Billing > Billing
Out of Network Chiropractic Provider
shanbull:
Man, this is a tough one. I have to say I can see both sides here. As an American in the midwest who watched our manufacturing sector fall apart due to offshoring and the subsequent suffering and poverty here that resulted, I am wary of exporting jobs, especially in the industry that I work in. On the other hand, people in these countries with fewer opportunities to advance economically are not meaning to personally take things from us and this is the simple reality whether we support it or not. Reetu did not cause this reality and is certainly only trying to live a comfortable life. Maybe she has family to support too. It would be difficult blame Reetu for masking her identity, knowing how vitriolic some people can become about this issue. It seems she did so out of fear of being rejected more than with a malicious intent, so I can look past it.
I remain hopeful that instead of allowing people to get rich off global inequity and exploiting weak labor laws elsewhere, we can all someday come together and insist that workers can't be paid less because of what area of the world they live in. A higher standard wage in developing countries and an equal playing field for those of us in the US benefits all of us. We should encourage this.
We also can't blame anyone who cannot in good conscience help someone who they feel has been deceptive and may contribute to job loss in our home country. Linda has a right to feel how she does as well. She is worried about economic consequences here and directly competes with offshore billing companies. It would not be in her best interest to offshore her own expertise too and we must respect both that fact and how she feels about it.
Above all, let us try to assume the best about others. We are the weakest when we divide ourselves into individual tribes and cannot affect change that way, and in fact there are a lot of people with a vested interest in preventing us from realizing this.
Michele:
One of the things that makes America great is that there is a great mixture of people here. We at Medical Billing Live have strong opinions about certain things as do most. We would like to make the forum a place where all can come and learn regardless of personal opinions. There is no rule on the forum where real names are required. From a personal standpoint we don't like when people are purposely deceptive but I guess in certain cases we can understand why they wouldn't be more forthcoming.
On a personal level we are opposed to offshore billing because in our cases we have had some bad experiences directly. Also, I do believe that there are legal issues with the protection of the data, etc. We are tired of people calling our business 800 line, barely able to speak English and asking us to give them our clients. It is offensive. We are a family business and their entire approach is that they will do it cheaper. We come from the angle of 'you get what you pay for'. We too are worried about the exporting of any more American jobs, but more than that it bothers us to see the money that providers lose to poor billing. But that is a fact that happens here in the US as well as abroad.
BUT with that said, We do not oppose people from other countries learning the business and doing a good job.
SnyderKristine, you have been asking a lot of questions and they are very basic in nature.
--- Quote from: SnyderKristine on May 14, 2014, 06:02:33 PM ---
I need help with this. Please pour in all the information you think I should know as a biller of a out of network chiropractor. Should I bill claims to all the insurance patient's provide, whether they have OON benefits or not. I am sure about Medicare that we do have to bill, but not about other payors.
I have so many questions in this. Please assist !!!
--- End quote ---
It would be helpful if your questions were a little more specific. It would be impossible for someone to post how to bill for an OON chiropractor. I think that your excitement probably took over when you were posting. :) People don't mind helping but like it has been said, we all are also working and doing many other things so researching on such a general basis for someone else is not practical.
I did have two thoughts about your question:
1. What was he doing prior to hiring you? Was he billing the insurances that do not have OON benefits? I would think it would be necessary for things like HSAs (Health Saving Accounts)
2. I am always leery of chiropractors who do a 'payment plan'.
SnyderKristine:
Finally, I am so glad that everything came down. I could not sleep last night, wondering about how me trying to do business or supporting my family is actually making someone lose their job. Well, Globalization has its own side effects and this is one of them.
We are also facing similar circumstances here in India. Now the only criteria recruiters look for while hiring someone for a job is "Speak English". There are so many BPOs around that you can barely think of anything else. Our entire youth generation is trapped in these call centers and BPOs, that they barely think of doing anything else of their own. Infact, it has some real adverse effects on very basic and historic things India has inherited from generations like culture, food, clothes, religion, etc. Owing to the price factor, Indian manufacturers choose to export the best quality product overseas, and distribute their cheapest quality product in India.
Let me not go beyond this, considering that everyone's opinion is byproduct of their experience and circumstances.
My intention is to simply run a Billing Company (not a BPO or call center), something that I cherish doing. I personally like this work, the feeling that I am able to help physicians who take care of patients. I am a science student and wanted to become a doctor myself, but could not do it due to financial difficulties. But my spirit is still the same, helping others do it!!
I hope I will not be treated with racism or any such feeling on the blog ::)
SnyderKristine:
Coming back to the main question about Out of Network Chiropractic Billing.
Michelle I just read the book co-authored by you and Alice about Chiropractic Billing. It was an old book though from 2010. But the information was pretty to the point.
What I have understood is that non-par providers:
1. can collect upfront payment from the patient at the time of service
2. Do not need to submit claims except in case of Medicare
3. Payment from insurance is normally made to the patient
4. Must verify insurance benefits prior to appointment, so as to determine the proper course of action required
What I don't understand is:
1. Is it really applicable, that we would be only submitting claims for Medicare patients?
2. If not, then how do I decide which insurance to submit claim to and which not? (My doctor does submit claims for patient as a courtesy)
Before I signed the contract, the billing was handled by a local lady, who moved to a full time job to support her house. In turn, she asked her son and his girlfriend to manage it. But they did not turn up and were not communicating properly with the Doctor.
Hence, she decide to move on!
I have never worked for this specialty before and that is the reason why I am feeling little nervous!!
And I ask basic questions just to keep things simple. If someone would have noticed, I have never answered or comment on any other questions, because I am too shy to put my opinion, at least at this point when i have so much to learn. I am mute learner, with no wrong intentions!!
Michele:
--- Quote from: SnyderKristine on May 16, 2014, 02:01:05 PM ---
What I have understood is that non-par providers:
1. can collect upfront payment from the patient at the time of service
--- End quote ---
Yes
--- Quote from: SnyderKristine on May 16, 2014, 02:01:05 PM ---2. Do not need to submit claims except in case of Medicare
--- End quote ---
They do not need to however many do as a courtesy to their patients. If the patients are getting paid they will keep coming.
--- Quote from: SnyderKristine on May 16, 2014, 02:01:05 PM ---3. Payment from insurance is normally made to the patient
--- End quote ---
Usually but it depends on the plan.
--- Quote from: SnyderKristine on May 16, 2014, 02:01:05 PM ---4. Must verify insurance benefits prior to appointment, so as to determine the proper course of action required
--- End quote ---
Not necessarily but it's a good idea. They don't have to verify benefits if they are collecting up front, but if they want to advise the patient what their plan will or will not cover they may want verification done.
--- Quote from: SnyderKristine on May 16, 2014, 02:01:05 PM ---What I don't understand is:
1. Is it really applicable, that we would be only submitting claims for Medicare patients?
--- End quote ---
Not sure what you mean. Are you saying would you only submit Medicare? If so, it really depends on the dr. What does he want done? Does he want claims submitted to all insurance as a courtesy? What will he pay you for? (to submit claims or not to submit claims)
--- Quote from: SnyderKristine on May 16, 2014, 02:01:05 PM ---2. If not, then how do I decide which insurance to submit claim to and which not? (My doctor does submit claims for patient as a courtesy)
--- End quote ---
Kinda the same answer as above. The dr needs to decide what his policy will be and stick to it.
--- Quote from: SnyderKristine on May 16, 2014, 02:01:05 PM ---And I ask basic questions just to keep things simple. If someone would have noticed, I have never answered or comment on any other questions, because I am too shy to put my opinion, at least at this point when i have so much to learn. I am mute learner, with no wrong intentions!!
--- End quote ---
You should share when you feel that you have information that may be helpful. That's what works on this forum. Not all will give the same advice but that is why it is advice. We all learn from each other.
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