Quarantines, office closures, and public safety concerns regarding COVID19 created a huge demand and sudden surge of telehealth services. Telehealth has long served a small subset of the therapy population, but it’s never been widely reimbursed or accepted by insurers. Now that carriers have started to reimburse and offices are able to evaluate how their patient’s fare with the new therapy model – is it here to stay? Can we go back now?Continue reading
Telehealth: How’s it going? Increasing COVID numbers in March and April left many providers and insurers scrambling to get telehealth underway in their clinic. Telehealth has always been an excellent medium for certain patients, but it has never been the norm, and many therapy clinics did not even offer telehealth before COVID. While specialists were researching the technology and reaching out to patients, insurers were also evaluating their own policies and releasing many, many memos on what they will or will not cover as it relates to telehealth.Continue reading
With the World Health Organization officially labeling Coronavirus as a pandemic and confirmation of the virus multiplying throughout the states, Insurance Companies and Public Health Organizations are getting serious about what it’s going to take to battle this – not just medically, but also organizationally and administratively.Continue reading
EEP had a great time attending ASHA and it was so great to see several of our current clients and meet many other new providers! We were able to speak to providers in all situations from all states and learned a lot about the wants and needs of the community.Continue reading
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!