Insurance Visit Limits – Submitting Claims
Please Note! Due to the high volume of irritating spam and slow-down of participation here, we are no longer accepting new comments, questions, or subjects on this Forum. We are keeping all the subjects and comments for review as there is a lot of good stuff here relating to practice-building subjects. So, dig deep! Thanks to everyone who participated here but it is time to move on to bigger projects educating the public about acupuncture! Matt Bauer
01-May-2013 02:31 PM
ILoveAcupuncturePosts: 35 | Hi Matt, Insurance question as I’m running into this for the first time…. When a patient reaches the number of visits that insurance said they would cover, is there any reason to continue submitting the claims after that limit? For example, for one patient, I was told during verification that she has a 12 treatment limit and she will soon be at the 12th visit. She wants to continue and knows that she has to pay up front after the 12th and is okay with that. I was just wondering if there is any reason to still send it through to insurance, for example, if they ever extend treatment limits or dollar amounts. Thanks! |
01-May-2013 04:06 PM
Matthew BauerPosts: 211 | I wouldn’t go through the trouble to bill the insurance but you could give the patient a super-bill receipt that they could turn-in to the insurance themselves. Matthew Bauer |
02-May-2013 04:39 AM
BudPosts: 4 | Hi guys, I agree with Matt, I don’t deal with insurance companies unless I absolutely have to. Many potential patients ask if I take insurance but I explain that I will supply them with a superbill with the CPT & ICD-9 codes that will enable them to get a reimbursement, if their insurance company covers any sort of alternative medicine. Most will cover pain management but get in touch with your malpractice insurer, AAC has a nice book out that explains the different companies and what they cover as well as the codes. I just don’t like the insurance dance that goes on if you don’t cross your “T’s” or dot your “I’s”. |
02-May-2013 10:26 AM
ILoveAcupuncturePosts: 35 | Thanks, guys – I appreciate both perspectives. I do actually bill insurance and I’m happy to do so – have had new patients from it and it’s been manageable on my own so far. I was just wondering specifically about after they reach their approved limit. I will take your advice, Matt, and not worry about it after that point unless they need a superbill for FSA or something similar. Thanks again! |
02-May-2013 10:38 AM
Matthew BauerPosts: 211 | Thanks for your feedback and welcome to the Forum! Just so you know – I do advocate that those who are just starting out or are not satisfied with their practice incomes not only accept insurance but bill for the patient. This is part of my overall advice to make yourself as accessible as possible, i.e., make it easier not harder for your patients to use your services. I also teach that once you learn the insurance billing ropes, it is not so difficult or time consuming. Now – again – this is for those who want to build their practice. Those who are happy where they are financially have the ability to then look to make things easier on themselves like giving super bills and letting the patient take care of the insurance. Best – Matthew Bauer |