cover such visits. However, the cost of chiropractic care can vary widely, and there are several factors that may affect the price you pay out of pocket. 1. The Base Fee Most chiropractic clinics charge a base fee, which is often called the office visit cost. This is the amount of money the clinic charges for a basic visit where they collect your personal and medical history and when the chiropractor discusses your pain with you, as well as what may be causing it. You will likely pay the base fee each time you visit. 2. X-Ray Costs Before mapping a treatment plan, your chiropractor may order a course of X-rays to determine whether your back or neck pain is caused by something he or she may be able to view and diagnose. Issues such as compressed or slipped discs may show up during X-rays or an MRI. These tests may cost several hundred dollars, so it is important that you discuss any future costs with your clinic before they proceed, as well as any payment options they might offer for such tests. 3. Therapy Choices Your chiropractor may offer you several different types of therapies when it comes to planning your treatment. These might include ultrasound, hydrotherapy, and laser treatments to target and treat the source of your pain. A chiropractor such as one from AmeriWell Clinics will likely discuss each option with you and help you understand the cost and benefit of each so you can feel at ease about your future treatments. 4. Your Lifestyle You may be able to reduce your chiropractic costs by adhering to your treatment plan and your chiropractor’s recommendations. For example, if he or she wants you to avoid jogging because of the impact it has on your spine and recommends walking or another type of exercise, following your advised treatment plan, could reduce the number of sessions you require and save you money. The cost of chiropractic care can vary widely depending on the type of pain you experience and treatment needed, but your local chiropractor may have payment options for you. Reach out to a nearby clinic today for further advice and information.
How to beat insurance companies at their own game – The “claim” lifecycle
Hey everyone, Dr. Brian Capra here. Tonight we’re going to start getting into how we’re going to beat insurance companies at their own game. So I’m going to quickly review something here, just kind of a little bit more of a schematic. This is my first screen sharing, so hopefully this is working for you right now. What we’re going to do is first of all talk about just overview of what we’ve already spoken about. Number one, insurance companies, we know how they get money, they get premiums from either employers or just patients out there that buy health insurance on the market, right, so they get premiums. Then what happens is the doctor over here, poor doctor on the right hand side over here, submits a claim to the insurance company. The insurance company delays reimbursement. We’re going to go into more depth about this, but we’ve already kind of talked about how the whole process is rigged in this way, where, how do they delay reimbursement? Part of it is just preventing you from getting the claim out to begin with. Forget the fact that they get the claim and deny it and all that stuff, but making complex coding systems and all that is part of the issue. So delays in reimbursement. They collect money. So as soon as they don’t pay you at the time you saw the patient, interest starts accruing on the money that’s yours still sitting in their bank account. So they’re going to collect that money, that interest, that’s called the float. They’re going to put that money, they actually reinvest that, there’s some very complex financial mechanisms that they use, so they’re going to reinvest that. Then they take all of those profits combined, they either keep the profits, they invest in better systems, technology, automation, and also invest in audits. All right. Eventually, hopefully they pay us, but then we have denials and underpayments, et cetera, that we have to deal with. So this is just kind of, I put together a quick overview. What I’m going to start talking to you about right now, we’re going to go into a lot of depth about each one of these steps, is how are we going to beat … What I talked to you last video about was how are we going to use their people, the types of person that they use, or our people? When I say people, our staff, our teams, how are we going to start to reposition those things, use them in a different way, use different types of people, leverage technology, automation, artificial intelligence, and leverage different processes to basically beat them at their own game? We’re going to go over a quick overview and I’ll come back to this and go into more depth that the way you beat them at their own game is on the claim level meaning every single claim you have to beat them at it. All right, so the claim starts when a patient actually checks in the door into your office, and then we see the patient, create a document, and we got submit the claim to insurance. I’m going to get back to cash in a second here so don’t get scared there. The claim is accepted by the insurance company. The AI, I’m going to go in depth about this, artificial intelligence looks for errors, submits it back to the office. We have EOB posting, secondary claim submission, secondary EOB posting, same process to find claims that need followup. The claim is fully processed, now we have a patient balance. If it was a cash patient, we just bypass all those steps and the claim, whether it’s cash or insurance, a claim is a claim. There’s a diagnosis code, there’s procedure codes, there’s the associated fees that go with those procedure codes for, you can have a different payer system even for cash patients. But we wind up with the patient balance and then we have all kinds of automation and technology that we can use to get that patient balance down to zero as fast as possible. So the name of the game is to leverage people, process, and technology to get that timeframe from time of service, the time the patient was seen in your office or checked in, to the time you have a zero balance for that patient. Obviously for insurance, that gets more complicated. So I’m going to go into more depth, little bit step by step in the next video. Stay tuned. Thank you very much. Again, this is Dr. Brian Capra From Genesis Chiropractic Software, and I will see you soon
How to beat insurance companies – people process and tech – automate, focus, measure
Hi everyone, Dr. Brian Capra here from Genesis Chiropractic software. And another video in the series here, I’ve been building on, each one building on the ones before. Last week, last I was on I was talking about how we can use people, process, and technology to beat insurance companies at their own game. Something that we’ve been doing at Genesis for close to 15 years now. So I’ll try to give you kind of a, some of the context here. What we’re going to focus on with people, process, and technology are three things. Automate. Automate everything possible. In order, in doing so, by automating everything possible, and we’ve automated literally using artificial intelligence, automation, aggregating data across thousands of providers, we’ve been able to automate more than, I think it’s 62% to 72% more automation in Genesis than any other system. When we automate, then we can focus. We can focus on the things that actually get you paid. And that doesn’t have to be just insurance, it’s cash as well. Focusing you and your team on just the tasks that get you paid, and I’m going to go a little more in depth about that. And then once we automate and we’re able to focus, then we can measure. We can measure how much work was actually needed to be done, how much work was actually completed, the quality of the work. And then we can also start to measure not just our own performance as an individual practice but also see the trends across the entire profession as far as what insurance companies are doing trend-wise so we can continue to battle, build more automation, more rules, better artificial intelligence, to beat them at their own game. I have a really cool example of how we’re able to actually beat insurance companies at their own game, specifically in New Jersey. So, what am I talking about with automation? I’m going to just start with insurance claims. This is going to expand into way more than that. It’s going to expand into the patient experience, and patient retention. Of course other things that affect your revenue. Let’s talk about insurance. So we’re going to automate everything, right? We’re going to automate benefit verification. We’re going to automate, like we do in Genesis, and maybe I’ll post some videos of some of the documentation, but we’ve now built an even better documentation system that’s been released this year in beta, it’s starting to get to full production right now. Where the documentation is completely automated from the intake form into the exam form into the daily note in every document after that. Where we can take out all the manual steps that you have to do right now. And as well, on your daily notes from visit to visit make it super simple for you to make changes and updates to that. So, benefit verification. Documentation of every single visit. Not only documenting, but the next step in actually collecting insurance is making sure that you create a claim. Well, in a lot of systems, in a lot of technologies out there, it’s kind of two different processes where you create your document, then you create your claim, and hope you don’t get audited later. What we’ve done with Genesis is make the document, create the claim. Meaning that what’s documented in your visit actually generates the claim, the codes, the diagnosis codes, the procedure codes, the modifiers, the time units, the diagnosis linking. All those things so that literally in seconds while you’ve seen a patient you can create, your claim is actually created, and it’s compliant, meaning that it’s actually supported by your document and submitted to the insurance company in real time. Then if for some reason you tweet something or things didn’t work properly, it’s going to go through a huge, huge rules engine where we have millions of validations, or rules, or artificial intelligence rules that are going to scrub that claim. This is not clearing house scrubbing. This is Genesis level scrubbing with millions of rules that we’ve learned, you know, tens of millions of claims over the years. All right? So now we’ve got the claims that maybe need a little bit of tweaking before they go out. Just focusing your team on correcting them if need be. The claim submission, like I just said, is real time. EOB posting is now automated, right? Secondary claims go out automatically, secondary EOBs come in automatically, and post. And then we’re going to talk about probably the most important difference with automation, using automation, to make sure you’re keeping those insurance companies accountable and make them pay the second, the first time, the first minute that you have something that you can legally do to make them pay as soon as possible. Making sure that comes right to you. What do I mean by that? We know, just go back and watch the previous videos, and how they’re legally allowed to create these laws and rules, and that we have 90, I’m sorry, 30 days to pay you and get an EOB back to you. Making sure that they pay on that day. Really we know that they should pay at the time you see the patient, or right after you’re finished seeing the patient, right? But we know the laws aren’t quite that way. So when we get that EOB back, if there’s something that needs to be followed up on, it has to be done that second. I’m going to show you how this applies to the follow up being done the second it’s due. It doesn’t just apply to insurance claims. It applies to every part of the patient life cycle. The no shows, the no future appointments, the care plans. I’m going to talk about that in other videos. But now we have identified the claims. I mean, we, the technology and the artificial intelligence, is actually
