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One of the most common questions I get is what insurance company can I bill?

In Most states you can bill for car accidents and work related injuries but there are certain rules in some states like having to bill under a chiro or PT. More states are willingly paying for massage.  There are even some companies that have extra CAM benefits for their employees.  Each plan and each person who is on that plan is different.  so you have to call each time to find out the details.

I would like to use this group here to start sharing info on what states you can bill and what insurance companies you can bill.  Helping others in your area learn the ropes is an important part of helping the profession grow.

Insurance billing can be intimidating but once you learn the ropes, it can be a nice supplement to your income. Getting the support you need for handling such a difficult process can help you to get over your fears and concerns about billing insurance.  It can also help you with the many ethical challenges when billing insurance.

Please start adding discussions and start with posting your state/city and what you are finding as far as what companies you can bill and what companies are paying.  Please do not share what they are paying right now. (there may be some legal implications around that.)

So happy billing

thanks

Julie Onofrio

Views: 694

Replies to This Discussion

I mostly bill car insurance companies--State Farm, Farmers, Gieco, Nationwide, and a few others that I've worked with have been great. I have billed to Workmen's Auto Insurance and will not take another client who has them for their insurance, they were horrible to work with! 

I'm just beginning to work with a client on Worker's Comp insurance...we'll see how that goes.

I'm in Oregon City, Oregon.

I'm in PA and while I'm unable to bill directly to medical insurance; I have had clients get reimbursed from flexible spending accounts and Aetna Health Funds, especially when a doctor has written a prescription for massage with a diagnosis I copy onto their receipt. 

I am able to bill directly to auto insurance and workers compensation claims, but I will only do so for existing clients.  Billing directly is time consuming and tediuous; once I've verified coverage and availability of funds, I then have to wait typically 45-60 days for payment, which in my experience is not consistent, nor is it enough to cover the cost of my time spent doing paperwork in addition to the bodywork. 

I would advise anyone submitting directly to be sure to mail your claims with a "Return Receipt" from the post office.  Legally insurance companies are required to respond to you in a timely manner, the return receipt helps to ensure this.  The one time I didn't mail a claim that way, the insurance company supposedly never received the claim. 

Susan Hart

http://www.serenityachieved.com

 

Hi ladies! I am educating myself on billing MVA claims, and am excited to start... but I can't seem to find info on exactly who it is I send the bills to. Is it the adjuster? If so, I'm assuming the address will be different for each claim? Or is it the main insurance headquarters, therefore the same mailing address if all clients have Farmers or Geico, regardless of who the adjuster is? It's probably a silly question, but I'd like to know the little details like that before I take on my first case.

 

Thanks so much!!

Call the claims adjuster and ask them who and where to send the bills to.  The client should have the persons name and phone number.  Ask if they want the chart notes too when you send the bill. Most do.

I usually get a letter from the client that states the claim info - date opened, claim number, adjuster and who to send the bill to.

Julie

Amy Sargent said:

Hi ladies! I am educating myself on billing MVA claims, and am excited to start... but I can't seem to find info on exactly who it is I send the bills to. Is it the adjuster? If so, I'm assuming the address will be different for each claim? Or is it the main insurance headquarters, therefore the same mailing address if all clients have Farmers or Geico, regardless of who the adjuster is? It's probably a silly question, but I'd like to know the little details like that before I take on my first case.

 

Thanks so much!!

You may also be able to submit your claims electronically which cuts down the time significantly.  I use www.officeally.com.  It's free.

Excellent - thank you!

 

One more question just so I'm sure - do you need to apply in order to be able to bill MVA's and Worker's Comp like you do for billing regular health insurance, or does the client just provide their Rx letter and claim number and any LMT can bill from there?

 

Thank you! And thank you for creating this forum site... I'm so glad I found it!  :)

As far as I know, some states you have to apply to take workers comp.  You don't have to apply to anything to bill MVAs.  You do have to find out if you can bill for MVA's - I think there is one state like PA or something and Now starting next year FL MT will not be able to bill for PIP.

That is why I am trying to get more involved in this and share that info about where you can bill and what you can bill for so thanks

With OfficeAlly, are you able to scan and upload your SOAP notes and the 1500 form, or does it need to be encrypted by a special program in order to be HIPAA compliant?

 

Also, I've heard that with the 1500 form, you can't submit copies... they have to be original forms with the red ink... is this true? I was thinking that I could create a master copy for each client with their info and then just add the billing information after each visit but now I'm not sure I could do that...?

I don't think you can send soaps with officeally but not totally sure - you will have to ask them.  The new form is the CMS 1500 and doesn't have red ink.  I do that with one client - making the master copy and then just adding the dates of service and bottom part. It is up to each insurance company as to what they want on a form

Amy Sargent said:

With OfficeAlly, are you able to scan and upload your SOAP notes and the 1500 form, or does it need to be encrypted by a special program in order to be HIPAA compliant?

 

Also, I've heard that with the 1500 form, you can't submit copies... they have to be original forms with the red ink... is this true? I was thinking that I could create a master copy for each client with their info and then just add the billing information after each visit but now I'm not sure I could do that...?

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