M ore chiropractors arc using third-party billing to outsource their insurance billing. Simply, third-party billing may be a huge relief for insurance management pain. Just like any other businesses, these insurance outsourcing companies heavily promote their sen ices and make many promises to rccniit new clients. Usually, you should pay no more than 6 to 7 % to have all of your insurance managed. Now. the questions you need to ask about third-party billing companies arc: Do they really keep their promises? Arc they as aggressive to recciyc payment as they claim to be? Arc they as available for all of your questions as they claimed they would be? Are they as profitable as they should be? Do you really save money compared to using an in-house insurance biller? Let's find out the answers together now. "We will be aggressive for you to get paid." Every chiropractor's billing insurance wants to hear that kind of promise. We certainly do not want our insurance income manager to be lazy because being lazy means losing money. Since chiropractors arc working so hard, they certainly do not want that. Frankly, though, if you read a statement like that, stay away from that company. It is a promise only. Think about it for a minute. How aggressive can any third-party biller be with insurance carriers, or even worse, with a Medicare auditor? Being aggressive with health insurance may also mean mistakenly billing and then receiving payment for a sen ice you have not rendered. In the short term, you may be paid, but everything will be fixed during your next audit, and more. Main chiropractors have learned this the hard way. If they arc really aggressive, they can only get you in trouble and make it worse. The only formula that works for being paid is to process your insurance claims and documentation the right way. Is this simple? Being aggressive with insurance is only a marketing strategy. Don't get into that kind of stuff. "We will process all your insurance claims and get you paid." This is the goal. When this is accomplished, then 25% of the work is done. The other 75% is as important, but many chiropractors forget about it. When you search for a third-party insurance billing company, make sure they will post all your payments precisely in all patient files. This is important to keep your system accurate and to control your financial, but it is cnicial for an audit. In the case of an audit, which will happen at some point if you havcn"t had one yet. those accurate reports for payments will show the auditor how well organized you arc and how well you maintain your system. By default, you may have to pay back all claims not explained in detail. They told you that you will be paid, right? But what are they doing with claims that have not been paid or were denied? A reputable third-party billing company will find the reason and will maximize their efforts to find the solution so they can resubmit the claim and get you paid. That's all they can do. They cannot be aggressive and thev cannot argue with the insurance company. They cannot do anything like that. They should only be good, well organized, and knowledgeable, and use these qualities to maximize your insurance claims and payments within legal parameters. "If you billcr quit, don't hire someone else. Use our service." This is not only a promise, this will happen. One of the great advantages you have is certainly eliminating staff turnover and hassles. You may have one chiropractic assistant at the front desk and a third-party billing company to manage your insurance claims, and you will be in great shape. Make your own calculations. How much cost your insurance billcr now compare to 6 or 7% of all your paid claims. In most cases, it is a "no braincr." You may have to change or add one small task for your front desk CA. Since you need to know the patients insurance eligibility immediately, you may ask your front desk CA to verify it on the web or to call the insurance company to find how about how much money is left for your sen ices. Usually, the CA will have to complete a small form and can get this done very quickly, so it should not be a problem at all. "Responsibility is yours." Don't expect a third-party billing company to be responsible for your claims. During an audit, you cannot say. "You did not know." or. "You didn't do this." or. "My third-party billing company did that." You arc solely responsible for all insurance claims and payments. That is why you have to produce good and accurate documentation and SOAP notes to support all your claims. It is also the reason why it is so important to choose a very good and serious third-part) insurance billing company. Claude Cote is an expert in EHR systems, insurance hilling and chiropractic clinic management for 22 years. He has installed EHR system in 18 countries over 5 continents and nationwide in USA. He is the President and Founder of Platinum System ('.II ( \>rp (www.plalinumsyslem.com}. For comments or cpieslions. please email lo info (i plaliimmsyslem.com
