If you are a mental health / behavioral health professional, working in private or group practice, you will have your work cut out for you. We want to help you with some quick tips and answers. Earlier we discussed if counselors can bill clients for the remaining balance.
But what do you do if a patient changes their insurance information and does not tell you?
We talked to the Senior Medical Biller at Thriveworks, Alicia Potts, and she gladly shared her knowledge with us.
This problem happens very often.
A client doesn’t let you know they have a change in their policy. Typically, you will send the claim, wait for it to get paid, only to find out the claim has been rejected because the client has changed their policy.
Now you are left to find the patient and the patience, and get their insurance information, but you will face to issues:
A. Do they still have insurance? Maybe they dropped their policy (or they dropped the insurance), and now you have to have them pay for the whole session.
B. You have to call the patient, find out their insurance, and hope their insurance does not require an authorization (because you may be past a certain amount of time to bill with some insurance companies).
Good news: Sometimes your clearinghouse will send it, and it will reject it right away, but that is not always the case.
There are cases where the patient may not even lose their job, but the company decides to change insurance companies, and then the insurance didn’t get updated, and you’re claim gets rejected. What do you do?
If time allows, you can call the day of the session to see if they are still active with the insurance company. If their insurance has changed, it may not be an insurance company that you accept as a provider, the deductible may high, and the claim may be denied because you are not in network.
So it is best to call if you can.
For more information:
UPDATE 09/2014: To focus on providing excellent medical billing to Thriveworks franchises, we are no longer providing billing services to non-Thriveworks practices.
Learn more about the exciting benefits of opening a Thriveworks Counseling center in your area, here: Counseling Franchise.
Your Friends at Thriveworks
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