Medical Billing Forum

General Category => General Questions => Topic started by: QueenAlicia on November 15, 2012, 03:07:44 PM

Title: Chiro reimbursements timeframe
Post by: QueenAlicia on November 15, 2012, 03:07:44 PM
Is there a time frame that it takes Chior's to be paid?  I have a Chiro in WI that states it take 30-45 days to get paid from insurance when claims are filed electronically.  I thought was off because I have seen checks sent out a few days after filing.  Is this Chiro or state specific?
Title: Re: Chiro reimbursements timeframe
Post by: DMK on November 16, 2012, 10:56:01 AM
Blue Shield of CA pays us in 7 days (filed electronically).  Blue Shield out-of-state plans pay in about 14 days.  Blue Cross is about 14.  Medicare PROMPTLY pays in 14 days (electronically paid).  Worker's Comp is 30 working days. Personal Injury varies from company to company, but in California, ALL companies are supposed to pay in 45 days MAXIMUM unless they require other information or authorization.

My WORST payers are United HealthCare and CIGNA.  It's like pulling teeth to even figure out WHERE to send bills, and that's ELECTRONICALLY!!!!  They all have the same E-payor number but they sure know how to lose a claim!
Title: Re: Chiro reimbursements timeframe
Post by: QueenAlicia on November 16, 2012, 11:09:48 AM
That's what I thought! I have never seen a panel take that long even with my EAP providers. I haven't had many issues with Cigna, they usually pay or cut the check 2 days after filing.  My only issue with Aetna is how they send the check to the patient and the patient spends the money instead of paying the provider.  However, this provider is in Wisconsin so I don't know if it is a state specific issue.  My provider also stated that there is a group of providers in her state that have a centralized billing system/dept and they have seen that time frame as well.  Boy, I can't wait to prove it wrong and get the reimbursements in faster. ;)
Title: Re: Chiro reimbursements timeframe
Post by: DMK on November 16, 2012, 12:47:56 PM
What's your secret with CIGNA?  They are the biggest pain in the butt for me! 

CostCo employees have Aetna, and Aetna always pay me direct.  Are your providers OON?  I do have to get all my EOB's online from Aetna, but I get the check, so it's a few mouse clicks to get the EOB's.  They pay a little slower, but they pay well.
Title: Re: Chiro reimbursements timeframe
Post by: QueenAlicia on November 20, 2012, 04:08:54 PM
I actually have no secret. I just make sure the claim is clean and then I check the report daily.  However, I will say that this provider would wait awhile to send me the EOB's so I had to go into cigna to pull it of the site.  I noticed that I would file one day and 2 days later the check was issued.  They are the easiest payer so far. I just have to repeatedly remind the provider about collecting copay.  It could depend on the specialty too  :-\
Title: Re: Chiro reimbursements timeframe
Post by: DMK on November 21, 2012, 10:16:49 AM
It may be a CALIFORNIA chiropractic issue.  You have to get treatment authorized through ASH on most plans, send the PAPER claim to ASH for pricing, then they push it to CIGNA for payment.  It takes soooooo long!
Title: Re: Chiro reimbursements timeframe
Post by: QueenAlicia on December 04, 2012, 12:59:10 AM
LOL, you know that CA just has to be difficult.
Title: Re: Chiro reimbursements timeframe
Post by: PMRNC on December 04, 2012, 08:38:19 AM
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LOL, you know that CA just has to be difficult.

Here's a little tidbit about California you might not know.. All health insurance claims that come out of California in any way (provider, policy written, carrier, etc) have to be handled by a REGISTERED and California trained examiners.  When I worked for 2 carriers out here on the East coast I had to go through a specific training program just to handle a California claim.  Back then we only had 2 or 3 examiners and tech reps (quality control) that could do it so if they were out for any reason claims sat.  Just thought you might find that interesting. lol
Title: Re: Chiro reimbursements timeframe
Post by: DMK on December 04, 2012, 10:09:17 AM
That explains a lot!  Leave it to wacky California to figure out a way to slow down the machinery of business!
Title: Re: Chiro reimbursements timeframe
Post by: QueenAlicia on December 11, 2012, 04:23:26 PM
Although it is a wacky state, I love it and the weather.

Did you know that claims handled by BCBS are handled by people in the Phillipines? ::)  A fellow biller used to work for BCBS and she told us this as an AMBA meeting. 
Title: Re: Chiro reimbursements timeframe
Post by: PMRNC on December 11, 2012, 04:26:55 PM
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Did you know that claims handled by BCBS are handled by people in the Phillipines? ::)  A fellow biller used to work for BCBS and she told us this as an AMBA meeting. 

Doesn't surprise me. NJ DMV uses offshore call banks as well as their social services (food stamp) dept.   Shouldn't really be a surprise for AMBA members either since they have no problem giving memberships and certifications to offshore companies. 
Title: Re: Chiro reimbursements timeframe
Post by: QueenAlicia on December 11, 2012, 04:37:59 PM
I see why they do it, do I like, HELL NO, but I can't do anything about it, yet.

The only thing I can do is educate myself and the doctors out there who do offshore. I hate it with a passion and if I could assist in helping in any cause that is legal, legit and respectful I will give my energy to helping to get it banned/made illegal.  Offshore topic just boils my blood.
Title: Re: Chiro reimbursements timeframe
Post by: PMRNC on December 12, 2012, 07:22:33 AM
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I see why they do it, do I like, HELL NO, but I can't do anything about it, yet.

Sorry, I can't see why at all. I have over 7000 active members and not one penny taken from an offshore company, not one offshore company is profiled or advertised through us, nor will ever be.

There have been bills pending in legislation but they seem to get dropped right after coming out of the house. The last one was blocked by the senate in July 2012. I continue to watch. I think you will finally see one in the near future that will penalize American businesses for using offshore, that will be the most likely scenario before an all out ban.  We do have a say, we just have to be a little louder. If you know your own physician is sending claims offshore, do not authorize that. Too many physicians, associations, physician advocate groups just take the position.. "Oh well, we can't do anything" and that's simply not true. I have NO PLAUSIBLE excuse, explanation to ever take a member who engages in offshore outsourcing nor will profits ever come before principal with me. EVER.  The more we look the other way and say "oh well" the more it continues.   Educate your clients, your own physician, present the facts, show them the problems associated with offshore outsourcing, it starts there. :) 
Title: Re: Chiro reimbursements timeframe
Post by: DMK on December 12, 2012, 10:10:34 AM
Be PRO-Active not RE-Active!  Knee jerk emotions get us nowhere, educate everyone in your circle!