Medical Billing Forum
Payments => Insurance Payments => : Tschoser October 23, 2020, 09:32:30 PM
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Hello,
Our office has multiple Residential, Partial Hospitalization and Intensive Outpatient facilities that we bill (out of network) for and we are considering developing a tool to help us decide if a plan reimburses fairly or if we should make supplemental payment arrangements with the patient or family. Prior to creating something ourselves I wanted to check with everyone here and see if anyone knows of a software or database that can help us estimate the reimbursements for our services. If no one knows of something already existing I would be interested in starting talks with other providers or billing organizations that specialize in the above levels of care for mental health and substance abuse so that we could share data and maybe create a screening tool that would let the user know when a plan will be a dud or offer great reimbursement.
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I have not heard of a software to track that information. It will be interesting to see if anyone else has.
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Hello,
Our office has multiple Residential, Partial Hospitalization and Intensive Outpatient facilities that we bill (out of network) for and we are considering developing a tool to help us decide if a plan reimburses fairly or if we should make supplemental payment arrangements with the patient or family. Prior to creating something ourselves I wanted to check with everyone here and see if anyone knows of a software or database that can help us estimate the reimbursements for our services. If no one knows of something already existing I would be interested in starting talks with other providers or billing organizations that specialize in the above levels of care for mental health and substance abuse so that we could share data and maybe create a screening tool that would let the user know when a plan will be a dud or offer great reimbursement.
I too manage the billing for the mentioned facility types and levels of care. Although this sounds appealing, I think it would be detrimental to quality 3rd party companies that already have this information. I haven't yet heard of a centralized database to house reimbursement information and especially not by state. I doubt the payors would allow this for very long either. I do know that some billing companies offer an app to their clients which has historic payment information by level of care/policy. Always limited to their own histories though which is subject to a lot of variables (i.e. how they construct their ub04 claims; repricing; etc)
Message me directly if you wish to speak further!
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Hello,
Our office has multiple Residential, Partial Hospitalization and Intensive Outpatient facilities that we bill (out of network) for and we are considering developing a tool to help us decide if a plan reimburses fairly or if we should make supplemental payment arrangements with the patient or family. Prior to creating something ourselves I wanted to check with everyone here and see if anyone knows of a software or database that can help us estimate the reimbursements for our services. If no one knows of something already existing I would be interested in starting talks with other providers or billing organizations that specialize in the above levels of care for mental health and substance abuse so that we could share data and maybe create a screening tool that would let the user know when a plan will be a dud or offer great reimbursement.
Hey Tschoser,
I can help you with that. Feel free to message me.