The VA Community Care Network (CCN) is VA’s direct link with community providers to ensure Veterans receive timely, high-quality care. CCN uses industry-standard approaches and guidelines to administer services, pay for services promptly, and manage the network to its full potential.
There have been some recent changes to how providers receive electronic funds transfers through the CCN. Triwest EFT enrollment used to go through CAQH Enrollhub. However, due to recent changes of Triwest/VA CCN EDI going through PGBA, providers must now enroll for EFT/ERA through PGBA.
Providers who were previously enrolled with EFT through CAQH Enrollhub will start receiving paper checks until they are re-enrolled through PGBA. PGBA requires two paper check numbers issued within the past 30 days to process Triwest/VA CCN EFT enrollment.
What are Electronic Fund Transfers and Why Do They Matter?
An electronic funds transfer is the electronic transfer of money from one bank account to another, either within a single financial institution or across multiple institutions, via computer-based systems, without the direct intervention of bank staff.
Receiving your VA CCN payments faster because EFTs transmit money directly into your bank account. You no longer have to go to the bank to deposit your money or wait for a check in the mail. Utilizing EFTs further streamlines your revenue cycle and reduces the number of daily tasks your practice has to perform.
What are Regional Networks in the VA CNN Program?
CCN comprises six regional networks covering all U.S. states and territories and is being deployed in a phased approach. Once fully implemented, CCN will be the preferred national network VA uses to purchase care for Veterans in their community. 
CCN comprises six regional networks. It covers all U.S. states and territories and relies on Third Party Administrators (TPAs) to develop and administer regional networks of high-performing licensed health care providers on behalf of VA. CCN has an established set of regional boundaries aligned to state boundaries to provide local flexibility and increased access to care. Each regional network of CCN serves as the contract vehicle for VA to purchase care in the community. With CCN, there is a focus on transparency, accountability, quality, and increased communications between VA and Veterans.
The regions are as follows:
Region 1:
- Connecticut
- Delaware
- District of Columbia
- Maine
- Maryland
- Massachusetts
- New Hampshire
- New Jersey
- New York
- North Carolina
- Pennsylvania
- Rhode Island
- West Virginia
- Vermont
- Virginia
Region 2:
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Michigan
- Minnesota
- Missouri
- Nebraska
- North Dakota
- Ohio
- South Dakota
- Wisconsin
Region 3:
- Alabama
- Arkansas
- Florida
- Georgia
- Louisiana
- Mississippi
- Oklahoma
- Puerto Rico
- South Carolina
- Tennessee
- Virgin Islands (U.S.)
Region 4:
- Arizona
- California
- Colorado
- Hawaii
- Idaho
- Montana
- New Mexico
- Nevada
- Oregon
- Texas
- Utah
- Washington
- Wyoming
Region 5:
- Alaska
Region 6:
- American Samoa
- Guam
- Northern Mariana Islands
What is the Latest Development of EFTs and the VA PC3 Program?
If you are in TriWest Region 4 or 5 (Alaska) and previously received EFTs from the VA PC3 program, you may begin seeing paper remittance. This is due to the transition of the VA PC3 program to VA CCN program. PGBA handles electronic claims and fund transfers for the VA CCN program in Region 4 and 5. To continue receiving EFT, you will need to register for PGBA EFT enrollment in the link below. PGBA requires 2 paper check numbers issued by VA CCN within the past 30 days to process the EFT enrollment.
What To Do In Order to Continue Receiving Electronic Fund Transfers?
Once you have submitted your EFT application, it takes approximately thirty (30) days to receive and process EFT requests. After your EFT application is processed, it takes seven (7) days for EFT to begin. After the 7-day period, you will receive EFT payments (for any VA CCN claims you submit) in the next payment cycle. A payment cycle is generally 2-3 days. Claims received after your EFT enrollment has been processed will be paid electronically. Until then, you will receive paper checks.
The good news is that you can submit VA CCN claims for multiple providers. PGBA processes EFT payments based on NPI. Payment for all locations under the registered NPI will be transmitted to the financial institution transit/routing and account number indicated on the EFT Authorization Agreement. If a specific location requires payment to a different account, it must have a different NPI and you must submit a separate EFT Authorization Agreement form.
Where Can You Register for the PGBA EFT Enrollment?
Download the EFT Authorization Form found on TriWest Payer Space on Availity.com. Print and complete the EFT registration package and mail it to: PGBA, LLC., PO Box 108853, Florence, SC 29502-8853. Once you receive a notification letter, you’ll start receiving your payments through EFT.
There are no fees to sign up for EFT, but you are encouraged to double-check with your bank to determine if they apply any fees to EFT.
Whether you suffer from physical or mental health issues, massage therapy offers an essential primary or complementary treatment option. Massage for wellness comes with many health benefits that help treat a variety of diseases and conditions. Read on to learn more about the different types of massages and how a holistic treatment plan can include massage therapy!
What is Massage Therapy?
A type of integrative medicine, massage therapy involves a certified massage therapist who manipulates the soft tissues of the body, including muscle, connective tissue, tendons, ligaments, and skin. By using varying degrees of pressure and movement, the massage therapist can induce pain relief for health conditions or relaxation for overall well-being. 
Massage therapy has its roots in both Eastern and Western medicine and has been practiced in most cultures to some extent. In fact, it’s one of the oldest remedies people have used for pain relief with a history that dates back about 5,000 years ago.
What are the Types of Massage Therapy?
There’s an array of different massage techniques, including:
Medical Massage
Unlike other forms of massage, which focus on relaxation, a medical massage is for medical needs and is prescribed by a physician as a form of treatment for diagnosed medical conditions. It’s also billed to insurance companies in fifteen-minute increments. The massage therapist may use a variety of techniques that will focus on the area of the body that is being affected by the medical diagnosis.
Swedish Massage
Swedish massage is a gentle full-body massage that helps to especially release muscle knots and fully relax patients.
Hot Stone Massage
While this kind of massage therapy is similar to Swedish massage, hot stone massage involves heated stones instead of or in addition to the massage therapist’s hands. The heated stones help to improve blood circulation and relieve muscle tension for relaxation and pain relief. Generally, hot stone massage relieves more muscle tension than the Swedish method due to the heat involved.
Aromatherapy Massage
This kind of massage therapy uses traditional massage techniques with the addition of essential oils. By combining gentle pressure with essential oils, this type of massage is designed for an emotional component. During treatment, the massage therapist will give a full-body massage while applying diluted essential oils to the skin.
Sports Massage
A sports massage is useful for treating repetitive muscle injuries from athletics or to help prevent a sports injury from occurring. This kind of treatment can also be used to increase flexibility and your overall athletic performance. Generally, a sports massage involves a full-body massage with the massage therapist focusing on certain muscles or parts of the body that need more attention.
Reflexology
Reflexology focuses on the pressure points in your hands, feet, and ears. During treatment, the massage therapist uses finger pressure, kneading, and rubbing on these different pressure points to induce relaxation.
Trigger Point Massage
This type of massage targets “trigger points,” or areas in the body that cause pain such as tightness in muscle tissue. The massage therapist focuses on relieving these trigger points with gentle strokes combined with deep pressure to reduce pain. Trigger point massage is ideal for those seeking to alleviate chronic pain.
Thai Massage
Thai massage is a unique blend of yoga, massage movements, and stretching. Unlike the other types of massage therapy, Thai massage is more active and involves the massage therapist moving and stretching the client in a sequence of postures, typically on a floor mat. In addition to being stretched in various positions, you will also have the massage therapist applying pressure to your body with their fingers and palms.
Top Conditions that Massage Therapy Can Help Treat
Massage therapy can help provide relief for many conditions, including:
1. Chronic Pain
Massage promotes relaxation, making it a great method for reducing a variety of pain conditions, from those caused by surgery or injury to chronic problems. Research has shown, for example, that massage therapy can help those who suffer from the common problem of low back pain. Massage can promote blood flow to parts of the body experiencing pain and release the body’s natural painkillers.
2. Anxiety
Massage for wellness can help those who suffer from mental health issues. For example, a study found that massage lowered the stress hormone cortisol in patients suffering from anxiety by 53%, according to the American Massage Therapy Association (AMTA).
3. Depression
When your muscles and connective tissues become stiff or rigid, it can cause pain and limit your movement. Massage therapy can help relieve this tension in your muscles and connective tissues. It also increases your blood flow and promotes relaxation.
If you have depression, massage therapy probably won’t cure your condition – but it may help relieve the physical symptoms associated with it. For example, massage may help alleviate sluggishness, back pain, joint pain, and muscle aches, which in turn helps to relieve fatigue and sleeping problems.
4 Repetitive Strain Injuries
Massage helps reduce symptoms in people suffering from repetitive strain injuries, or issues that affect the muscles and joints and cause symptoms like tenderness, throbbing pain, tingling, or loss of sensation. These issues can be caused by overusing a group of muscles, maintaining a particular posture for a long period of time, heavy lifting, and other factors. Research on patients with carpal tunnel syndrome, for example, found that massage therapy helped reduce pain and increase grip strength.
5. Cancer Recovery
Research shows that breast cancer patients benefit from a reduction of stress and anxiety when treated with massage therapy. For example, in a 5-week study at the University of Miami in 2003, massage therapy and progressive muscle relaxation therapy were compared in 58 women with stage I and II breast cancer. Both groups reported feeling less anxious, and the massage group also reported feeling less depressed. The massage group also showed increased levels of a brain chemical called dopamine, which helps produce a feeling of well-being. In addition, for the massage group, there was an increase in protective white blood cells that help boost the immune system from the first to the last day of the study.
6. Migraines
Many factors contribute to headaches, including stress, fatigue, and other health issues, including disease. Massage helps ease tension and pain, which helps patients reduce the symptoms of headaches or avoid them altogether. Migraine sufferers who receive massage for wellness experience fewer episodes of head pain, less severe symptoms, and improved quality of sleep, according to research.
7. Osteoarthritis
While there is still a need for further research on massage therapy for osteoarthritis of the knee, current studies suggest that it may have short-term benefits in relieving knee pain. Of six studies that evaluated massage therapy for osteoarthritis of the knee (408 total participants), five studies found that it provided short-term pain relief. Two of the studies that showed pain relief (149 participants) involved the use of essential oils (aromatherapy massage).
Why Effective Massage Therapy Insurance Billing Matters When Treating Patients
When massage therapists deliver treatments, medical billing processes ensure that they receive reimbursements for their care. While medical billing is an integral function of the reimbursement process, it can be very complex; the slightest error can delay payments for weeks, if not longer. Ensuring the most accurate medical billing allows medical therapists more time to spend doing what they love – delivering care to their patients.
However, balancing your holistic practice’s insurance enrollments, billing, and coding while delivering care to your patients can be overwhelming. How can you manage them all? By outsourcing your massage therapy insurance billing, your holistic practice can streamline your revenue cycle management – and save you the time and energy you can devote to your patients!
As an experienced billing provider for holistic providers, including massage therapists, Holistic Billing Services can help your massage therapy practice navigate the medical billing process to minimize denials and delays so you can increase revenue. With an expert partner by your side, you can focus more on treating patients to help your practice grow rather than worrying about insurance billing. To learn more about our massage therapy billing services, talk to one of our billing and coding experts today.
Did you know the healthcare industry loses more than $150 billion a year to no-shows alone? While there are a variety of reasons patients might miss their appointments, like simple forgetfulness or something unexpected taking precedence, it’s in your holistic practice’s best interest to implement a no-show policy. Without one in place, you’re leaving money on the table and wasting your staff’s precious time.
What is a No-Show Policy?
A no-show is when a patient misses their scheduled appointment without informing your holistic practice; this is different from a cancellation, which accounts for the patient communicating their intentions with your practice.
Thus, a no-show policy is the set of guidelines, rules, and penalties that a practice implements to manage patients who intentionally – or unintentionally – miss their appointments. Such a policy discourages your patients from missing their appointments and therefore reduces the adverse impact of no-shows on your holistic practice.
The Effects of No-Show Appointments on Holistic Medical Practices
Simply put, appointment cancellations and no-shows bring only negative consequences to your holistic practice. A missed appointment means no revenue and leaves your knowledgeable staff idle – all cost and no compensation. Precious resources like time and money are wasted when a patient cancels last-minute or doesn’t stick to their appointment, which significantly impacts your practice’s bottom line.
Strategies that aim to overcompensate for no-shows, like overbooking appointments, mean that your holistic practice can’t efficiently allocate its resources; essentially, such approaches can be fiscally irresponsible and result in the burnout of your staff.
What Are The Benefits of Creating a No-Show Policy?
Streamlines the Appointment Cancellation Process
Implementing a no-show policy helps your staff know what to do when patients don’t show up for their appointments. With an established protocol to refer to and communicate with patients, your employees can limit scheduling disruptions, handle follow-ups and rescheduling efficiently, and even fill empty time slots more quickly so your holistic practice won’t miss out on the income potential for that particular time window. 
Discourages Patient No-Shows
Since a no-show policy informs patients of the fees they will incur if they don’t show up, it discourages them from missing their appointments. Without a no-show policy, patients have no accountability whatsoever that will encourage them to go to your clinic.
Boosts Revenue Cycle Management
Ideally, every appointment you set should bring you money. If your patients don’t show up for their appointments, you don’t get paid. The fewer no-shows your practice has, the fewer disruptions there are to your workflows! This means your holistic practice’s patient and team scheduling staff run smoothly since they won’t have to spend extra time overbooking each day in the event of no-show patients. All of this ultimately means you’ll be more profitable since your operations will be better streamlined to account for forgetful patients.
How to Write a No-Show Fee Policy
-
Enable your patients to cancel in a convenient manner
Allow a timeframe for patients to cancel or move their appointments without getting penalized. Life happens, and it helps your patients to have the ability to cancel or reschedule their appointments on their time. When you add an appointment cancellation window in your no-show policy, you show your practice to be understanding and caring. That’s good for business, of course. You don’t want to be viewed as a holistic practice that nickels and dimes its patients!
-
Establish fees for canceling – or to incentivize keeping the appointment
Fees in a no-show policy will help deter patients from missing their appointments since they’ll know how much it’ll cost them; you can also utilize a type of reward system to incentivize patients who keep their appointments! Consider these points when writing your policy:
- Straight fee: Every time patients miss their appointments, they’re charged a no-show fee
- Reward system: Patients who show up on time and keep their appointments can get rewards, such as gift cards or other incentives, depending on your practice.
- Fee erased upon return: A small fee is added to your patients’ bills when they don’t show up for their appointments; however, if patients reschedule and arrive on time, the fee is removed.
-
Explain how your policies are enforced
Besides charging a fee, implement best practices that prevent patients from rescheduling if they exceed a specific number of missed appointments. For example, if you set a no-show limit of three appointments and your patient fails to show up for the fourth time, restrict their online or over-the-phone booking privileges. Be sure to send patient no-show letters to remind repeat offenders of the importance of keeping their appointments, and follow up on patients if they need to reschedule. Doing so discourages patients from missing their appointments without canceling, can minimize no-shows, and can reduce potential costly disruptions to your holistic practice’s workflows.
-
Remind your patients of their appointments
Part of your policy should be outlining a timeline of when the patient will get reminders about their appointments. Patients can sometimes forget their appointments, hence the no-shows. Prevent a good chunk of no-shows by calling patients a few days before their schedule or sending them quick reminders. In your policy, list when these notifications might happen so they can expect to get them.
-
Communicate your policies
Any new policy is only useful if the pertinent parties are aware of it! Ensure your patients know the consequences of missing appointments by communicating your no-call no-show policy. Below are a few common, yet effective, strategies to inform your patients about your policy. 
- Display your no-show policy on your online booking portal so patients know the guidelines and associated fees if they miss their appointments without giving you notice.
- When patients set appointments over the phone, ensure your employees inform them about your no-show policy. Your staff can say something like, “We look forward to seeing you. If you need to cancel your appointment, please do so within the next 24 hours to avoid getting charged the no-show fee of $25.”
- Include your no-show policy on your website so your patients can access it easily. To get more bookings, add a link to your appointment form or include your phone number so your patients can set appointments immediately.
Without a solution in place to reschedule no-shows, improve cancellation management, and fill empty appointment slots, these tasks are wasting your staff’s valuable time. That’s time that could be spent providing a top-notch care experience, making each and every patient feel welcome, or helping patients coordinate care, or answering patient’s non-clinical questions.
Since 1999, Holistic Billing Services has handled coding and billing issues for a variety of healthcare practices. We understand that each practice is unique and requires a customized solution that aligns with its long-term goals and increases its medical billing metrics. That’s why we work closely with our clients to help them set up holistic billing services and solutions that meet their specific needs and allows them to deliver the best care possible. To find out what we can do for your practice, contact our team today for a consultation.
While there are many factors involved with running a successful holistic practice, one of the cornerstones of success is having a streamlined medical billing operation. Insurance companies, both public and private, have numerous requirements and legal regulations by which your holistic practice needs to comply – including patient copays. Read on to learn the differences between copays and deductibles, and what to consider before waiving a patient’s copayment!
What are Co-Pays?
A co-payment, or co-pay, is a fixed amount for a covered service, paid by a patient to the provider of service before receiving the service. It may be defined in an insurance policy and paid by an insured person each time a medical service is accessed. For example, if you hurt your back and go see your doctor, or you need a refill of your child’s asthma medicine, the amount you pay for that visit or medicine is your co-pay. Co-pays cover the patient’s portion of the cost of a doctor’s visit or medication; the remaining balance is then covered by the patient’s insurance company.
Co-pays typically vary for different services within the same plans, particularly when they involve services that are considered essential or routine and others that are considered to be less routine or in the domain of a specialist. For example, co-pays for standard doctor visits are typically lower than those for specialists, while co-pays for emergency room visits tend to be the highest.
What are Patient Deductibles?
On the other hand, a deductible is an amount a patient pays for most eligible medical services or medications before their health plan begins to contribute to the cost of covered services. If the patient’s plan includes co-pays, they pay that flat fee at the time of service – at the pharmacy or doctor’s office, for example – and, depending on how their plan works, what they pay in co-pays may count towards their deductible.
After meeting a deductible, patients typically pay co-insurance—a certain percentage of costs—for any services that are covered by the plan and continue to pay the co-insurance until they meet their out-of-pocket maximum for the year. Co-insurance is a portion of the medical cost the patient pays after their deductible has been met. Basically, it ensures that the patient and their insurance carrier each pay a share of eligible costs that add up to 100%.
Issues With Waiving Patient Copays
What seems compassionate and helpful for your patients might get your holistic practice into hot water. Consider the following issues to consider when deciding whether or not to waive a patient’s copay.
Is It Illegal to Waive Insurance Copays?
It is a felony to routinely waive co-pays, coinsurance, and deductibles for patients. Waiving the collection of this portion is illegal and considered health insurance fraud because your office is claiming the wrong charge for services when insurance claims are created. To explain this further, we will use the following example: If your patient has a $10 co-pay, then the insurance company will pay $90 on a $100 bill. However, if the co-pay was waived, the patient’s bill is only $90 total, not $100.
The same laws apply to Medicare, Medicaid, and Tricare patients, but the risk is greater if your office does not comply—healthcare providers may be charged with fraud against a government agency. Waiver of coinsurance raises potential Federal Anti-Kickback Statute, Federal False Claims Act, and state law liability issues.
Waiving Co-pays for Some, But Not All, is Unfair
Your holistic practice must offer hardship programs to all patients – not just those with public health insurance. You cannot forgive a patient’s insurance debt for patients with public health insurance during times of crisis, yet require patients with private insurance to pay full co-pays regardless of their financial circumstances. Your practice’s medical billing operations need to be fair and equitable to all of your patients.
When Should You Waive Patient Co-Pays?
There are different scenarios in which healthcare providers may feel it’s appropriate to waive the patient’s insurance responsibility; scenarios may include patients who would like to extend professional courtesy to colleagues or their families, when patients are in severe financial distress, or when collection efforts have negligible results. Each example involves regulatory and legal issues that healthcare providers must consider, and should be given great consideration without just casually waiving the co-pay.
If a patient is in financial distress, healthcare providers may choose not to collect debts without risking allegations of insurance fraud. For example, if the physician doesn’t collect the patient’s insurance responsibility during a period of extreme financial hardship, the physician can choose not to pursue collection activity against the patient for the co-pay that’s owed.
Transform Your Revenue Cycle Management With Holistic Billing!
Our experts here at Holistic Billing Services believe that our success is your success. From handling medical billing and coding to offering consulting services and much more, our team is dedicated to making it feel like we’re in-house. With a focus on holistic practices, insurance background, and proven consultants, our team can effectively ensure the financial success of clients, allowing your holistic practice to focus on what it does best: treat patients.
Our expertise is rooted in professional, technical, and global billing for hospital and stand-alone holistic care practices. To learn more about how outsourced medical billing with Holistic Billing Services can empower your practice, contact us today. We’ll work with you to build a customized solution that meets the specific needs of your practice and allows you to get back to treating patients.
Most kids, as well as a lot of adults, are afraid of needles. So the pairing of acupuncture and kids might not be an obvious one. However, as more and more parents are seeking alternative methods of treatment for their children, it might be a good next step for your holistic practice to incorporate pediatric acupuncture into its services! This specialty can be incredibly rewarding work, but there are some practical steps to consider first.
What is Pediatric Acupuncture?
Parents are turning to acupuncture because it provides a safe resolution of illness, while also preventing future illnesses. Acupuncture and acupressure stimulate the body’s ability to restore and heal itself. Pediatric acupuncture can be the right tool that not only stimulates the immune system, but also relaxes the nervous system and regulates the digestive and hormonal systems.
How Does Pediatric Acupuncture Compare to Traditional Acupuncture Treatment?
Pediatric acupuncture is commonly known as shonishin and it rarely uses needles. Instead, this form of acupuncture utilizes the practitioners’ hands and rounded tools to stimulate the acupoints of the child. The practitioner will gently and rhythmically rub, tap and press the skin to produce gentle stimulation sensations.
How to Specialize in Pediatric Acupuncture
It’s important to know the ins and outs of working with babies, kids, and teens. As with most things in life, it takes practice, practice, practice! The more kids you see the easier it will become to work with them.
Presuming you or your acupuncture specialist already have a solid foundation in theory and diagnosis, there are some critical differences in pediatrics that you need to know. For example, knowing the most common organs that are deficient in children or how to tap into the developing meridian system.
You’ll want to review the most common conditions you’ll treat children for, as this will help inform your treatment plan:
- Allergies
- Asthma
- Eczema
- Chronic Low Immunity
- Digestive Problems
- Acute Conditions: fever, cough, ear infections, colds
Nutrition is at the core of pediatric health since children are rapidly growing. You need to know what children should be eating – and avoiding – because nutrition is so central to every holistic treatment plan. It would also help to research special diets, like GFCF and GAPS, so you know when to recommend them and how to help parents implement them.
Pediatric Acupuncture Best Practices to Consider
Make Sure You Have Pediatric Acupuncture Training
While it’s acceptable to start treating kids in your practice without additional training, it’s worth finding a local colleague who specializes in treating children and who can provide expert guidance during hands-on training.
A core component of this specialty, though not used in every pediatric acupuncture treatment, is to make sure you use pediatric needles when performing procedures on kids. These needles are much smaller than adult needles and are virtually painless. With smaller needles, the procedure will be much easier to perform and will ease the mind of both the child and parent.
Consider Needleless Acupuncture Treatments
Building trust with your patients is extremely important, especially when they’re children. Part of earning and maintaining that trust is to have a backup treatment plan when a child tells or shows you they’re uncomfortable with needles or any other tools you may be wanting to use.
It helps to have a very wide range of tools available since some kids will like certain types of Shonishin tools and not others. For example, the tools that tap can be too stimulating and ticklish, so a pediatric patient might prefer tools that brush. It’s important to keep in mind there’s a clear power difference between the child patient and adult acupuncturist, which is why you should ensure your pediatric patients feel in control of what happens to their bodies during their visit. If a child isn’t comfortable with needles, be prepared with another plan to treat them.
Don’t Isolate Parents from Children During Treatment
When treating children, it’s important to keep the parents or guardians involved in the pediatric acupuncture treatments you’re providing. For example, if you’re treating a child under five or who is nursing, it’s important to treat the mother at the same time, if possible. Consider also treating the caregivers when treating a young child because of how inherently in tune children can be with their guardians. Unspoken emotions and energy can be transferred between parents and a child, so it’s important to keep the unit together and in communication.
Don’t Discourage Playtime
When it comes to younger patients, they might feel more comfortable sitting in their parent’s lap, especially during the initial visit, or even playing on the floor while you perform the treatment. Toys are an extremely important tool for your ability to treat kids! When they’re waiting in the waiting room, they can have these toys to play with and bring with them into the room and that creates a kind of safety. When you are treating your pediatric acupuncture patients, you can allow for distraction so that you are able to do more of what you want for the treatment.
Streamline Medical Insurance Billing for Holistic Practices with HBS!
Medical billing is especially complicated for holistic practices and can possibly overwhelm your business as you focus on growing your practice and provide care for your patients. By outsourcing your medical billing, you can leave the responsibility of insurance enrollments, credentialing, and medical billing and coding to the experts – saving you time!
As an experienced billing provider for holistic practices, Holistic Billing Services can help your practice navigate the intricacies of insurance billing claims to minimize denials, increase your revenue, and grow your practice. We understand the unique needs of holistic practices, as well as the common obstacles you face when it comes to medical billing and coding. With a knowledgeable partner by your side, you can streamline your billing and increase your revenue cycle management! To learn more about our services, talk to one of our billing and coding experts today.
More Americans than ever before are embracing holistic healthcare over conventional medicine with nearly 40% of adults using some form of alternative medicine. Whether it’s to alleviate chronic pain, reduce stress, or for other benefits, there are countless holistic approaches to prevent, treat, and manage almost every condition or illness. But what exactly is holistic medicine, and how does it compare to conventional healthcare practices? Keep reading to learn all that and more!
What is Holistic Medicine?
Holistic healthcare is a form of medicine that treats the “whole person,” treating not the physical self, but also the emotional, spiritual, and mental facets as well. Whereas conventional western medicine seeks to provide treatment for pain or the ailment, holistic healthcare focuses on both treatment and prevention. For example, if a patient has an ailment and turns to holistic therapy for help, the holistic practitioner will seek any underlying causes, including the patient’s stress levels and diet.
What is Western Medicine?
Western, also known as Conventional, healthcare is an approach to medicine that’s based on modern science, and which evaluates the human body, its disorders, and medical treatments in purely-biophysical or biochemical terms. Common treatment methods include drugs, radiation, and surgery, for example. Additionally, western medicine often utilizes the most statistically-likely diagnosis and treatments that work on larger populations through scientific studies, over individualized or specialized methods.
Holistic Medicine VS Western Medicine: How Are They Different?
Treatment of Illness
Holistic healthcare primarily differs from conventional medicine in the diagnosis and treatment of illnesses. In holistic practices, identifying the disease is not the singular goal because illnesses are viewed as effects of the patient’s individual lifestyle; thus, treatments will vary for each person. Holistic treatments often incorporate medication, natural solutions or supplements, or diet and exercise regimens, like yoga. On the other hand, conventional medicine often includes formal tests and standardized treatments for every patient based on the illness. Treatments often include medication, with brief suggestions for lifestyle changes rather than concrete emphasis or direction to make those changes.
Cause of Ailment
While conventional medicine looks at physical components, such as corporeal symptoms and genetics, for the causes of illnesses, holistic healthcare looks at the overall wellness of the patient. This includes any possible imbalances, such as issues with mental health and diet, and discussion on how to level out imbalances. For holistic practitioners, environmental and emotional influences are factors equally important to the wellbeing of a patient as physical components.
Insurance-Coverage
Until recently, many holistic practitioners were not covered by insurance or were out of network. Even still, many holistic practices may find it harder to be covered by insurance. One survey by the National Center for Complementary and Integrative Health found that Americans pay more than $30 billion per year on alternative medicines out of pocket. With trends like these, insurance companies are taking note and are moving to be more inclusive of holistic healthcare. On the other hand, conventional medicine is more likely to be covered by insurance providers, and thus more accessible to Americans.
Benefits of Holistic Medicine
There are numerous benefits to utilizing holistic healthcare in your wellness journey, ranging from the practitioner’s approach to their overall goal of treating you as a whole person rather than the symptoms of an illness. Such advantages include:
- Practitioners who offer safe, natural, and effective medicinal treatment options that include lifestyle and self-care, and who use alternatives to traditional prescription drugs and invasive procedures whenever possible
- Aiming to treat the underlying cause of disease or condition, instead of just managing the symptoms; holistic providers will take time to understand their patient as a whole and treat them as such as opposed to just treating individual components
- Prevention is the primary goal, as well as helping the patient unlock their innate healing abilities; patients are seen when they’re well and when they’re sick, which helps the patient and practitioner form a plan for continued well-being and disease prevention
Examples of Holistic Medicine
Here are some of the more common examples of holistic medicine:
Chiropractic Medicine
Chiropractic is an alternative medicine that is concerned with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine. This area focuses on the relationship between the body’s main structures – the skeleton, the muscles and the nerves—and the patient’s health. Chiropractors believe that health can be improved and preserved by making adjustments to these structures, particularly to the spinal column.
Acupuncture
A key component of traditional Chinese medicine, acupuncture treatment involves inserting very thin needles through a patient’s skin at strategic points along the body, at various depths. Due to their small size, the needles don’t bring any discomfort but can provide relief by interrupting pain signals throughout the body. While acupuncture has been traditionally used to treat discomfort from a wide variety of diseases and conditions, it is increasingly used as a remedy for pain management and overall wellness.
Massage Therapy
A type of integrative medicine, massage therapy involves a certified massage therapist who manipulates the soft tissues of the body, including muscle, connective tissue, tendons, ligaments, and skin. By using varying degrees of pressure and movement, the massage therapist can promote pain relief for health conditions or relaxation for overall well-being.
It’s one of the oldest remedies people have used for pain relief with a history that dates back about 5,000 years ago.
Yoga
Yoga is a mind and body practice; various styles of yoga combine physical postures, breathing techniques, and meditation or relaxation. Yoga is an ancient practice that may have originated in India, and involves movement, meditation, and breathing techniques to promote mental and physical well-being.
Tai Chi
The essential principles of tai chi include the mind being integrated with the body through control of movements and breathing, generating internal energy, mindfulness, and song. The ultimate purpose of tai chi is to cultivate the qi or “life energy” within each person in order for it to flow smoothly and powerfully throughout the body. Total harmony of the inner and outer self comes from the integration of mind and body – empowered through healthy qi – via the practice of tai chi.
Reiki
Reiki is a Japanese form of alternative medicine called “energy healing”. Reiki practitioners use a technique known as palm healing or hands-on healing through which a “universal energy” is said to be transferred through the palms of the practitioner to the patient in order to encourage emotional or physical healing.
Meditation
Meditation is a practice where an individual uses a technique – such as mindfulness, or focusing the mind on a particular object, thought, or activity – to train attention and awareness, and achieve a mentally clear and emotionally calm and stable state. It’s also a consciousness-changing technique that can promote a wide number of benefits on psychological well-being.
Streamline Medical Insurance Billing for Holistic Practices with HBS!
No matter what type of holistic practice you’re running, your medical insurance billing processes could use some help. Medical billing is especially complicated for holistic practices and can possibly overwhelm your business as you focus on growing your practice and provide care for your patients. By outsourcing your medical billing, you can leave the responsibility of insurance enrollments, credentialing, and medical billing and coding to the experts – saving you time!
As an experienced billing provider for holistic practices, Holistic Billing Services can help your practice navigate the intricacies of insurance billing claims to minimize denials, increase your revenue, and grow your practice. We understand the unique needs of holistic practices, as well as the common obstacles you face when it comes to medical billing and coding. With a knowledgeable partner by your side, you can streamline your billing and increase your revenue cycle management! To learn more about our services, talk to one of our billing and coding experts today.
There are challenges unique to being a job seeker in today’s world, but there are also challenges regarding hiring practices, especially in the holistic practice industry. How can you continue to grow your holistic practice with the best talent? What can your holistic practice do to ensure the smoothest onboarding experience for your new hire?
Find your answers to your questions surrounding hiring best practices further in this article and help your holistic practice ensure both growth and success.
Why Following Hiring Best Practices Matters for Holistic Health Care Practices?
Here at Holistic Billing Services, we understand that holistic medicine is unlike most medical specialties. This has its advantages – less local competition, more loyal patients, freedom to run your practice as you see fit – but can also come with drawbacks, like problematic payer relationships, smaller patient populations, and a smaller pool of potential employees with a background in holistic medicine or billing. 
Since it can be challenging for holistic practices to find job candidates with specialized experience, it‘s critical to hire as smartly as possible. The key is not to expect any employee to walk in with a keen understanding of the ins and outs of your holistic practice. Rather, it‘s essential to make sure you hire staff with the capacity to learn quickly and provide your holistic patients with top-of-the-line service. Here are some tips on attracting best-in-class applicants, making sure they‘re right for your holistic practice, and getting them to choose to work for you.
What Are The Best Hiring Practices?
There are many facets to the hiring process, no matter what industry you’re in! The following best practices tips will help make this process more focused, positive, and rewarding for your holistic practice.
Have an Open Mind During Recruiting
Look around your holistic practice’s office and do a mental audit of your current staff. Are you happy or unhappy with their performance? What skills are missing from your current team? Which employee‘s performance would you most like to see emulated by an incoming staffer?
Avoid making repeat mistakes – did your last two temp-agency hires prove unsuccessful? Try advertising with an online job posting site, instead. Or, if you‘re happy with the team you have, ask around for referrals; good people tend to know good people!
As you review resumes, think through your goals and the human capital on your team. Do you have a capable staff that could train a ’blank slate‘ hire without holistic healthcare experience? If so, don‘t discount recent graduates. If not, don‘t feel bad about holding out for someone with a more specific medical office background.
Plan and Align Expectations with Hiring Managers
Your holistic practice should be leveraging data to help you target the right candidates for your open positions, conducting intake meetings with hiring managers, and coming prepared to those meetings armed with data to help guide the conversation. Intake meetings are an essential foundation for the employment process; recruiters and hiring managers need to be aligned on recruiting goals and ideal candidate profiles, especially when scouting for new or unique positions. As the person or team with expert knowledge on the holistic practice industry, you should be able to speak to the number of potential candidates available in a given market, as well as insights on salary expectations or market cost of the position you’re hiring for.
Be Thorough & Honest During Callbacks and Interviews
In the interest of time, you may want to just pluck out the first few qualified candidates from your applicant pool and bring them in right away. Do your best to avoid acting on that impulse! Narrowing down your list too quickly can put you in a bind, and if the interviews go poorly, you‘ll be back to square one.
Instead, conduct five-minute phone interviews with 7-10 strong candidates, and bring the top four in for interviews. That way, you‘ll have a good idea of the candidates‘ interpersonal skills before they come into your holistic practice.
When interviewing candidates, give them an honest overview of what the job entails and how much it pays; observe how they react. Are they eager? Intimidated? Displeased? Don‘t shy away from explaining the ’tough parts‘ of the job; the hire you choose should be prepared to accept the good and bad aspects of working at your holistic practice. It behooves all parties involved to have a candid conversation about the rewards and challenges of the work!
Be Direct During Offers & Onboarding
If you have only one opening, avoid making an on-the-spot offer until you‘ve interviewed your top four candidates. Once you‘ve met them all and narrowed it down to the right person, extend the offer right away while being direct about the start date and pay. Don‘t give the offeree too much time to decide whether to accept; you don‘t want to lose your #2 prospect to another opportunity if #1 doesn‘t work out.
Then, prepare to make your new hire a well-informed employee by plotting out your training plan in advance of your new staffer‘s first day. Who will be the primary trainer? Who will cover the trainer‘s other responsibilities while he or she tends to the new hire? Try to plan a comprehensive experience for your holistic practice’s newest employee, one that includes demonstrations of daily task management like record keeping, resources pertinent to training, icebreaker questions to help them acclimate to the team, and more. These efforts will help them adapt to your holistic practice’s environment, and give them a foundation for success!
Set Your Expectations From the Start
An essential part of bringing your newest employee up to speed for your holistic practice is to clarify your expectations of them and their progress over the course of a set period of time. Make sure your new hire understands how long you expect training to take, and how soon you‘ll expect them to start working with patients and contributing to office productivity. Establishing a general timeframe for them to feel comfortable navigating your holistic practice and personal timeline for becoming more involved with their duties will help you evaluate their progress. Maintaining clear communication about such expectations, and being available to help answer questions or challenges they encounter, will help them thrive in your holistic practice’s environment. Careful planning is always the best way to ensure any new hire‘s success.
How Holistic Billing can Elevate Your Holistic Hiring Practices
Established in 1999, Holistic Billing Services is an integrative health services firm focused on streamlining your documentation, billing, and coding process to enhance your revenue cycle management. Our secure online portal provides acupuncture practices, massage therapy practices, and chiropractic practices an easier way to manage their health insurance billing so they can focus on delivering quality patient care and growing their practices through effective hiring processes!
As the nation’s largest billing provider for holistic healthcare, we service over 1,200 practices across the country. Thanks to our knowledge of insurance reimbursement and healthcare auditing risks, holistic practitioners average over $185 per hour of treatment with our billing and coding services. Contact us today and see what we can do for your holistic practice!
Like millions of people, watching a lot of fictionalized law shows on TV might leave you with the impression that you fully grasp various facets of the legal system and its regulations. In reality, laws and regulations can vary wildly between states, and it’s important to recognize that there are guaranteed to be far more complications than what might be explained in a crime drama. One such example is non-compete agreements, which sound pretty straightforward but can be handled differently across the country. This blog outlines what non-compete agreements are, how they’re enforced, in which states they’re illegal, and much more.
What is a Non-Compete Agreement?
A non-compete agreement is a contract that prohibits an employee from working for or becoming a competitor for a certain period. These arrangements are enforced when a relationship between an employer and employee ends, and the employer wishes to prevent the employee from competing against them in their next position, whether working for a competitor in the same market or starting up another business in the same field.
Non-compete clauses usually contain language that limits you from engaging in competition with your employer. In the healthcare industry, for example, these provisions often preclude you from practicing within a specific distance surrounding the practice and for a specified period. Under most state laws, a practice can enforce a non-compete agreement if it meets the following criteria:
- protects the practice’s legitimate business interest
- is specific in geographical scope
- has a narrowly tailored durational scope
How an Employee Non-Compete Agreement Works
Non-compete agreements overall should be both fair and equitable for all parties. They require certain information to be considered enforceable, including:
- An effective date on which the agreement will begin
- A reason for enacting the agreement
- Specific dates during which the employee will be barred from working in a competitive sense and the location covered by the agreement
- Details as to how the non-competing party will be compensated for agreeing to the terms
If your employer’s practice has more than one location, then you may be restricted within a radius from each location under your contract, even if you’ve never been to that particular location. If the language in the clause is vague or does not clearly describe the exact terms of your restrictions, the clause might be unenforceable or open to greater interpretation than either party anticipated. This is why having an attorney review your employment contract prior to signing is recommended since non-competes will greatly limit where – and when – you practice.
Which States Allow Non-Compete Agreements?
A majority of states do allow and enforce non-compete agreements, but several have specific exemptions. For example, Arizona exempts broadcasters; Florida exempts mediators; Vermont exempts beauticians; and so on.
The following states specifically exempt physicians from non-compete agreements:
- Alabama
- Arizona
- Colorado
- Delaware
- Illinois
- Maryland
- Tennessee
- Texas
In a few states, non-compete agreements are not enforced at all. In North Dakota and Oklahoma, for example, non-compete agreements are unenforceable. California has gone a step further: Not only are noncompete agreements unenforceable, but an employer who requires employees to sign them can be sued, even if the employer never tries to enforce the agreement.
If your state doesn’t allow employers to require employees to sign noncompetes, you should bring this to your employer’s attention immediately – and don’t sign the agreement. Be sure to verify your state’s regulations regarding non-compete agreements before implementing them in your practice.
What Happens If You Break a Non-Compete Agreement?
Generally, if you violate a valid and enforceable non-compete agreement, it is likely that your former employer will file a lawsuit against you. This lawsuit could seek compensation for money damages and actual losses suffered by your employer, it could simply seek to enforce the non-compete agreement by filing a court order against you, or could seek both money damages and a court order. In very rare cases, the court may prevent you from working for a competitor for the duration specified in the non-compete.
There could be serious legal consequences, so be sure you have appropriate counsel evaluate the agreement before signing it and advise you of professional moves after signing it.
What to Do If You Are Asked to Sign a Non-compete Contract
Bottom line, our recommendation is before you sign any papers, always have a lawyer well-versed in your particular state laws review your agreement, then negotiate something you feel is reasonable. This empowers you to be more informed of the legal ramifications of signing a non-compete agreement rather than just hoping things will work out – you’ll be saving yourself money and headaches down the line. 
For example, if you’re asked to sign a broad agreement that could significantly restrict your ability to earn a living in the future, it would be well worth consulting with a lawyer to find out whether the agreement is legal and learn what steps you can take to negotiate a more limited arrangement with your employer. One of the most important factors of a non-compete agreement is the time frame it encompasses. Determine the effective dates of the agreement well in advance and seek legal counsel, as employers can set non-compete agreements only within a realistic timeline and cannot permanently prevent former employees from furthering their careers in that field.
Holistic Billing Services knows it takes a lot to run a streamlined and effective practice. Serving your patients and treating them with the best holistic approaches should always be your top priority, but sometimes massive piles of paperwork, billing errors, and insurance delays can weigh you down and poorly affect your practice.
Our experts here at HBS believe that your success is our success. From handling medical billing and coding to offering consulting services and much more, our team is dedicated to making it feel like we’re in-house. With a focus on holistic practices, insurance background, and proven consultants, our team can work with you regarding all holistic practice-related matters, and even help you navigate legal complexities like non-compete agreements. Contact us today!
Holistic Billing Services knows it takes a lot to run a streamlined and effective practice. Serving your patients and treating them with the best holistic approaches should always be your top priority, but sometimes massive piles of paperwork, billing errors, and insurance delays can weigh you down and poorly affect your practice. There’s got to be a better way than swimming through regulations and claims forms, right?
That’s where outsourced medical billing services can play a key role in improving your practice’s operations. From reducing filing errors to keeping your records organized, there are many benefits to utilizing a third-party billing service. Keep reading to learn more!
What Are Outsourced Medical Billing Services?
Many holistic practices process billing with in-house staff, which comes with the responsibility for potential complications that come with the billing process. Whether it be organizational issues, delayed payments, or any other challenges frequently associated with the medical billing process, your in-house billing team can quickly be overwhelmed.
By outsourcing medical billing, your medical practice can avoid these common stressors. Outsourcing your medical billing is when your practice lets a dedicated third-party code and bill your procedures. By trusting a medical billing company with your information, you can rely on the professional expertise of their staff to find the most comprehensive and efficient way of processing your coding and billing so your medical practice can focus on other areas of improvement.
Why Does Accurate Medical Billing and Coding Matter for Holistic Practices?
Accurate medical billing and coding means your holistic practice is efficient, maintains a clean claims rate, and is overall optimized for profit. If your holistic practice is repeatedly producing errors in its administrative paperwork and insurance claims, then your revenue cycle and reputation will be negatively impacted. Partnering with expert medical billing outsourcing services can result in a streamlined workflow, reduced mistakes, and increased revenue and earning potential for your medical practice. Plus, experienced medical billing outsourcing companies regularly generate comprehensive performance reports, and can keep you better informed of delays and payment issues than your on-site staff could.
The Top Benefits of Outsourcing Medical Billing Services
When it comes to outsourcing your holistic practice’s billing, there are a variety of benefits! From saving time to reducing inaccuracies, utilizing a third-party service can streamline your holistic practice in many ways. Such advantages include:
More Time and Resources Available for Other Responsibilities
In the holistic field, we recognize you often wear many hats and have a wide range of responsibilities. However, medical billing is a full-time job. In order to stay on top of the volume of transactions in an accurate and timely manner, you’ll need a separate team dedicated entirely to billing. By outsourcing medical billing for your holistic practice, you will save your administrative staff hours that can be allocated to other pertinent needs.
Enhanced Transparency with Performance Reports
Holistic practitioners might worry that outsourcing medical billing means relinquishing control of the RCM process to a set of strangers – but that’s not the case. Once you contract with a firm, your outsourced billing team becomes obliged to earn you positive marks on a defined set of metrics, such as first-pass payments, denial rates, and collection ratios. This dedicated team also provides data on your holistic practice’s efforts and outcomes, which gives you unprecedented transparency into your revenue cycle.
Fewer Medical Billing Errors
Billing errors, inaccurate coding, and other inefficient collection policies have the potential to result in a huge revenue hit. Everyone makes mistakes—but when it comes to medical billing, just one mistake can turn into a delayed payment for your holistic practice. Between incorrect patient information, authorization errors, duplicate billing, and more, billing errors can be a costly expense. Outsourcing medical billing can help ensure your holistic practice is profitable, and that the medical billing process is up-to-date and free of human error.
Increased Patient Satisfaction
Every holistic practice aims to deliver excellent care and customer service, but juggling everything on your practice’s plate makes it difficult to meet all your patients’ expectations. Your support staff is always going to be responsible for managing scheduling tasks, executing patient check-in and check-out, keeping the books, and handling clinical concerns. By outsourcing medical billing, you’re freeing up your staff’s time to better attend to patient needs, resulting in higher satisfaction rates and better patient retention.
What to Look For In A Medical Billing Company
You want your holistic practice to work with the best medical billing company out there, right? With so many factors to consider, be sure to explore your options thoroughly. These questions are a good place to start when researching holistic medical billing services:
What Medical Billing Services Do They Provide?
Revenue cycle management is a complex process, which involves a variety of important tasks. It is vital to identify each of these tasks and assign them to either the practice or the medical billing company. Not every medical billing contract is the same. For example, your holistic practice might want to input charges on-site, while another practice might choose for the billing company to not only enter the charges, but also complete the coding for the encounters. All steps need to be discussed and clear expectations set.
What Training Does Their Staff Receive?
Proper training of a medical billing company’s staff is essential to maintaining their core competency. Before you engage in any agreements, confirm that the billing staff is certified and receives continuing education to maintain their certifications.
What is Their Approach to Working with Your Holistic Practice?
When it comes to outsourcing medical billing, both the provider and the outsourced company must mutually agree that the relationship is a partnership. There are many benefits to outsourcing medical billing, while still feeling like it’s being handled in-house. You want your practice to feel valued and supported by your third-party billing team!
Transform Your Revenue Cycle Management With Holistic Billing!
Our experts here at Holistic Billing Services believe that our success is your success. From handling medical billing and coding to offering consulting services and much more, our team is dedicated to making it feel like we’re in-house. With a focus on holistic practices, insurance background, and proven consultants, our team can effectively ensure the financial success of clients, allowing your medical practice to focus on what it does best: treat patients.
Our expertise is rooted in professional, technical, and global billing for hospital and stand-alone holistic care practices. To learn more about how outsourced medical billing with Holistic Billing Services can empower your practice, contact us today. We’ll work with you to build a customized solution that meets the specific needs of your practice and allows you to get back to treating patients.
If your holistic practice’s billing staff isn’t diligent with billing practices, mistakes such as upcoding, downcoding, and inaccurate information can go undetected until it’s too late. This can lead to a high number of rejected claims and ultimately impact your practice’s clean claims rate. Ensuring accurate billing and coding can protect your holistic practice from fines and inefficient billing practices that puts your practice at risk.
What is a Clean Claims Rate?
Your holistic practice’s clean claim ratio is the average number of claims paid upon the first submission. Every provider would love to reach a percentage above 95, but it’s about more than just reaching that number – it’s about streamlining your practice!
Holistic practice budgets are tight, and your staff’s time is the most precious resource you have. So if your clean claims rate is less than 85%, it means your staff is likely having to spend extra time on identifying denial reasons, coordinating with payers, and re-submitting claims. Overall, the clean claims rate directly affects your holistic practice’s overall revenue cycle.
How Do Clean Claims Impact Holistic Practices?
Every claim that is not paid on the first submission wastes your holistic practice’s valuable time and money. The Medical Group Management Association (MGMA) estimates that the average cost to re-work a claim that has been rejected or denied is $25 for each claim. If your integrative healthcare practice has to rework 100 claims per month, then it costs your practice an average of $2,500 a month to work on unclean claims; that’s an estimated $30,000 a year!
Many rejected claims are resubmitted multiple times, often without their errors even being addressed or corrected. This creates the potential for further revenue losses, such as when your holistic practice has a rejected claim that needs to be reworked beyond its timely filing deadline.
Additionally, inaccurately submitted claims can result in legal trouble. If your holistic practice submits too many improperly filled out claims, you can be flagged for potential fraud and abuse. The U.S. Department of Justice (DOJ) enforces laws, such as the False Claims Act and Anti-Kickback Statute, to crack down on coding abuse like improperly used modifiers, overcharged services, and more. In fact, fraudulent claims can cost your holistic practice thousands of dollars in fines!
What Is a Strong Clean Claims Rate?
Holistic practices should strive for a 95% clean claims rate, however, few practices actually reach that target goal. Most practices receive reimbursements the first time a claim is submitted for approximately 75% to 85% of claims they bill, which means about one-quarter of claims are denied or delayed due to errors or incomplete documentation.
Some studies have found that holistic practices have a clean claims ratio as low as 65% – resulting in 35% of bills needing to be redone. This translates to upwards of $20 billion per year in either delayed or permanently lost reimbursement in the United States alone.
You should not be satisfied with a clean claims rate under 95%, and especially anything under 90%. Although errors are bound to happen, anything above a 5% unclean claims rate is costing your holistic practice money and time. By keeping your clean claims standard high, you can increase your clean claims ratio and overall profitability.
Best Practices to Achieve a 95% Clean Claims Rate
How can your holistic practice achieve a 95% clean claims rate? Though this may seem like a lofty goal, there are some medical billing strategies that your practice can implement to help improve your clean claims rate – and your overall revenue cycle management!
Keep Patient Information Updated
From contact information to insurance carriers and more, there’s a lot of patient information that can change. With inaccurate patient data being a lead cause of denied claims, it’s crucial to have patients confirm or update their current information before receiving services. To help verify patient information in advance, use precise documentation to avoid delays and be sure to have patients update their forms at every visit, or even sooner with automated reminders.
Be Mindful of Insurance Claim Filing Timelines
Filing claims usually requires submitting within a tight window. Any time a claim is submitted outside of that window means an increase in denied claims. Ensure your holistic practice’s administrative team is on the same page with maintaining deadlines.
If your goal is to have a near-perfect clean claim ratio for your holistic practice, one of the best ways to do that is to pay attention to claim deadlines. If there are any issues associated with patient coverage prior to their date of service, resolve them so the claim is not submitted late. One best practice is to aim for authorization between three and five days prior to service.
Verify Billing Modifiers
When it comes to your modifier usage, it’s important to confirm that you’ve applied them correctly and to the right procedure. One way to help ensure this is done efficiently is to create a guideline of customized National Correct Coding Initiative (NCCI) edits for reference. Having a compilation of frequently-used codes and modifiers means your administrative team won’t have to search through thousands of codes to find the exact one they’re looking for. Overall, this will help optimize the billing process of your holistic practice!
Increase Your Clean Claims With Holistic Billing!
By using these tips to boost your holistic practice’s clean claims rate, you’re sure to make the most of your practice’s revenue in the future. However, these tips definitely require time and effort to do it successfully. If you’re in need of expert medical billing services, let Holistic Billing Services be your go-to source for an error-free billing solution.
With decades of experience dealing with a broad range of medical billing issues for all kinds of holistic practices, the team at HBS has seen just about every kind of medical billing error an organization can make. That’s why our clients trust us to help them manage their insurance claims to ensure they’ll be accepted as clean claims on the first attempt, avoiding lengthy back and forth negotiations with the insurance company. And best of all, you’ll avoid the scrutiny of federal and state auditors.
Contact us today to learn about Holistic Billing Services medical insurance billing services and find out how we can help you increase your clean claims rate!
These breast cancers are called hormone sensitive or hormone receptor positive. Mechanism of action [ edit ] Colesevelam is part of a class of drugs known as bile acid sequestrants. Partial recanalization of in-stent thrombosis in case No https://apotheekzonderrecept.com/vardenafil/. Aspirin, ASA; Butalbital; Caffeine; Codeine: (Moderate) Unless contraindicated, aspirin is used in combination with tirofiban.
Rosiglitazone belongs to the class of medications called thiazolidinediones. Paired, adequate liver biopsy samples were available for 89% of subjects. Reliable success rates When it comes to stimulating ovulation, Clomid is very successful, resulting in the release of mature eggs in roughly 80% of women who use it leki online. There have been no specific clinical studies of Albumex 20 in the elderly.