Medical Billing Forum

General Category => General Questions => Topic started by: Christy on March 06, 2013, 11:11:53 AM

Title: Electronic Billing Q?
Post by: Christy on March 06, 2013, 11:11:53 AM
HI all,

I have a PsyD whom I am meeting with for a consult. She currently handwrites paper claims and wants to go electronic. She states that she "wants me to create log ins for the individual carriers" so she can submit claims electronically.

I am familiar with electronic claims submission thru PM software/clearinghouses- but have never heard of going about it this way.

I assume she is mistaken- but I want to clarify. I have never done behav health billing and thought *maybe* this is a unique system for these types of providers because they submit treatment forms?

Or is she just confused?

Title: Re: Electronic Billing Q?
Post by: DMK on March 06, 2013, 01:24:25 PM
Several of the insurance companies we bill do have direct billing portals.  We use a clearing house because they check the claims, forward the claims, and report on problems immediately (and it's a one touch deal, I can literally do my electronic billing in just a few minutes). 

I'm sure there are pros and cons to both ways of doing things, and no matter what you choose it will be faster than handwriting a claim.

Title: Re: Electronic Billing Q?
Post by: Christy on March 06, 2013, 01:34:11 PM
thanks DMK  :D!  would you mind sharing which ins cos have direct portal billing?  thanks!  like you- I am a one touch clearinghouse kinda gal  ;)
Title: Re: Electronic Billing Q?
Post by: RichardP on March 06, 2013, 01:55:20 PM
I responded to Christy with a comment about electronic billing directly between the biller and the insurance company.  DMK sounds like she is making reference to that comment.  But I don't see my post here.  Maybe it was deleted by admin??  Maybe I posted to a different thread in error??  I'm posting this mainly to see if it will show up.

Christy, in my original post I stated that direct electronic billing between biller and insurance carrier depended on the carrier and the state.  In California, we can send electronic billing directly to Medicare, Blue Cross, and I think Blue Shield of California - and that's it.  It has been a while since I checked.  You would need to figure out what carriers in your state accept this.  I don't know of a master list for all states.  At a minimum, you can direct bill to Medicare, if you get permission from them to do so.  They will put you through some tests to make certain that your software talks to theirs.
Title: Re: Electronic Billing Q?
Post by: DMK on March 06, 2013, 04:03:25 PM
We CAN direct bill through Anthem Blue Cross, Blue Shield, Medicare (same as RichardP) as well as United healthcare, ASH, Delta, and Cigna. 

I found the links on the sites when I was verifying insurance coverage.

A clearing house is easier, but you've got to please your customers.  Just have your facts at hand for any argument you come up against! :D
Title: Re: Electronic Billing Q?
Post by: PMRNC on March 06, 2013, 05:10:46 PM
I agree with others, a clearinghouse is MUCH MUCH more efficient. It will save a lot of times. The provider can still however submit their OTR's direct as my mental health providers do but I leave that clinical issue to the provider I don't get involved with that aspect short of a report showing which authorizations are going to be needed or extended.