When owning a holistic practice, one of the most important things to consider is how to handle insurance billing; this can be tricky and time-consuming, but ensuring that your patients receive the reimbursement they are entitled to is essential. As a holistic practitioner, choosing an insurance biller who understands the unique needs of your practice, whether it be acupuncture, chiropractic, or medical massage, can help you navigate the complex world of insurance billing. This blog post will discuss critical factors on how to pick an insurance biller for your holistic practice covering acupuncture, chiropractic, or a medical massage practice.
Experience and Expertise
One of the most important things to consider when choosing an insurance biller is their experience and expertise in your field. Each type of holistic practice has its unique billing requirements and codes, so it is essential to choose an insurance biller who is familiar with the ins and outs of your field. For example, suppose you run an acupuncture practice. In that case, you will want to choose an insurance biller who has experience with acupuncture insurance billing and is familiar with the codes and procedures specific to this field. The same goes for chiropractic and medical massage practices.
Credentials and Accreditation
Another critical factor to consider when choosing an insurance biller is their credentials and accreditation. Selecting an insurance biller certified in medical coding and accredited by professional organizations in your field is essential; this will ensure they have the necessary knowledge and training to handle your insurance billing needs. Additionally, it is a good idea to choose an insurance biller who is a member of professional organizations such as the American Medical Billing Association (AMBA), the National Association of Medical Billers and Coders (NAMBC), or the Healthcare Business Management Association (HBMA)
Communication and Responsiveness
When it comes to insurance billing, communication, and responsiveness are key. You would like to choose an insurance biller who is easy to communicate with and responsive to your needs. It is crucial to have a clear and open line of communication with your insurance biller so that you can address any issues or questions that may arise. Additionally, you want to choose an insurance biller who is responsive to your needs and can help you navigate any challenges that may come up.
Services Offered
When choosing an insurance biller, it is essential to consider their services. You want to select an insurance biller who can handle all aspects of your billing needs, including credentialing, insurance benefit verifications, submitting claims, following up on denied claims and managing patient accounts. Also, you’d like to choose an insurance biller who can help you with coding and compliance issues and give you regular reports on your billing status.
Cost
Lastly, it is vital to consider the cost of the insurance biller’s services. While cost should not be the only factor in your decision-making process, choosing an insurance biller who offers competitive rates is essential. Also, you’d like to select an insurance biller who is open about their fees and can give you a detailed breakdown of their costs. It is essential to choose an insurance biller who has experience and expertise in your field, is certified and accredited, has good communication and responsiveness, and offers a range of services at a competitive cost. By considering these factors, you can ensure that your insurance billing needs are met and that you receive the reimbursements generated by your work.
How does this relate to a billing company focused on acupuncture, chiropractic, and medical-massage billing? While you are busy filling your schedule, your time does not need to be consumed by the tedious and complicated medical coding and billing process. By letting a trusted firm like Holistic Billing Services handle your online appointments, SOAP notes, or 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 in EHR and medical billing! Contact us today to get started building a custom solution that suits your acupuncture practice needs and goals.
Healthcare documentation is a critical component for your holistic practice, both in terms of delivering great care to your patients and for insurance billing purposes—not to mention the importance of having some form of documentation in the event of a legal situation.
Treatment notes are needed to keep a live record of how your patient is feeling and what plans have worked in the past or what needs to change for the future; keep reading to learn more about a particular outline of healthcare documentation called SOAP notes and how they can play a role in your holistic practice’s insurance billing cycle.
What Are SOAP Notes?
One standard form of healthcare documentation is called SOAP notes, which stands for Subjective Objective Assessment and Plan. Each section of this general formula is key to gathering a comprehensive report of the patient’s current experience and determining the best treatment plan.
Subjective
This is the first section of SOAP notes and pertains to the subjective experience of the patient you’re treating; this includes their feelings, perspective, and personal views as relevant to the treatment setting. The purpose of this section is to provide context for why the patient is visiting your holistic practice and to allow the patient to put into their own words what is going on with them.
Depending on the setting of your holistic practice and what type of treatments you offer to your patients, this section might have a few other subheadings to further elaborate on what the patient is experiencing.
For example, if you were doing a consultation for massage therapy services, you might include the following sections:
- Rate the intensity of pain on a scale of 1 to 10
- Describe the sensation of the pain, such as shooting, dull, cramping, tingling, throbbing, aching, etc.
- Note the places of pain on the body
- Explain how the pain started and how it might change during the day with different movements, what makes it worse or what helps reduce the pain, etc.
This initial section is important for illuminating how a patient’s condition is affecting them so that you can determine how best to address their pain points—both literal and metaphorical.
Objective
As opposed to subjective, this second section deals with objective, unbiased facts regarding the patient’s condition. Such information might include:
- Patient’s vital signs
- Diagnoses
- Allergies
- Imaging results
- Lab data
- Behavioral or physical signs
- Body posture
- Range of motion
It’s important to distinguish between symptoms and signs in this section; symptoms are considered subjective whereas signs are considered objective notes. As with all medical documentation, it’s also crucial to filter out any kind of assumptions in the note-taking process; each objective note should be verifiable through evidence.
Assessment
This third step of SOAP notes is where you bring together the subject and objective portions of your documentation and determine what might be ailing your patient. In this section, you might list whatever problems or diagnoses that patient is presenting with, in order from most to least important or severe.
The assessment portion of SOAP notes is important because it provides documentation of the diagnosing process and serves as a record of your thinking. Assessing the patient is helpful for other providers to review your conclusions and inform them on how best to deliver holistic care from their specialty or perspective.
Plan
The final step in writing SOAP notes is, of course, to outline a plan of care for the patient you’re serving. This section might include information like:
- What follow-up appointments are needed
- Referrals to other specialists
- Orders for further testing
- Therapy needed
The plan section is an essential conclusion to the SOAP notes outline because it provides the appropriate next steps and pertinent information for the patient to follow in order to begin their plan for treatment.
Importance of SOAP Notes and Treatment Documentation
The phrase “if it’s not documented, then it didn’t happen” might sound extreme, but in the world of healthcare—whether medical or holistic—it’s the norm. Treatment documentation is essential because it functions as part of the patient’s medical history, enables collaborative care between providers and authorized entities, results in a better quality of care, and more.
SOAP notes are simply one outline to follow when doing healthcare documentation; it’s an easy acronym to remember yet ensures that all cornerstone portions of a patient’s experience are documented. From the patient’s subject experience and reported history of their ailment to what your recommendations are for treatment, SOAP notes provide a comprehensive record that can be referred to in the future.
Why SOAP Notes are Important for Insurance Billing
SOAP notes are also important for insurance billing purposes; because healthcare documentation is an essential part of operating a successful holistic practice, it’s vital that your insurance billing process is as streamlined as possible. SOAP notes—and healthcare documentation, in general—are crucial for insurance billing purposes for the following reasons, including:
Improved Patient Outcomes
With precise, consistent documentation comes better patient outcomes. This, of course, helps insurance companies regulate the cost of healthcare because improved patient outcomes are the result of efficient and effective care.
Streamlined Claims Processing
As you well know, you can’t just willy-nilly code a patient-provider interaction with just any kind of coding; you need to back up your medical billing and coding with evidence of why you’re submitting a claim for that interaction! SOAP notes and healthcare documentation overall help justify why you’re submitting a claim for reimbursement.
Reduce Risk
Precise, comprehensive documentation that follows a logical line of reasoning is an effective way to reduce the risk of malpractice claims at your holistic practice. It’s hard to justify any kind of treatment plan or diagnosis without evidence, so SOAP notes and other forms of healthcare documentation are essential to reducing your practice’s risk in terms of delivering misguided care.
Streamline Your Holistic Practice’s Medical Billing with Holistic Billing Services!
Do you find yourself staying late to catch up on the medical billing and coding process of your holistic practice? Turn to the experts at Holistic Billing Services to streamline this entire process for you so that you can focus on what matters most: delivering great care to your patients.
Contact us today to learn how our experienced team can help boost your medical billing process and optimize your revenue cycle along the way!
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?
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!
As an insurance billing company, Holistic Billing has new providers contacting us daily about how to start medical billing. The first step is to get a National Provider Identifier number otherwise known as your NPI number. However, many holistic practices are unaware of how to apply for an NPI.
Luckily, the application process for getting an NPI number is pretty straightforward. Follow this guide and the NPI application checklist to help your holistic practice obtain its NPI!
What is an 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 NPI will not change, even if your address, taxonomy, or name changes. Although every NPI is unique, it does not carry specific information about you, such as the state where you practice or your specialization.
The NPI must be used in place of other provider identifiers, such as a Provider Transaction Access Number (PTAN), Online Survey Certification & Reporting (OSCAR), and National Supplier Clearinghouse (NSC) when used in HIPAA standard transactions. For reference, HIPAA standard transactions are exchanges involving the transfer of health care data between two parties for specific purposes.
Why Does Your Holistic Practice Need an NPI?
Your holistic 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. If your practice applies for enrollment, you must have an NPI. Any enrollment application without an NPI will be rejected.
An NPI also carries other benefits as well, such as simplifying electronic transmission of HIPAA standard transactions and efficient coordination of benefit transactions. However, it’s important to know that applying and receiving an NPI will not ensure you’re Medicare credentialed or replace your current insurance enrollment.
3 Options for Getting an NPI Number
Your holistic practice can get an NPI Number in one of three ways, depending on your preference.
Option 1: Apply Through a Web NPI Number Application
You can apply for an NPI through a web-based application. Visit the National Plan and Provider Enumeration System (NPPES) website. Individual providers must create a username and password through the Identity & Access Management (I&A) System, and log in to NPPES using that username and password.
Option 2: Apply Through a Mail Paper Application
You can complete, sign, and mail a copy of the application (Form CMS-10114, “NPI Application/Update Form”) to obtain an NPI number to the NPI Enumerator address listed on the form. To request a hard copy application through the NPI Enumerator, call 1-800-465-3203 or TTY 1-800-692-2326, or send an email to customerservice@npienumerator.com.
Option 3: Apply Through an EFIO
The final option you can apply for an NPI would be to permit an Electronic File Interchange Organization (EFIO) to submit application data through a bulk enumeration process. For more information on this option, check out the CMS website here.
NPI Application Checklist: How to Fill out the NPI Application
Your holistic practice can use this NPI application checklist to ensure that you have all the correct information when filling out the NPI number application from the CMS.
- Reason for Submitting NPI Number Application Form
- Entity Type (Are you an individual or an organization that renders health care?)
- Identifying Information (including that of sole proprietorships and incorporated individuals)
- Organization Name(s)
- Correspondence Mailing Address Information
- Business Practice Location Information
- Medicaid Identification Number (if applicable)
- Other (Non-Medicare) Provider Identification Numbers
- Provider Taxonomy Code(s)
- Individual Practitioner’s Signature
- Authorized Official’s Signature for the Organization
- Contact Person’s Information
The world of insurance billing is complex, and even more so for holistic practices. Understanding when to use the right acupuncture billing codes and procedures is essential to any successful medical practice – whether holistic or traditional. Accurate coding and billing practices ensure a streamlined reimbursement process so your practice can get paid and deliver the best care to your patients.
As a billing company focused on holistic healthcare providers, Holistic Billing is an expert in the world of acupuncture billing CPT codes. In any given year, roughly half of our new clients have never billed insurance before they started with Holistic Billing Services, so we are quite accustomed to their most frequently asked questions. Find the answers to many of the most common questions about Acupuncture CPT codes and billing practices below!