Medical Credentialing

healthcare-management-vs-healthcare-administration

Projecting cash flow in a medical practice

Cash flow is the amount of cash a business generates and uses in a given period. Understanding cash flow as part of your business plan is essential to ensure that the practice has enough money to pay its bills and invest in its future growth. Projecting cash flow in a medical practice can be daunting, but it is essential for the practice’s financial success. In this blog post, we will discuss the steps involved in projecting cash flow for a medical practice and provide tips for maintaining a healthy cash flow.

Step 1: Identify your sources of cash

The first step in projecting cash flow is to identify the sources of cash for the practice. These sources include patient payments, insurance reimbursements, and investments. Understanding the timing of these payments and any trends or fluctuations in the amount of cash received is essential. For example, if the practice experiences a spike in patient volume during the summer months, it will likely receive more money during this period.

Step 2: Identify your uses of cash

Once you identify the sources of cash, it is crucial to identify the uses of cash for the practice. These uses include expenses such as rent, salaries, supplies, and equipment. It is important to understand the timing of these expenses and any trends or fluctuations in the amount of cash spent. For example, if the practice plans to purchase new equipment, it will likely spend more money during the month or quarter in which you bought the equipment.

Step 3: Create a cash flow projection

With an understanding of the sources and uses of cash, the next step is to create a cash flow projection. This projection should include an estimate of the amount of cash received and spent in a given period. It is vital to have both expected and unexpected events in the projection and any trends or fluctuations in the amount of cash received or spent.

Step 4: Monitor and adjust your projection

Once you create the cash flow projection, it is essential to monitor it regularly and make adjustments as necessary; this may include adjusting the prediction based on actual results or making changes to the practice’s operations to improve cash flow. For example, if the practice is experiencing a cash flow shortage, it may need to increase its billing and collections efforts, recruit patients or reduce its expenses.

Tips for maintaining a healthy cash flow

  • Review your billing and collections process: A poor billing and collections process is one of the most significant contributors to cash flow problems. Regularly reviewing and improving this process can help ensure that the practice receives payment for services promptly.
  • Control expenses: Keeping expenses under control is essential for maintaining a healthy cash flow. Reviewing expenses regularly and finding ways to reduce them can help to improve cash flow.
  • Communicate with patients: Clear communication regarding their financial responsibilities can help ensure that payments are received promptly.
  • Maintain a good relationship with insurance companies: Building a good relationship with insurance companies can help ensure that reimbursements are received promptly.
  • Keep an eye on future trends: Monitoring future trends in the healthcare industry can help to anticipate any changes that may impact cash flow.

In conclusion, projecting cash flow in a medical practice is a vital task that requires a thorough understanding of the sources and uses of cash. By following the steps outlined in this blog post and implementing the tips for maintaining a healthy cash flow, medical practices can ensure they have the resources they need to grow and succeed in today’s competitive healthcare landscape.

How does this relate to a billing company focused on acupuncture, chiropractic, and medical-massage billing? While you are busy projecting your cash flow, let us handle your EMR technology needs and the tedious and complicated medical coding, and billing process. By allowing a trusted firm like Holistic Billing Services, to capture your online appointments and SOAP notes, or offloading your medical billing burden, your time, energy, and creativity are freed up to focus on what matters most: your patients. The friendly experts at HBS have decades of experience and are eager to help you succeed! Contact us today to get started building a custom solution that suits your acupuncture practice needs and goals.

Read More
Multiracial medical team having a meeting with doctors in white lab coats and surgical scrubs seated at a table discussing a patients records

Top 3 Benefits of Outsourcing the Medical Credentialing Process

Medical credentialing ensures patients receive the best quality care from credentialed providers; in other words, it’s basically an industry standard that helps maintain quality assurance. Credentialing also means that providers can file claims with various agencies, such as private insurance companies and Medicare. However, the medical credentialing process can take months and is tedious—that’s why it’s so beneficial to outsource this process. Keep reading to learn more!

What Is the Medical Credentialing Process?

Medical credentialing is vital for all new hires, but it’s also performed at regular intervals even after hiring to conform to the standards of regulatory organizations including The Joint Commission (TJC), The Centers for Medicare and Medicaid Services (CMS), and the National Committee for Quality Assurance (NCQA).

The medical credentialing process typically involves three phases and can take up 180 days:

Credentialing

During this phase, a provider’s qualifications and experience are verified and evaluated. For example, the credentialing authority—known as a Credentials Verification Organization, or CVO—will contact the university or school where the provider received their degree; this authority will also contact certification boards and licensing agencies to confirm the provider’s standing and relevant credentials. Other employers will attest to work experience as needed; essentially, this phase involves verifying the background and experience of the provider going through the credentialing process.

Privileging

This intermediate phase of the credentialing process gives the provider permission to perform specific services at the proposed institution based on your credentials being verified. Basically, the provider has been recognized for demonstrating competency in their field. Privileging is an important step because it validates your credentials and enables you to perform the services you have experience in.

Enrollment

The final component of the medical credentialing process is enrollment. This allows you, the provider, to bill and be reimbursed for the services for which you have been credentialed and are privileged to perform. Naturally, this is the end goal for holistic providers who are billing insurance companies or programs like Medicare because this phase solidifies your standing in the healthcare and holistic marketplace.

Who Can Become Credentialed?Confident female doctor in front of team, looking at camera smiling, multiracial team with black female doctor

The medical credentialing process is for any healthcare provider who needs to be credentialed in order to maintain competitiveness and be vetted for insurance or Medicare billing. A multitude of different kinds of facilities and services are obliged to acquire and maintain the proper credentials to act as healthcare providers, including:

  • Durable Medical Equipment
  • Home Health Services
  • Hospice Care
  • In-Home Care Services
  • Prosthetics/Orthotics
  • Radiology/Diagnostic Imaging

Essentially, the medical credentialing process can apply to any individual or entity that provides healthcare services.

Top 3 Benefits of Outsourcing the Medical Credentialing Process

While the medical credentialing process is vital for a streamlined billing experience and for a high quality experience for the patient, it’s also a tedious and time-consuming process. It involves a mountain of paperwork and can take months to complete; luckily for you, you have the option to outsource this challenging process!

The top three advantages of outsourcing the medical credentialing process for your holistic provider include:

Your H Practice Can Accept Patients with Insurance and Medicare

Being able to accept patients who carry insurance or are supported by Medicare is a game changer for your holistic practice! Medical credentialing helps make this happen; private insurance companies, as well as government programs like Medicare, have an incentive to minimize the costs of their operations and part of this results in only working with providers who are credentialed. Credentialed professionals and providers demonstrate verified competency in their field and, therefore, pose minimal risk. Overall, the medical credentialing process further recognizes and validates your authority to deliver high quality care to members of your community.

It Enables Your Team to Handle Other Important Matters

Chances are you, as well as each member of the team at your holistic practice, wear many hats; this means you’re balancing administrative work with customer service all while delivering great care to your clients. The medical credentialing process is a significant undertaking that would further deplete your team’s time and efforts that might be otherwise better spent elsewhere. By outsourcing the medical credentialing process, you and your team can continue to support every other initiative at your holistic practice while a team of experts handles your important credentialing journey.

It Ensures Accuracy Following the Credentialing Process

What good is completing the medical credentialing process if the application has missing, outdated, or inaccurate information and has to be done again? Not much! Overlooking significant aspects of the medical credentialing application can result in significant delays and overall frustration for your holistic practice. Postponed credentialing means postponed opportunities to serve patients with insurance or Medicare, which essentially impacts your revenue cycle.

Furthermore, each state is likely to have different credentialing regulations and requirements. Not understanding your state’s regulations can also throw a wrench in the medical credentialing process. Outsourcing this process, however, means you don’t have to worry about inaccuracies or misunderstandings!

Outsource Your Medical Credentialing Process with Holistic Billing Services!

Medical credentialing maintains and perpetuates confidence in the quality of healthcare providers and works to keep costs down; medical credentialing is a win-win for everyone involved! If you need to gain or update your medical credentials but don’t want to deal with the headache of completing the process yourself, then let Holistic Billing Services handle it for you!

Our team of experts will ensure accuracy and navigate the process for you so that you and your holistic practice can continue doing what you love: serving your community! Contact us today to learn more!

Read More
va massage therapy

How to Start Providing VA Massage Therapy (+ Tips for Billing the VA)

A recent consumer study found that 88% of respondents reported massage therapy was beneficial to their overall health and wellness. Want to offer massage therapy services to the veterans in your community, but aren’t sure how to manage billing the VA? We’re here to help you understand this process better so you can deliver quality care to veterans at your holistic practice.

There are numerous methods of massage therapy, including:

  • Medical massage
  • Hot stone massage
  • Swedish massage
  • Reflexology
  • Trigger point massage
  • Thai massage

Each method implements a particular set of movements that target muscles in order to increase blood flow, promote relaxation, alleviate physical pain, and encourage overall wellness.

Does the VA Cover Massage Therapy?

It depends on the specific circumstances and location. Some VA facilities may offer massage therapy as a form of rehabilitation for veterans, but it is not a widely covered service under VA benefits. It is best to check with your local VA facility or speak with a VA representative to determine if massage therapy is covered in your area.

Benefits of VA Massage Therapy

Massage therapy has been proven to treat a wide array of conditions veterans might be suffering from, including:

  • Chronic pain: Massage therapy treatments help stimulate blood flow to parts of the body experiencing pain, which helps promote the release of natural painkillers; since massage therapy results in relaxation, overall chronic pain conditions can be managed with treatments. This is an especially timely holistic approach in light of the ongoing opioid epidemic.
  • Depression: One study found that 11% of veterans were experiencing elevated levels of depression; massage therapy can help alleviate the physical symptoms of this mental condition, such as back pain, body aches, sluggishness, and more. 
  • Anxiety: A 2016 research study demonstrated that Swedish massage therapy treatment was successful in reducing the symptoms of Generalized Anxiety Disorder (GAD). Veterans often experience complicated symptoms of anxiety linked to PTSD and homelessness, which can increase the risk of suicide; incorporating a massage therapy treatment plan into an overall wellness plan can help mediate these symptoms.

How To Start Treating Veterans at Your Massage Therapy Practice

The US Department of Veterans Affairs recognizes clinical massage therapy as “one of the evidence-based, complementary and integrative health (CIH) approaches within the VHA Whole Health System of care” and covers the cost of this care when deemed necessary. Follow these steps to start treating veterans with massage therapy at your holistic practice!

Apply for Your National Provider Identifier (NPI)

A National Provider Identifier, or NPI, is a 10-digit identification number issued to healthcare providers in the U.S. by the Centers for Medicare and Medicaid Services. Your massage therapy practice will need to apply for an NPI if you are a HIPAA-covered health care provider or if you bill insurance for your services.

Determine Your Region

The VA Community Care Network (CCN) is divided into six regions that cover the continental United States in addition to Hawaii, the Caribbean, and the Pacific Islands. TriWest manages the western networks while Optum handles the eastern regions. Find out which region your practice resides in.

Get Credentialed

In order to provide quality care for veterans at your holistic practice with massage therapy, you’ll need to be credentialed with the region’s third-party administrator. This process typically takes at least three months to complete. Depending on your region, contact the following to get started with the credentialing process:

  • Region 1: 888-901-7407 (Optum)
  • Region 2: 844-839-6108 (Optum)
  • Region 3: 888-901-6613 (Optum)
  • Region 4: 866-286-4174 (Triwest)
  • Region 5: 877-226-8749 (Triwest)

The VA has not officially contracted with an agency for Region 6; contact information is pending for that region.

Complete Registration Paperwork

Upon completing the credentialing process, you’ll need to submit the necessary paperwork to become fully registered with the network. This paperwork is submitted electronically and will include details regarding any final requirements that must be met in order to finish the credentialing process.

Receive Patient Authorizations

Once your holistic practice has been verified and authorized by the VA’s network, you’ll start to receive referrals to treat veterans who are approved to start massage therapy treatment. Your CCN administrator will provide the patient’s authorization letters before the patient’s first visit to your practice.

va massage therapy

Checklist for Initial Claims Processing

When submitting an insurance claim to the VA for the first time, you’ll need to submit all the authorization letter pages together with the claim. Make sure you transmit all the following information with your massage therapy claim to avoid a denial:

  • A cover letter
  • The date range for services
  • Authorization numbers
  • The total number of visits authorized
  • The patient’s demographics including address, date of birth, and social security number
  • Documentation and CPT codes of treatments administered

By following this checklist, you can ensure your Veterans Administration insurance claim will have all the accurate information it needs for a smooth billing process. 

Maximize Your Reimbursements for VA Insurance Claims with Holistic Billing

As a medical billing provider with a special focus on holistic and integrative health practices, such as massage therapy practices, Holistic Billing Services can help you get credentialed by your region’s CCN and help you start treating veterans right away. We have plenty of experience navigating the unique VA billing guidelines, which allows us to maximize your reimbursements and keep your practice’s revenue flowing.

To learn more about how you can get started providing acupuncture for veterans and active service members without worrying about having your VA claims denied, talk to our massage therapy billing and coding experts today!

Read More
medical credentialing

What is the Medical Credentialing Approval Process for Holistic Practices?

As a holistic practice, you want to deliver the best treatments of holistic medicine to your patients – while also ensuring you are paid! To service your patients and grow your holistic business, however, you will want to consider provider credentialing as an in-network provider to bill insurance plans. To be approved, you must meet the numerous medical credentialing requirements for your practice. Besides meeting the requirements, you also must ensure that all the complicated paperwork is filled out accurately and the right documentation is gathered. 

Don’t be discouraged, however! There are ways to ensure you’re approved the first time you apply for medical credentialing. Here are some considerations to keep in mind so you have everything you need to know before starting the insurance billing credentialing process.  

What is Medical Credentialing?

The process of verifying a healthcare provider’s qualifications for administering care to patients to bill insurance providers, medical credentialing is necessary to receive reimbursements for services. Medical credentialing is a common process for most insurance billing, including many commercial insurance companies, medical groups, surgery centers, or government plans like Veterans Affairs, Medicare, and Medicaid. 

Generally, the medical credentialing process involves various applications, forms, and documentation, though the exact requirements vary on the insurance provider. Typically, the provider credentialing process must verify that the medical practice’s documents are current and valid. This can include medical licenses, malpractice insurance, DEA, board certifications, and any other additional information necessary to complete the credentialing process.   

What are the Common Challenges in the Medical Credentialing Approval Processs?

Although the medical credentialing process is essential to receive reimbursements, there are many potential issues – and ensuing consequences – that can occur. Since provider credentialing is integral to generate revenue, it’s one of the most important processes for a holistic practice. However, data errors, accidental omissions, or any other hiccups in the process can result in incomplete credentialing and possible financial complications. 

Medical practices – holistic or not – lose revenue and waste valuable time and money with common medical credentialing mistakes. So, being aware of the common challenges in the medical credentialing approval process can help avoid these costly errors!

Incomplete Applications

A common mistake that plagues medical practices, sending incomplete provider enrollment applications can set back the provider credentialing process for weeks, if not months. The general application for credentialing requires an extensive amount of paperwork and documentation – all that needs to be filled out correctly. Failure to complete the provider credentialing application accurately can result in lengthy reimbursement delays and denied claims that can negatively impact your bottom line. 

While some mistakes are inevitable, ensuring qualified credentialing helps eliminate the margin for human error, saving your holistic practice time and money. 

Lack of Organization

An organized practice can lead to inaccurate provider credentialing applications, lost paperwork, or extra time spent on the entire process as a whole. Having all your important paperwork and data where it should be and gathered will avoid any issues in the future, such as claim denials or inaccurate physician contact information. 

Proper organization can also make the entire medical credentialing process as efficient as possible, so your holistic practice can focus on the day-to-day operations of delivering services to patients and receiving payments. 

Not Updating Information

Even after healthcare providers are credentialed, all provider contact information needs to be kept up to date. Depending on the state in which you practice, licenses and credentials need to be renewed regularly. During the re-credentialing process, having up to date information on every individual practicing, including licenses and contact information, will be important for an efficient and accurate process for your holistic practice. 

Besides making the process exponentially easier, keeping up to date with physician licenses will also help avoid potential bad patient outcomes if a physician is practicing without an updated license. 

Medical Credentialing Checklist for Holistic Practices

To avoid possible claims denials and lengthy issues, you want to make sure your provider credentialing is as accurate the first time around as possible. Since the medical credentialing process can be lengthy and full of complicated documentation, a checklist can help ensure no important data is missing. 

Here are some medical credentialing checklists for holistic practices to help provide an accurate and speedy credentialing outcome! Remember that, depending on the state in which you practice, you may have additional medical credentialing requirements that are not fully covered by the process. 

Massage Therapy Credentialing

massage therapy

  • Know your state requirements for holistic practices
  • Provide your NPI (National Provider Identification)
  • List all relevant professional licenses
  • Provide any evidence of education or training
  • Include all board certifications
  • Include DEA certifications
  • Malpractice Insurance, if applicable
  • Current Competence to Practice certifications

Chiropractic Credentialing

chiropractic treatment

  • Know your state requirements for chiropractic holistic practices 
  • Get your NPI (National Provider Identification)
  • Licensure: All practitioners must have and maintain a current, unrevoked, unsuspended, and unimpaired license to practice chiropractic in the state where their holistic practice is
  • List education or training
  • Practitioners must also complete and maintain all continuing education hours as required
  • If your practice performs X-rays, make sure to follow radiographic guidelines and x-ray criteria
  • Include all board certifications
  • Include DEA certifications
  • Malpractice Insurance, if applicable
  • Current Competence to Practice certifications

Acupuncture Credentialing

acupuncture treatment

These are essentially the basics for acupuncture credentialing in most states in the District of Columbia. 

  • Graduated from an academic program with U.S. Department of Education recognized accrediting agency
  • Passed relevant licensing or certification examinations, or is nationally board certified by the NCCAOM®
  • Holds a license in the appropriate jurisdiction
  • Education or training
  • Include all board certifications
  • Include DEA certifications
  • Malpractice Insurance, if applicable
  • Current Competence to Practice 

Turn to Holistic Billing Service’s Medical Credentialing Services to Get Approved for a Network the First Time Around!

Medical credentialing for holistic practices can be a lengthy and complicated process, but one that is an option to receive reimbursements from insurance companies as an in-network provider. An efficient and accurate provider credentialing service is essential for a healthy bottom line, but the process can be full of complicated paperwork that needs to be filled out precisely. By outsourcing your medical credentialing to professionals, you can trust that your credentialing is filled out correctly – the first time around!

At Holistic Billing Services, you can trust our team of experienced billing and coding experts to understand the unique needs of holistic practices and can help you take steps to accelerate your revenue cycle management and avoid claim denials. Since we deal exclusively with holistic healthcare practices like acupuncture, massage therapy, and chiropractic treatments, we are familiar with the medical credentialing approval process and how it affects your business. For any questions about holistic billing, feel free to contact our team today, and let us know how we can help your holistic practice!

Read More