[MUSIC PLAYING] Another lesson ready to roll out, so let's get on it. This lesson will cover practical pointers regarding filing claims, accepting payments, and completing billing. These processes can be very confusing but are critical for successful business and for profit. Success in managing finances is directly related to the topics in this lesson, which happen to be skill of attention to detail, persistence, patience.
Attention to detail is necessary for client intake, accounting, and accurate claim submissions. The skills of persistence and patience are necessary for collecting money. It's essential for you to evaluate the extent to which you have these skills.
If you feel that these skills are lacking, you may want to consider alternative means for completing claims and payments, such as an office administrator or a biller. Many aspects of financial management are complex, and your first thoughts may be to simply hire out these processes.
Indeed, processes may be hired out, but in the beginning, it is more likely when client sessions are low that you'll want to learn these processes to have money and have skills in these areas. Additionally, utilizing an Electronic Health Record system, or EHR, makes the process of filing, billing, and accepting payments a doable feat. Even if you choose to hire professionals to assist with financial management, it is still wise to be aware of how all of these processes work in order to better run your business.
Getting and remaining paneled by insurance companies is tedious-- I mean, really tedious, like pull-your-hair-out tedious. You see what happened to me? Regardless, it is the most likely way that you will make an income. Becoming insurance paneled is a very detail-oriented process due to the need for-- accurate data reporting, careful attention to signing contracts, dos and don'ts allowed by specific insurance plans.
Beyond insurance payments, you will need to determine how you will complete client billing and payment. Great detail is needed in reporting correct information for accurate accounting and billing. Many counselors will need to set up a payment system that includes credit card processing and check depositing. Also, there are many acronyms that are used in medical billing and coding that you'll need to get to know, some examples include-- EOB, or Explanation Of Benefits; DOB, or Date Of Birth; DX, or Diagnosis; TX, or treatment; CPT, or Current Procedural Terminology; EHR, or Electronic Health Record; ICD, International Classification of Diseases.
Setting up and learning any new process, even when the process will save time, requires a high degree of persistence, such as learning how to use an EHR, learning how to reconcile insurance payments, or learning individual insurance companies' authorization process and billing procedures. A high degree of persistence is necessary for-- follow through with insurance companies for purposes of paneling, follow through with insurance companies for purposes of authorizations and referrals for counseling, follow through with insurance companies for correction of claims.
Now correction of claims is the process you need to go through to correct any insurance claim that was rejected due to an error. Many times, any of the above processes can become overwhelming, resulting in failure to complete the task, resulting in not getting paid. It is not uncommon to have to make more than one call to reconcile any of these processes. And calls can last anywhere from 5 minutes to 60 minutes. So pace yourself, take breaks when needed, and create a timeline or task list to keep yourself on track to ensure completion.
Patience is necessary for insurance and client payments. An insurance company may take six weeks to pay for one counseling session. While you'll probably charge the client a copay or a deductible payment at the time of service, getting the insurance company's end of the payment will take time. Sometimes you'll realize that a client has a deductible to meet after you've already provided services, and you'll need to bill the client allowing 30 days for payment. Now large gaps of time can lapse between service and payment, and you must exercise those zen skills and just chill.
Patients and heavy tranquilizers may also be needed when calling insurance companies as this can involve-- waiting on hold, needing to leave a message, waiting for return calls, attempting to get explanations to why claims are rejected, specific insurance procedures, and sometimes staffing cases with an insurance case manager. So here's what we covered in this lesson-- skill of attention to detail, persistence, patience.
[MUSIC PLAYING]
(00:00-00:38) Introduction
(00:39-03:22) skill of attention to detail
(03:23-04:42) persistence
(04:43-06:09) patience
(06:10-06:21) Summary