02/12/2019
Approving procedures that aren't covered or require pre-authorization
The content of the follow part of this post is a major part of making sure your practice or facility not losing money because of not having a system in place for best practice. "All insurance plans are different, and sometimes companies can be surprising with what they will or won't cover. When a healthcare provider is preparing to perform a high-cost procedure, he or she should know what the patient's plan covers. Nowadays, many employers are choosing plans with reduced coverage for their employees. As a result, there may be some patients who are unable to cover the cost of their portion. One alternative may be to offer patients a payment plan for procedures in which they incur a significant charge.
On the same note, since some insurers won't reimburse specific procedures unless they've been pre-authorized, providers must be certain to clear them with the appropriate insurance companies before moving forward." Let me know if this information was helpful. Message if you have question I can help with.
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Home / Why NueMD? / Resources / Industry News / Medical Billing / Top 4 billing challenges facing healthcare providers." April 17, 2013, by Blake LeGate