We are a family business, I'm a chiropractor and my wife, Jessica is an acupuncturist. We've been billing insurance companies for the past 13 years for our own practice and have learned the in's and out's of acupuncture and chiropractic billing (usually the hard way!)
We focus on six areas related to billing:
1. Setup - You may know what your TIN/EIN, Type 1 and Type 2 NPI numbers, billing address, facility address(es), and mail address is, do the insurance companies know? Prior to any billing we audit your contracting information with all the insurance companies you bill to make sure you are set up correctly (and getting paid!)
2. Patient Insurance Verification - knowing what the patient has for acupuncture benefits and what the insurance company's acupuncture policy covers (diagnosis limitations, service limitations, license limitations) are the first step in getting the valuable care you provide paid.
3. Billing - Submitting clean, properly coded bills and correcting claims that have errors before they go out is integral in getting you paid on time. We review each charge/claim you submit for accuracy and to maximize reimbursement.
4. Follow up - Not following up on unpaid claims is probably the area where providers lose the most money. Constantly reviewing aging claims is essential to getting you paid for all the care you provide.
5. Reporting - Clean, concise reporting on a monthly basis lets you know the status of your billing. Do you know how many claims have been billed, paid, and are 30, 60, and 90 days old? We provide monthly reporting so you can better understand the status of your billing and where you (and us) need to focus our billing energy.
6. Education - Probably the single most important aspect of billing is knowing how to do it properly. We focus not just on billing and fixing claims, but making sure you are billing in a compliant and appropriate manner. Many healthcare professions learn billing "as they go" and from friends and fellow practitioners resulting in improper, bad or even fraudulent billing. Bad billing raises red flags and leaves providers at risk for post-payment audits and investigation. Billing incorrectly also leaves money on the table in covered, but unbilled services.