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!
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Over the last few years, more people than ever before are turning to acupuncture and other holistic treatments to alleviate ailments. As more people intentionally seek this service, your practice is likely to grow in size as members of your community begin to visit.
With this exciting growth in business comes the not-so-exciting amounts of medical billing paperwork – not to mention the headache of it all! Holistic Billing Services knows medical billing can be a challenge to navigate, especially for acupuncture practices. This post addresses some of the most frequently asked questions about billing for acupuncture to equip you with the fundamentals of medical billing.
What is Medical Billing?
Medical billing involves a healthcare provider submitting, following up on, and appealing claims with health insurance companies in order to receive payment for services rendered; such as testing, treatments, and procedures. It can be a long, grueling process that requires jumping through hoops left and right to receive payment for services rendered.
Why Is Medical Billing Important for Acupuncture Practices?
Though it may be a complicated process, it is also absolutely necessary for acupuncture practices because it is the most common way of getting paid for services rendered. The majority of your patients will likely have some form of insurance as payment, so your practice needs to be adept at navigating the many facets of dealing with insurance companies. This includes being knowledgeable of the appropriate medical billing codes for the treatment you provide to your patients, keeping track of the relevant patient records, and understanding how to communicate with the insurance company in order to be reimbursed.
Top Acupuncture Billing Questions and Answers
Medical billing can be a challenging portion of your acupuncture practice’s administrative needs. Let’s review some of the top acupuncture billing questions with our expert answers:
When Should I Update My Insurance Verifications and Medical Credentials?
Insurance verification is a critical component of billing insurances for acupuncture, and medical credentialing is a key part of this, too. Current verifications have the strongest correlation with successfully getting claims paid, which is obviously essential to your acupuncture practice. Patient plans and/or benefits will often change at the start of a new year, so it’s imperative you request new insurance verifications as soon as the new calendar year starts.
I am In-Network for a Couple of Insurance Companies, How Often Should I Re-Negotiate My Rates?
Managed care contracts are usually written to auto-renew on an annual basis so you will want to analyze your contracts annually. Use the end of the year to calculate your per-visit reimbursement for a given contract and compare it to per-visit reimbursements for your cash and out-of-network patients. Based on these figures, you can determine if the volume of patients seen from a particular payer offsets any variance in reimbursement. Then, negotiate accordingly.
Which Procedure Codes are Most Frequently Used by Acupuncturists?
In general, the most frequently used CPT procedure codes are those relating to medical evaluation and management, a few of which include:
- 99201-05: New Patient Office Visit
- 99211-15: Established Patient Office Visit
- 99281-85: Emergency Department Visit
- 99241-45: Office Consultation
Specifically for acupuncturists, the following are the most frequently used CPT codes:
- 97810: Initial Acupuncture Session (Tip: do not report this in conjunction with 97813; use one or the other)
- 97811: Subsequent Unit of Acupuncture (You may use it in conjunction with either 97810 or 97813)
- 97813: Initial Acupuncture with Electrical Stimulation (Don’t report this in conjunction with 97810; use one or the other)
- 97814: Subsequent Unit of Acupuncture with Electrical Stimulation (This may be used in conjunction with either 97810 or 97813)
Accurate medical billing codes are instrumental for streamlining your billing process and further growing your acupuncture practice.
Do You Have a List of Insurances That Will Pay for Acupuncture That I Can Use?
Unfortunately, we don’t have a perfect answer for this! Insurance benefits will vary from plan to plan – even within the same insurance company – so there’s no quick shortcut for knowing if the patient‘s insurance will cover acupuncture. It’s really a case-by-case basis when serving patients who might have Medicare, go through the VA, or hold a private insurance policy otherwise. HBS recommends that you verify the patient‘s benefits before you treat the patient by contacting the payer directly or confirming their insurance plan prior to each visit.
Do I Have to Implement Electronic Health Records (EHR) in My Practice?
No, although you will need to document each patient visit, there is no legal mandate to implement EHR for your acupuncture practice. The Centers for Medicare and Medicaid Services (CMS) rolled out Meaningful Use non-compliance penalties in 2015, but most acupuncture practices do not meet the minimum revenue standard for Medicare so these penalties should not apply to your practice.
Though not legally required, using electronic health records can greatly streamline your administrative tasks and help your acupuncture practice operate more efficiently.
Can I Bill Insurances for Massage Therapy?
Yes, there are insurance plans that will pay for massage therapy treatments performed by a licensed massage therapist or licensed acupuncturist! As always, be sure to verify the patient’s insurance benefits information and utilize accurate medical billing codes. The following are the most frequently used for massage therapy sessions:
- 97124: Massage Therapy
- 97140: Manual Therapy
- 97112: Neuromuscular Re-Education
- 97010: Hot/Cold Packs
- 97110: Therapeutic Exercise
Have More Questions About Acupuncture Billing? Reach Out to the Experts at HBS!
HBS is an acupuncture billing service that is experienced in billing for both licensed massage therapists and licensed acupuncturists. As an experienced billing provider for holistic practices, Holistic Billing Services can help your practice navigate the insurance billing process to minimize denials and increase revenue.
With our team of experts 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 acupuncture or massage therapy billing services, talk to one of our billing and coding experts today.
HBS recognizes the critical role billing plays in running a profitable holistic practice. We also acknowledge the profound impact billing errors, rejected claims, and clunky processing can have on your revenue cycle. To help you avoid common billing errors, here are some best practices for the most accurate medical billing process possible.
How Inaccurate Coding Can Affect Your Practice
Medical billing errors can have a number of negative impacts on your holistic practice. The most obvious problem is the increased denial rates, which means your insurance reimbursements will decline as well. Given that many holistic practices operate on relatively small margins, even a slight uptick in claim denials could put your business at risk.
In addition, there’s the extra time and resources spent on resolving the denied claim! A bill that’s initially rejected due to an error typically takes twice as much time to process, and the work required to follow up on it takes away from time that could be spent building up a practice or delivering better services to patients.
If medical billing and coding errors increase in frequency, the quality of the patient experience dwindles, profits are adversely affected, and the overall revenue cycle for your holistic practice is stymied. Efficiently adhering to the medical billing process and procedures can prevent these consequences through accurate claims management.
Top Medical Billing and Coding Errors in Holistic Medicine
Holistic Billing Services knows humans make mistakes; the goal is always to learn from them! Make your staff aware of these top billing errors so as to further mitigate the potential of these slowing down your holistic practice:
Scattered Claims Filing Practices
Accurate medical coding lies at the heart of efficient claims filing in billing processes. Delayed claims filing creates untimely billing practices, and is one of the most common medical billing mistakes. Deadlines are critical in the claims filing process as it essentially decides whether the claim will be accepted or rejected, and greatly affects your revenue cycle. To avoid such a situation, put effort into establishing an efficient system for billing and filing claims in your holistic practice.
Unorganized Data Collection
Another frequent point of failure in the billing process is inaccurate or insufficient data collection and usage. Mistakes can occur when patient information is not comprehensively collected or when clinical procedures are not filed in a timely and accurate manner. Improper medical billing can be drastically reduced when patient data is collected efficiently and used toward medical billing codes effectively. Capturing and utilizing complete data further minimizes the possibilities of duplicate claims, which can delay payment processing even more. Automated information filling, such as social security numbers and demographic codes, can speed up the medical billing process and procedures.
Failure to Verify Insurance
Insurance issues are among the top reasons for most claim denials and typically result from a routine oversight of not checking for changes in patient-provider information. Since insurance information can become outdated at any time, you must implement a verification step into the billing workflow for every single patient visit. By incorporating this double-check into your billing process and verifying the patient’s insurance at every visit, you’re confirming there are no policy-related issues that could result in denied claims.
Lack of Follow-Ups
When members of your medical billing team are not consistently following up on outstanding payments, your revenue cycle is adversely affected. Problematic claims remain unattended and thus negatively affect your holistic practice’s bottom line. Be sure to implement follow-up reminders for continuous monitoring of delayed payment claims to stay on top of revenue your practice has earned.
Best Practices to Avoid Medical Billing and Coding Errors
In addition to the general awareness of frequent medical billing errors, it’s essential to implement some of the following best practices to reduce the chance of complications in your holistic practice. Such tips include the following:
Routine Evaluation of Medical Billing Services
Medical coding and billing services are complicated processes, so it’s important for your holistic practice to routinely analyze its strengths and weaknesses in this sector. This analysis can establish a pattern of errors and successes, which can further adjust or solidify your practice’s billing methods. Whether it is inaccurate coding, untimely bill generation, information gaps, or clinical issues, the source of medical billing errors is easily identifiable through periodic analysis instead of turning a blind eye.
Consistent Excellence in Medical Coders
Employing coders who are experienced, methodical, and detail-oriented lies at the key to a successful billing process, as common medical billing mistakes are often the result of medical coder slip-ups. Whether a claim faces success or failure, therefore, lies in the hands of the medical coder – your employees are your best assets for maintaining a streamlined holistic practice!
Keeping Up With Changing Trends
Reducing the rate of denied claims and medical billing errors means your holistic practice needs proficient medical billing management. This includes up-to-date medical credentialing and medical billing systems that are automatically updated to account for ever-evolving codes and rules.
Ensure Accurate Medical Billing With HBS!
Using these tips on avoiding medical billing errors, 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 NCG Medical be your go-to source for an error-free billing solution.
With more than 40 years of experience dealing with a broad range of medical billing issues for all kinds of practices, the team at NCG Medical 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 NCG Medical’s medical insurance billing services and find out how we can help you accelerate your revenue cycle management.
As a medical billing company focused on holistic practices, our team of experts often speaks to hundreds of practitioners daily. Many of the questions medical practices have been around handling patient deductibles. At the beginning of every year, most patients have their health insurance benefits recalculated. That is to say, that the number of visits and deductible amounts are re-set on January 1.
So a frequently asked question through our provider hotline is, “How do I handle a patient‘s deductible?” Follow some of these tips to better manage patient deductibles so you can be paid on time for treatments.
What are Insurance Deductibles?
Insurance deductibles refer to the amount patients have to pay out-of-pocket before their insurance benefits will subsidize payment; the amount is identified when verifying insurance benefits. A patient’s deductible is determined by their insurance plan and will range in amount, so you will not know the exact balance until you verify the insurance benefits. Every insurer and plan varies when it comes to benefits, coinsurance, associated copays, and deductibles.
Medical billing and coding is a complicated, but necessary, process for both medical and holistic practices looking to be reimbursed for services. However, the world of medical billing processes can become rather complicated very quickly, with people throwing around a lot of technical terms that holistic practices may not be accustomed to hearing or dealing with. If your acupuncture practice plans on accepting insurance, you will need to become familiar with this terminology to maximize your insurance reimbursements and minimize denied claims.
You will frequently hear the following common acupuncture billing terms when dealing with insurance claims or working with an experienced acupuncture billing company like Holistic Billing Services. To ensure a streamlined acupuncture billing experience, keep this list handy in case you ever need to quickly reference unfamiliar acupuncture billing terms!
What is Acupuncture Billing?
Medical billing is the process of healthcare providers submitting claims with insurance companies in order to be reimbursed for their services. This can include anything from treatments, procedures, and testing. The medical billing process is essential for most practices to receive payments.
Acupuncture billing practices are not the same as traditional medical billing and have a different set of requirements. Before billing can be initiated, many holistic practices must first be credentialed with health insurance companies. On top of your holistic practice’s insurance enrollments, the right billing, coding, and SOAP documentation must be used.
Acupuncture billing uses its own unique set of codes. Since acupuncture services are always coded in 15-minute increments, you will use one code for the initial 15 minutes of service and then a separate code for additional units of time. Acupuncture CPT codes will only vary if you include electronic stimulation in your treatment.
There are numerous errors that can cause your insurance claims to be denied or delayed, resulting in your holistic practice not being paid on time for your services. A successful acupuncture practice is one with accurate acupuncture insurance billing, but how can you stay on top of it?
As an acupuncture billing company, our team at Holistic Billing understands that translating Eastern medicine techniques into Western medicine CPT codes can seem daunting. Even the most experienced acupuncturists get their procedure coding mixed up. But if you want to avoid insurance company denials, you need to use proper acupuncture CPT codes. Here are some helpful tips to avoid claim delays and denials so your practice can be paid for your acupuncture treatments.
How Providers Bill Insurance for Acupuncture
Current Procedure Terminology, or CPT codes, are used by insurance providers to document most medical procedures performed by healthcare providers, whether traditional or holistic.
These CPT codes characterize the type of procedure being done so healthcare providers can bill insurance companies for the right services and receive reimbursements.
Although holistic practices also use CPT codes to receive payments from insurance providers, they have their own unique codes and requirements which can make the process prone to errors. Understanding when to use the right acupuncture insurance billing codes is crucial to ensure a streamlined reimbursement process and receive timely payments for acupuncture treatments.
When mistakes are made during the billing process, whether due to inaccurate patient information or coding, the insurance company can deny the claim. This can delay the amount of time your holistic practice is paid by weeks – if not longer.
Chiropractic CPT codes are some of the most important components of the insurance billing process. Accurate chiropractic insurance billing is essential for your practice’s revenue cycle management, but errors can cause costly denials and delays.
As a billing company focused on holistic healthcare providers, Holistic Billing has the answers to many of the most common questions about chiropractic insurance billing and CPT codes. Find the answers below!
How Do You Bill for Chiropractic Treatments?
Chiropractic practices must bill insurance companies to receive insurance reimbursements using specific chiropractic CPT codes. These special CPT codes characterize the type of procedure being done so healthcare providers – whether conventional or holistic – can bill insurance companies for the right services and receive their due payment for treatments.
Holistic practices have their unique requirements when it comes to receiving insurance reimbursements. For a streamlined insurance billing process, practices must use accurate CPT codes that are unique to their specialty and procedures. Chiropractic CPT codes are some of the most important code sets for chiropractors.
Understanding the correct CPT codes for your medical practice is essential across all specialties when it comes to insurance billing. Holistic practices, including massage therapists, have unique health insurance billing needs. This includes specific CPT codes for massage therapy. Accurate massage therapy insurance billing is key for reimbursements to be processed faster and with fewer denials and delays.
Looking for a list of the most commonly used massage therapy CPT codes? Look no further! Holistic Billing is an expert when it comes to massage therapy insurance billing. Find the answers to many of the most common questions about the world of massage therapy insurance billing and CPT codes below!
How Do You Bill for Massage Therapy?
Just as with conventional medicine, holistic practices must bill insurance companies to receive reimbursements for their services using CPT codes. These Current Procedural Terminology codes, or CPT codes, are used by insurance providers to document most medical procedures performed by healthcare providers across all specialties. These CPT codes characterize the type of procedure being done so healthcare providers can bill insurance companies for the right services and procedures.
Like other holistic practices, there are unique CPT codes for massage therapy treatments that are specific to the specialty. For a massage therapist to receive quick and reliable payments from the insurance company, insurance coding and billing must be completed accurately. Errors can result in lengthy delays to the reimbursement process – or even denials.