Island
Software is pleased to offer this amazing tool for your practice!
This comprehensive insurance
billing manual is the perfect complement to your Massage Office™
software-- Unlocking the doors of insurance billing to help you build
your practice to the next level.
This manual contains all of the necessary
billing & documentation forms, codes, terminology, instructions, guidelines,
and information needed to accept medical referrals from physicians
and to bill and collect from insurance companies. The manual is generic
and can be used in any state so long as you are acting within your
scope of practice and as long as the insurance companies are willing
to pay. This Insurance Billing Manual is the ORIGINAL, written especially
for massage therapists. The manual has been kept revised and updated
as changes occur. With the purchase of this manual you will automatically
receive a yearly update of CPT codes as they are released by the AMA.
Information and suggestions plus explanations and personal experiences
that include but are not limited to the following:
Types of insurance
cases: Know the ones to stay away from right from the start.
What you can expect
to be reimbursed for and what not. UNLIKE WHAT SOME ARE TEACHING
AND PROMISING, you will NOT always be paid on every case, by every
insurance co.,in every state.
How to set up patient
file(s): Being prepared in advance is the key to success with
insurance cases.
Authorization /Verification:
How and when to get authorization and/or verification to treat a patient,
What is the difference?
Prescription:
Prescription wording is important. Document accordingly; prevent violation
of scope of practice. Know when and why there may be times you may
need to have prescription re-adjusted.
Forms & Letters:
What forms and letters are necessary, where to get them, and when
to use them.
Codes: What
codes to use and when. Using incorrect codes can cause delay, denial
or reductions. Procedure Codes, Modality Codes, and Diagnosis Codes.
Legal Testimony:
How best to be prepared in advance for legal testimony. What to do
to be ready in advance for depositions or trials.
Stopped Payment:
What to do when an insurance carrier stops payment with patient benefits
left. What to do with denials, reductions or delays?
Forms: And
other items available to assist in your collection procedures.
Promotion & Advertising:
How to increase your insurance business. Promotion & Advertising
ideas that did and did not work for me. Communication is the key!
Collections:
Collecting when insurance companies are slow or refuse payment. It
all starts on the initial visit and being prepared and organized up
front.
Insurance Commissioners:
How to report late or non-paying carriers to the Insurance Commissioner.
Does it do any good?
Documentation:
The profound legal importance of proper documentation.
Balances Due:
What to do when a patient becomes responsible for balances due, prevent
problems at first visit.
Copy Charges:
Can you charge for copies, reports, and testimony?
IME'S: How
an I.M.E. can affect a patient's case, your payment or patient's future
care.
Delays: Decrease
your chances of delay due to separation of notes and bills.
Ideas: To assist
when patient's attorney says you must reduce your attorney lien bill.
PLUS ADDITIONAL INFORMATION SUCH
AS:
Ethics: It is
of the utmost importance that you are ethical in your dealings with
patients,attorneys, physicians and insurance adjusters and other health
care providers. This is essential to protect your reputation as well
as the reputation and future for insurance billing and reimbursement
rights of all massage therapist's everywhere.
Terminology:
100 Terms including the definitions: You will need to know certain
terms relating to the insurance business. I have tried to cover most
of them.
Forms: There
are many types offorms that you will be needing in your practice Enclosed
in this manual you will find every kind of form necessary to begin
and carry on your practice. You may copy them for USE IN YOUR OWN
PRACTICE ONLY.
Codes: You
will learn about Physicians' Current Procedural TerminologyCodes (CPTC)
and ICD 9 CODES. A Massage Therapist may use only certain codes for
billing purposes, you will learn the ones mostly used.
Fees: Fees
that are most acceptable by the insurance companies for reimbursement,
most ethical, and how to locate fees most usual and customary for
your geographical region.
Addresses: Some
names, addresses and references are enclosed that you may find as
helpful in your practice as I have.
Tips On Going to Court:
What to expect when you are subpoenaed tocourt for depositions or
trials. The one main thing you can do to be prepared.
Explanations:
Many explanations are enclosed that will make the insurance billing
and reimbursement aspects of your business easier to understand or
to deal with.
Information pages:
Some informative pages are enclosed that may be referred to for your
convenience, or for sharing with your patients. Info such as Hydrotherapy,
when to use hot or cold packs, Neuromuscular Therapy, etc. I have
found these beneficial for educational purposes for patients and adjusters
alike.
Auto Accident Cases:
(P.I.P.): Treating the auto injured patient under theirAuto
Insurance Coverage Plan.
Attorney Lien Cases
(Slip &Fall): Information on accepting and treating the
injured patient with an attorney lien, other than auto accident cases.
Workers' Compensation
Cases: (W/C): Treating the injured patient within the Workers'
Compensation arena.
Major Medical Cases:
(M/M): L.M.T.'S in Florida are now required by law to be reimbursed
by insurance companies. Effective date, 10/1/1992. However, does that
mean that all insurance companies have to pay according to State law?
NO! The manual and classes explain the difference between State and
Federal laws. Private Insurance (Major Medical) billing information
is included in this manual. This manual does not fully discuss the
multitudes of managed care plans etc. that are available at this time.
TAXES: Deductions
you can take, and more.
INDEPENDENT CONTRACTOR
versus EMPLOYEE: What are you while
working for others? What are those working for you? Do you know the
legal & financial ramifications of being misclassified?