There are times when new practices are unable to enroll with major insurance companies. In this article, Nitin Chhoda provides some valuable tips on how to simplify the complicated process of enrollment and get your practice in-network with the payers you wish to work with.
Although physical therapy billing is complicated by the various billing requirements of insurance companies and government programs, some private practices are finding ways to simplify the process.
In fact, physical therapy billing is being redefined by physical therapy documentation software and EMRs.
The changes that are being make streamline the process, improve claims acceptance from insurance companies, and improve the patient experience.
Applications to Insurance Companies
For each insurance company that a physical therapy practice would like to bill, an application process must be completed and even certification may be required. Insurance companies have a lot of power in this regard and the process can be time consuming and costly.
These physical therapy billing applications cannot be taken lightly, and the terms of the final contract with each insurance company should be carefully reviewed.
The contract terms will determine just what you can bill for and what the limits are for each insurance company. Not only will this inform what the physical therapy billing staff does, but it should also be used to instruct physical therapists on how to work with patients to get the most benefit from the limits imposed by the insurance companies.
The Most Efficient Way to Enroll
There are now services that offer to apply on behalf of your practice for a fee. In many cases, this can be worthwhile, as the time and energy it takes to complete this kind of application takes physical therapy billing or management staff away from other duties.
Hiring a specialist to do this temporary work may be the most efficient way to enroll with a number of insurance companies as well as government programs like Medicare and Medicaid.
But this still involves a great deal of attention, at least from physical therapy billing and management. You may want to start by determining exactly which companies you want to enroll with.
Not every insurance company will be worth working with, especially if the limits are particularly low or they have a particularly high rate of rejection and denial of claims. Once you have drafted a list of potential companies and programs, you can work with an application company to get enrolled more quickly and efficiently.
Integrating Insurance Requirements into an EMR
A fully integrated and flexible physical therapy EMR can provide clinicians with the correct weighted procedures and treatment options so that when the information is transferred to the physical therapy billing staff, the billing process can be seamless and smooth.
A physical therapy billing and documentation software solution can help make enrollment smoother for physical therapy billing staff as well as for management. Once the terms are set, the specific can be entered into your EMR.