Insurance Management: A Third Party Billing Service May Be Your Solution

:dropcap_open:M:dropcap_close:anaging insurance is certainly one of the hardest tasks chiropractors have to perform in their office, and it is one of the reasons some chiropractors have decided to turn their office into a cash practice.  But turning your practice to an all cash practice is not an easy task.  It is difficult to convince your patients to pay cash when so many other chiropractors or health professionals in your area are managing insurance for them. Managing insurance requires a lot of skill and knowledge, and in order to get paid well and be able to comply with all the rules and regulations the billing staff needs to know and follow a lot of procedures. If you have a great billing employee working with you in your office, make sure you treat her (or him) well because they are hard to replace, believe me. But if you are not happy with your billing staff, or if your billing employee had to leave your office for some reason, a third party billing service may be your solution.  What is a third party billing service exactly?  Let’s see, step-by-step, how a third party billing service works.

 

A third party billing service will be your billing staff and will work remotely through the internet.  They will send your claims to insurance carriers and will post all payments received in each patient file.  A good TPBS will follow up on unpaid claims, just as an on-site billing employee would do.  If you ever decide to use a TPBS, make sure they will follow up on unpaid claims, because not all of them do.  Make sure they do not write off claims without proper explanations and documentation. The service will give you access to all available insurance reports.  This way, you will be able to see exactly where your claims stand. They will also keep you informed about rules and procedure changes that insurance carriers put into effect.  Essentially, they will work as your insurance management expert.

 

A TPBS is not a chiropractic assistant. They will not give appointments to patients or educate your patients about the benefits of chiropractic care.  Also, a TPBS will not add or change any medical information in the system. Only the chiropractor is authorized to do that. They will not recommend any number of visits, or present or explain any kind of care plans to patients.  Remember, they are not on-site; they work remotely.

 

TPBS are insurance management experts.They manage insurance for hundreds or thousands of other clinics. They know all the ins and outs of insurance management. For this reason, a good TPBS will be very effective for you. Financially, using a TPBS may be very beneficial. Usually, you may expect to pay anywhere between 5 and 8 percent of paid claims for such a service. If you make the calculations, this is quite a cheap way to replace your billing staff. There will be no vacation, sick leave or any other benefits to pay. If you choose the right TPBS, it is very possible that this service gets paid by itself with a very efficient paid claim percentage. With all information provided by the TPBS, you will be kept on top of your insurance management. You will be kept informed constantly about claims paid, submitted or on hold.  You will be asked to update clinical information if required by the insurance company.  As soon as this is done, your TPBS will make sure to send the transaction with the next insurance submission. The process is well covered and easy to work with.  Some chiropractors are not very excited about managing employees, but operating a chiropractic office forces them to do so.  Giving the insurance management to a TBPS may be a relief for this often time-consuming task. This saved energy may be transferred to where it should be: patients and chiropractic care.

 

In chiropractic, just like any other profession, there is no magic solution for everything.  Using a third party billing service will not necessarily suit all chiropractors’ offices, but may certainly help a lot of them.

 
Claude Cote  is an expert in EHR systems, insurance billing and chiropractic clinic management for 22 years.  He has installed EHR system in 18 countries over 5 continents and nationwide in USA.  He is the President and Founder of Platinum System C.R. Corp (www.platinumsystem.com).  For comments or questions, please email to [email protected]