If you accept insurance at your practice, you know just how hectic the beginning of the year can be. With clients changing coverage, new filing rules, and outstanding claims from the previous year, there’s a lot to juggle. This video will walk you through the steps you can take to make sure you keep getting paid in 2020.
Additionally, you can download this 2020 Insurance Changes Checklist to make sure your practice is prepared.
Download Your Insurance Payers 2020 Guide
MAGGIE: If you bill insurance, you know that the start of the year is when most private and government-issued insurance plans renew, and these changes can cause claim rejections, denials, and overall confusion.
DUSTIN: In this video we’re going to talk about four steps you can take to make sure you get paid by insurance in the new year.
MAGGIE: Make sure to enter your email to get access to our guide on changes to insurance in 2020. I’m Maggie, the Partnership Manager at SimplePractice.
DUSTIN: And I’m Dustin, a Senior Insurance Specialist. Employers and the federal marketplaces host open enrollment throughout November for people to choose their coverage that will start on January 1st of the new year.
MAGGIE: As healthcare providers, it’s important to be proactive to make sure that the insurance income your practice depends on is consistent, even as your clients’ plans change. We’re going to cover the 4 most important things you need to consider going into the new year to keep getting paid.
DUSTIN: 1. Talk to your clients about their coverage.
- Starting in December, ask your clients if they will have new coverage at the beginning of the year. Insurance companies usually start sending out member ID cards prior to the start of the new year, so ask if your client can send you a copy of their new card right away.
- If they aren’t sure, ask them to check with whomever they get their insurance through.
- With SimplePractice it’s easy to send a new insurance questionnaire to your clients through the Client Portal. It’s important to stay ahead of this information. If a client is switching to a plan that you are not in-network with, it may impact their ability to continue treatment with you. Do your clients the courtesy of finding this out ahead of time rather than a few weeks into the new year when they’ve already had multiple appointments with you.
MAGGIE: 2. Review your contracted rates with payers
- Speak with provider relations to determine if there are any changes to your rate.
- Make sure you know what your rates are for each service code and with each payer that you work with so you know what to expect to be reimbursed.
- This is especially crucial for your clients with deductibles because will not have this information. That’s because their insurance companies will not reveal to them what your contracted rate is.
- You don’t want to get caught not knowing what to charge your clients and accidentally under or overcharge them as a result.
DUSTIN: 3. Verify benefits as early as possible
- Your client probably doesn’t know much about their brand new coverage. It’s up to you to make the transition smooth. The client’s deductible may start over or their copay may have increased … make sure to verify all of this information before continuing treatment in the new year.
- Clients with better benefits in the new year may have a reduced copay. It’s important to update this so you don’t have to go back and reimburse them for overpayments.
MAGGIE: 4. Start the new year with a clean slate by resolving any outstanding balances
- You may have let a few things slide earlier this year. Now is a good time to wrap up existing billing issues, follow up on old appeals, and make sure that any past due authorizations are renewed.
- If a client will have insurance through a new payer at the start of the year, it can be very difficult to juggle two different insurance companies at once. Help yourself out by resolving any outstanding issues before you start submitting claims to a new plan.
DUSTIN: You can also expect that there will be new payer-specific filing rules in 2020. Those changes are usually out of your control, but staying in the know will help to ensure you don’t miss out on reimbursements.
MAGGIE: These changes can vary from a payer requiring an authorization on services that didn’t need one the year before, to one insurance company acquiring the other and changing the payer ID you need to submit to entirely.
DUSTIN: We want to help you stay ahead of these changes, so we put together a guide that includes all of the payer changes our customers have written in to us about.
MAGGIE: If there’s an update that you want to add, please reach out to our Customer Success team and give as much detail as possible about the upcoming change.
DUSTIN: To download the guide, simply add your email to the form at the [top] of this page.
MAGGIE: We hope you find this information helpful and wish you the best of luck with your practice in the new year.
DUSTIN: Thanks so much for tuning in and as always—
MAGGIE & DUSTIN: Keep it Simple!
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