Author Topic: Bundling  (Read 1203 times)

williamportor

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Bundling
« on: September 05, 2014, 10:32:17 AM »
Hello-

I'm about to sign up a new Chiropractic client, when I asked him what he would most liked to see improved in his billing situation he said " I'm tired of insurance reimbursements being lowered or bundled". I can understand his frustration, but what can an independent biller, such as myself do for our clients when insurance companies do such things?

Merry

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Re: Bundling
« Reply #1 on: September 05, 2014, 10:52:50 AM »
The only thing you can do is make sure that he is billing properly following the rules of each insurance co.  Chiro billing also can involve personal injury cases which can take years to pay so for those cases you may want to take a flat fee. Good luck. Sound like you are,doing well. 

PMRNC

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Re: Bundling
« Reply #2 on: September 05, 2014, 11:58:50 AM »
Hello-

I'm about to sign up a new Chiropractic client, when I asked him what he would most liked to see improved in his billing situation he said " I'm tired of insurance reimbursements being lowered or bundled". I can understand his frustration, but what can an independent biller, such as myself do for our clients when insurance companies do such things?

I don't work with chiropractors however I can tell you that most physicians in general are lacking a better "flow" which of course leads to more efficient practices and better reimbursement! Don Self is doing a webinar which sounds like it would be a good thing for all billers, practice managers and consultants to take. http://shop.donself.com/ANALYZE-A-PRACTICE-TO-INCREASE-PROFITABILITY-WEBINAR-ANALYZE-A-PRACTICE-WEBINAR.htm
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

shanbull

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Re: Bundling
« Reply #3 on: September 05, 2014, 01:18:23 PM »
Bundling for chiro is going to happen based on the contracts the provider signed and the NCCI rules, so he really can't get around that if the claim was correctly billed. You can't, for example, just add a modifier to separate the services in order to get the codes paid. Which I'm sure you know. But you can make sure he's familiar with the particular rules of each insurer so that he is able to bill all allowed codes. I have noticed that is an area where our new chiro providers often need some help, and they really like the reference sheets we give to them about this.

Another thing to look into is whether he needs to accept contractual adjustments on auto and worker's comp cases. Here, we do not need to accept adjustments from health insurance for either, and we don't have to accept liability insurance adjustments on auto cases. This includes bundling adjustments. So the balance will sit around for a while until arbitration/litigation is done, but the eventual payments are higher.

PMRNC

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Re: Bundling
« Reply #4 on: September 05, 2014, 01:45:01 PM »
Quote
Bundling for chiro is going to happen based on the contracts the provider signed and the NCCI rules, so he really can't get around that if the claim was correctly billed. You can't, for example, just add a modifier to separate the services in order to get the codes paid. Which I'm sure you know. But you can make sure he's familiar with the particular rules of each insurer so that he is able to bill all allowed codes. I have noticed that is an area where our new chiro providers often need some help, and they really like the reference sheets we give to them about this.

I didn't mean to imply you can work around these things at all.. I just find sometimes when you re-organize a physician's practice, the work flow, staff, etc it can make up for the other things wrong.. for example, a few months ago I worked with a podiatrist (I have NO experience with podiatry billing) who encountered a lot of things there was NO control over. We re-organized his staff, policies procedures and shifted a few things around in his office. Payments were coming in faster because staff was better able to manage the flow easier and more efficiently.  Of course we run into situations where providers think we can wave a magic wand, and we can't.. HOWEVER I think there are other things a good PM company/consultant can do to help make things more efficient which leads to better and faster reimbursements all around in general.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com