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Episode 16 Switching Insurance Credentialing from Group to Solo

WEBIn this episode, Katia asks Danielle about the process of switching your group practice credentialing over to a solo practice. Danielle answers questions about what you need before switching over your credentialing, how to update the insurance companies with your new practice information, and some pro-tips on how to streamline the process.

Actived: 4 days ago

URL: https://wp.beyourownbiller.com/episode-16-switching-insurance-credentialing-from-group-to-solo-practice/

EPISODE 6 VERIFYING BENEFITS

WEBIn 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.

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Be Your Own Biller, LLC

WEBInsurance credentialing and billing may seem like daunting processes with a great deal of paperwork, but they certainly do not have to be! The paneling process should be no harder than applying to graduate school if you know how to keep organized and when to follow-up. Billing can take you minutes a day if handled in an effective manner.

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Quick Tips: Mental Health Carve-Outs

WEBWhat the heck is a mental health carve-out? Mental health carve-out: When mental health benefits are covered under a different payer/play than the medical benefits or ‘carved out.’

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When To Use the 90785-Interactive Complexity CPT Code

WEBWhen should you use CPT code 90785: You should use this CPT code when one or more of the following is present in a session: When delivery of care is complicated due managing maladaptive communication among involved parties. In a case where the implementation treatment plan is hindered due to caregiver emotions or behaviors.

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Quick Tips: UHC and Telehealth Attestation

WEBUHC are requiring that you attest for telehealth services if you wish to be listed in their provider directory as a telehealth provider. Here's a rundown of some great resources so you know where to start.

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Insurance and Expanding into a Group Practice Be Your Own …

WEBFor the sake of this blog post, I am going to assume that you are in a solo practice with a sole proprietor EIN and have individual contracts with insurance companies. Here are the steps you should take when expanding from a solo practice to a group practice: 1. Prep work. Decide what type of business entity you want to form. LLC/PLLC, …

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Quick Tips: Group Therapy Billing

WEBAccording to Medicare guidelines, sessions are not to exceed 10 patients or participants max. Often, sessions are 6 to 10 clients. (Source) Because 90853 is not time based, a maximum of one unit per day may be billed for CPT code 90853. As always, check with each insurance payer to make sure they cover 90853 before you bill it.

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NBCC's FREE webinar series on Medicare

WEBEffective January 1, 2024, The Mental Health Access Improvement Act will allow licensed clinical professional counselors to bill Medicare directly for mental health diagnosis and treatment services in most settings. Watch NBCC's FREE webinar series covering what you need to know.

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Cover your benefit quote! Why you need to have a disclaimer …

WEB1. That the benefit check is a quote as of today. Claims can get proceed at any time and they might somehow meet their deductible etc. from the time you check their benefits to their appointment. 2. The benefit check is an estimate of their benefits and not a guarantee of coverage. Just like the insurance reps tell us when we call!

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Aetna Allows for In-Network Supervisory Billing

WEBAetna now allows for supervisory billing for in-network behavioral health! This seems to not apply for those out of network. Someone from my FB group called to inquire about this and here's what they heard from Aetna: "From what I could get from the rep on the phone a group needs to send a letter of intent to link those providers with the

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Package Pricing Be Your Own Biller Empowering Clinicians

WEBDouble check your first claims before billing. And MORE! { {content-9}} Purchase Now! “Credentialing/Billing Intermediate”. $ 525. Three Hours. This three hour package is great if you have started the credentialing and billing process but need more support in the beginning stages. Want guidance on how to set-up your CAQH and …

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How to Speak to a Human When Calling UMR

WEBHere are the steps: Look up benefits in the UMR portal by putting in the client’s member ID. Scroll down to provider service center and click on the hyperlink. A pop up will appear with the number and a code which you need. Call the number listed (877-233-1800), select 1 for ‘medical. Select option 4 ‘I have a passcode.’.

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No Surprise Act Information

WEBThe regulations implement part of the “No Surprises Act,” enacted in December 2020 as part of a broad package of COVID- and spending-related legislation. The act aims to reduce the likelihood that patients may receive a “surprise” medical bill by requiring that providers inform patients of an expected charge for a service before the

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Golden Thread Documentation Series

WEBRecorded on January 26th 2023 12 pm CST (1.5 hours) In this webinar, Steve will discuss what to include in your intake assessment note to meet medical necessity, community, and insurance audit standards. The intake assessment is arguably the most important part of the medical record as it is what you base the rest of your …

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Quick Tips: Billing For Two Services On The Same Day

WEBWhen the claim gets processed, some funky things may happen (based on my experience): You may get the EOB back and owe the client money due to them not having to pay two copays (for two services on the same day). Due to this–one of the claim lines (usually the lower paying CPT code!) is paid in full. One of the claim lines may get …

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