Tips on getting organized to get reimbursed
By Susan Hoy

Getting paid by insurance providers is not easy and should not be done haphazardly. Systemizing your billing process is key to getting reimbursed. Here are some suggestions:

• Knowledge is power. Keep up with changes occurring in the insurance industry. Join your state and national chiropractic associations. They are fighting your battles, and they offer educational seminars to help you get paid.

Attend these seminars regularly. And call your state association when you have questions.

• Know your codes. Do not leave coding entirely up to your staff. If the billing is done under your name, then you are responsible for it. Know your codes. Your career and practice are at stake.

Provide a chiropractic-specific coding book to your staff. Search for a coding book that has suggested letters that can be written for common insurance denial situations.

Before you give the coding to your staff, read it from cover to cover. You may find codes for services you render that you may not be charging.

• Verify coverage. Verify coverage and eligibility for every new patient as soon as possible and before the patient begins treatment. Make a copy of the patient’s insurance card and get photo identification so you know that patient is the person with coverage.

It is a good idea to have the patient verify the coverage also.

• Discuss payment policies. Inform patients about their payment responsibility at the onset of care. The only exception is if you collect for the total or a percentage of the first visit charges.

Many offices advise new patients about their payment policies before the first visit. For example: “Our policy is to collect for the total first visit (or 50 percent) at the time of service. Our insurance department will verify your insurance coverage and make the appropriate credit according to your coverage.”

• Computerize. Incorrect computerization creates disastrous results. Train your data-input clerk well to avoid errors in personal and insurance information, diagnosis codes, billing codes, and applying payments.

• Create an insurance spreadsheet. Build a spreadsheet of all insurance plans you accept.

In the left column list all codes that you may bill.

In the top row, mark a column for your fees, and in each subsequent column, the reimbursement each insurer pays.

Then, fill in all of the blanks with the appropriate numbers.

• Write your reports. Communicating with insurance companies is necessary for patients to get the care they need and the payment you deserve. Schedule report writing into your daily schedule.

• Track records and reports. Review patient records and write a report after approximately 10-12 visits. Track your reviews and re-exams by using a tickler file.

The longer a report goes without being written, the more difficult it is to complete. Set a goal to complete two to five reports daily, depending on your case log.

The bottom line is that report writing and record keeping, while not the most fun part of practicing, are part of running your practice.

Complicated paperwork and labor-intensive procedures keep you and your staff from focusing on patients. When that happens, patients go away. Take the time now to organize and systemize your report writing and paperwork process.

Susan Hoy is an award-winning team trainer and consultant. She can be reached at 215-674-0130; suzzhoy@aol.com; or through her Web site at www.beefitup.net.