Billing > Billing
reimbursement rates
mike:
Is it possible to renegotiate reimbursement rates from different insurance companies? If so, is it addressed in the "Mental Health Billing Made Easy" book?
I already purchased the book for my wife, the psychologist, but I neither one of us have had time to get past the first few pages. I could not wait to have that question answered because there are a few insurance companies that are not reimbursing appropriately for services, but she does not want to discriminate based on the insurance someone has. Hope the question makes sense. Thanks for any help.
DMK:
--- Quote from: mike on April 07, 2011, 10:39:44 AM ---Is it possible to renegotiate reimbursement rates from different insurance companies? If so, is it addressed in the "Mental Health Billing Made Easy" book?
I already purchased the book for my wife, the psychologist, but I neither one of us have had time to get past the first few pages. I could not wait to have that question answered because there are a few insurance companies that are not reimbursing appropriately for services, but she does not want to discriminate based on the insurance someone has. Hope the question makes sense. Thanks for any help.
--- End quote ---
Welcome to the wonderful world of health care! There will always be insurance companies who will reimburse significantly less than others. Plan accordingly, but JMO discriminating based on insurance isn't fair or kind. I believe Alice, Michele, and Linda have all mentioned that you can negotiate with insurance companies.
mike:
Thanks for the quick reply.
Yes, I agree that discriminating based on insurance isn't kind or even ethical. That is why I ask.
I would now like to know what JMO means.
rdmoore2003:
--- Quote from: mike on April 07, 2011, 10:39:44 AM ---Is it possible to renegotiate reimbursement rates from different insurance companies?
Yes it is possible to negotiate reimbursement rates. If you already have a contract with an insurance company, you will have to wait until the contract expires and when/if you decide to "reup" the contract, that is when you will negotiate.
--- End quote ---
PMRNC:
I do full credentialing and fee-schedule negotiating goes along with it. I usually require the practice have an attorney to sign off and give final thumbs up on the contracts and fee-schedule but I do all the leg work. Sometimes it works and sometimes it doesn't. I've run into situations where carriers will not even negotiate with you unless you sign a non-disclosure (meaning you won't talk about it with other providers..big no no) It's definitely not a service i would perform unless you have extensive experience with codes, fee schedules and more important, managed care contracts. Carriers do try to slip things in there and if you don't catch it you leave your client in a bad spot. For example a carrier tried to sneak in that if we left the contract we would have to give 6 months notice! LOL No way in hell. Those contracts are very long and tedious.
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