How Outsourcing Billing Can Make Your Therapy Clinic More Efficient

How Outsourcing Your Billing Can Make Your Therapy Practice More Efficient - Edwards Electronic Processing Blog

If you own a therapy clinic, you no doubt understand that billing involves more than just submitting claims. Duties such as requesting authorizations, applying payments to patient statements, and reconciling can comprise a full-time job. Chances are, you and your admin team don’t have the time to complete all of these tasks accurately. Calling in specialized help is one of the best ways to ensure that you and your therapists get paid in full and on time. Read on to discover why the EEP team suggests outsourcing your billing to a qualified agency.

  • Medical billers will accurately submit your claims. Claim submission can be a tricky process, with requirements varying by insurance provider. An experienced billing agency is familiar with these details, and will get your claims submitted on time and correctly. Instead of spending your time searching for the right way to submit claims, you can let the experts take care of it and reduce the risk of errors in the submission process that could extend your payment turnaround time.
  • They can handle erroneous denials. Trained medical billers will fight for you. Whether it means spending hours on the phone with insurance companies or tracking down medical documentation, billing agency staff do whatever it takes to address any erroneous denials. This saves you and your team precious hours and prevents lots of stress!
  • An agency performs thorough follow-up. Once a claim has been paid by insurance, there is sometimes a remaining balance on a patient’s account. keeping track of these unpaid balances and invoicing patients is important in order to collect what your clinic has earned for the treatments performed.
  • Specialized knowledge. If you choose to work with a billing agency with expertise in your particular specialties, you will get even more out of the relationship. Billers who work with just therapy clinics always know which CPT codes are appropriate and understand the nuances of billing for treatments, evaluations, IFSP conferences, and more.

There are countless other benefits to outsourcing your therapy billing to an agency. Read more about the services a therapy billing agency like EEP can provide.

Once you’ve decided to go with a billing agency, selecting the right one doesn’t have to be a daunting journey. Check out our blog post about how to find the right fit for your practice.

Insurance Authorizations 101

Insurance Authorizations 101 - Edwards Electronic Processing Blog

When a new patient arrives at your therapy clinic, there are several bases to cover before he or she can be treated. Along with standard intake forms and insurance verification, we recommend checking benefits and requesting an authorization. Following these best practices will protect you from the dreaded scenario in which you perform treatment and do not get paid.

Although therapy clinic owners and admins are generally most familiar with the process of obtaining an authorization from an insurance company, it’s wise for therapists to understand the process and act as another set of eyes. Let’s go over the basics:

What is an authorization? An insurance authorization is a determination by a patient’s health insurance carrier that treatment is medically necessary. Since commercial insurance plans consider therapy a specialty, authorizations are required in many cases. Florida Medicaid requires authorization for all therapy disciplines. While an authorization is not a guarantee that the insurance will pay, it is much more likely that benefits will be honored when the authorization is on file.

Why should I worry about authorizations as a therapist? You may feel that your responsibilities follow the paperwork process that your admin team normally takes care of. However, if you unknowingly treat a patient without an authorization on file, you could risk spending valuable time treating a patient and not getting paid, or experiencing a lengthy delay in payment time. In addition to the risk of lost revenue for you and your clinic owner, lack of an authorization can throw off your plan of care. Since the details in your plan of care depend upon your expectation of when a patient will meet certain goals, the amount of benefits and number of pre-approved treatments can impact whether you will be able to follow the plan. keeping an open line of communication with your owner and admins can help you avoid any miscommunication about the type and quantity of treatment you provide your patients.

Though you may not be responsible for requesting authorizations or attaching them to a patient’s file, our expert billers at EEP advise that you check to see if there is an authorization assigned to every patient case, especially for new patients. A few moments of due diligence go a long way towards making your treatment plan and payment process as smooth as possible!

Want to learn more about insurance authorizations? Check out how our partner EMR, TheraPlan, eases the job of a therapist by tracking authorizations for you!