Medical billing is probably not the first thing that comes to mind when you decide to start a new practice. You launched your private practice with dreams of guiding your patients through their mental or physical health journey. You cultivated the education, knowledge, and experience required to provide the medical and emotional support patients need. In the midst of all your dreams and goals, I’m fairly certain that understanding medicare codes and insurance reimbursements did not factor into your plans. And now that you’ve launched your practice, this new world of medical billing, which often is not as simple as sending an invoice, may actually seem like a nightmare rather than the stuff that dreams are made of.
If you’re launching a new practice or just starting to accept Medicare and/or insurance, some of the following questions may have arisen in your quest to understand how to bill accurately:
Should I bill “direct” or “incident to” and what’s the difference?
Who can use the CMS-1500 form?
Are there different rules for different states?
Does providing Telehealth services affect billing?
Or maybe your practice is well established but billing is beginning to really stress you out. Even once you gain an understanding of billing and coding regulations, they can and do change on a regular basis. Just this year, an “Update on Billing and Coding for the Psychiatric-Mental Health Nurse Practitioner” was released in the Journal of Psychosocial Nursing and Mental Health Services. Beyond that, navigating appeals and denials or managing billers when they are less than transparent, can be daunting tasks.
Yet, we all recognize that a vital part of continuing to help clients is continuing to generate income. And truthfully right alongside the love of working with patients is also the desire to get paid. After all, we’ve got to live, right? In order to facilitate that, accurate medical billing is an absolute necessity. Not understanding or appropriately utilizing medical coding and insurance reimbursements can cause constant under-billing, which leads to less income for your practice, or even over-billing which can, in fact, lead to fraud investigations.
Don’t let these questions or problems overwhelm you! Wherever you are in your private practice journey, we can help! Silver Leaf Practice Management Solutions is here to get your medical billing on track. Schedule a free consultation with us to tell us about your billing goals! We provide both DIY and billing options for your Private Practice.