In this episode, Katia asks Danielle what the options are for out of network providers who want to utilize a client’s insurance benefits. Danielle explains what a super bill is as well as how a clinician would submit a claim as an out of network provider.
In this episode, Danielle asks Katia about how to go about requesting a single case agreement for her out of network clients. Topics discussed include the benefits of getting a single case agreement, what information is needed to request one, and how it differs than billing as an out of network provider or in-network provider.
In Episode 9, Katia asks Danielle about why her claims would be denied and how to correct any claim errors. This one is an important one!
In Episode 8: Understanding an EOB, Danielle asks Katia all
about what an EOB is, how to review it, what it’s used for, and
what a provider needs to know about EOBs. Katia provides a clear
description as well as some tips about the importance of
reviewing the EOB.
In Episode 7, Katia asks Danielle all about the information needed to file a claim. Topics include, information needed from the client, from the provider, and more specific details about a claim.
In Episode 6, Danielle asks Katia how to verify a client’s mental health benefits once you are an in-network provider. Katia discusses some common questions that come up when verifying benefits such as what to do when a client has a “carve out plan” and how to calculate a client’s co-insurance rate.
In Part 3 of the Credentialing Series, Katia asks Danielle about the final steps to the credentialing process. Danielle answers questions about getting your contract, requesting fee schedules, and how you know you are effectively paneled. She also offers helpful tips to get set up with electronic billing. Visit the IAP Facebook Page for show notes and resources for this episode. Read more
In Episode 4 All About EAPs, Danielle discusses what an EAP (Employee Assistance Program) is, the benefits to clients and clinicians, as well as some of the cons to paneling with EAPs. She also shares some insider tips on how to find EAPs in your area as well as how to increase your EAP referrals.
In Part 2 of the Credentialing Series, Danielle asks Katia about the next steps after completing her CAQH profile. Katia answers questions about how to find insurance panels in your area and how to go about applying to panels.
In Part 1 of the Credentialing Series, Katia asks Danielle all about the first step in the credentialing process, making your CAQH profile.
Out of Network Billing TipsJuly 9, 2018 - 7:00 amHere are some tips to ease out of network billing confusion: What/Who is Out Of Network? Clinicians who have not signed a contract with an insurance company and do not have to abide by a contracted rate. Can still be subject to insurance audits for medical necessity and are still considered a HIPAA-covered entity. […]
6 Tips to Get Through a Care Review With an Insurance CompanyJune 26, 2018 - 7:00 amYou go to check your voicemail after a long day of seeing clients and you hear the message you’ve been dreading. It’s a representative from an insurance company wanting to do a care review on one of your clients and they’ve asked you to call them back. AHHHHH—but wait! Don’t panic. You’ll be just […]
Insurance and Expanding into a Group PracticeMay 21, 2018 - 5:00 amFirst of all—congratulations! If you are reading this post, that means you are at least thinking about expanding your practice and forming a group, which hopefully means you have a successful group practice or maybe just big dreams! For the sake of this blog post, I am going to assume that you are in a […]
What Clinicians Need to Know About the Interactive Complexity CPT Code (90785)May 7, 2018 - 10:25 am