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Billing Insurance as a Dietitian

How to Streamline Billing Insurance as a Dietitian!

If you're a dietitian in private or a group practice, then you may be interested in taking insurance. Creating and submitting CMS claims is not a simple task though. For insurance-based dietitians, they have to allocate time to bill for their services which takes away from client services and other income-generating services. Of course, not all dietitians decide to take insurance. If you're on the fence about whether or not billing insurance is right for you and your practice, then these are your options and how to streamline the process if you do take insurance.

1. Consider Offering Superbills

If you're seeing a client as an out-of-network provider, that doesn't mean you can't still allow your clients to be reimbursed for their sessions. However, you can let them do the work of getting reimbursed. If you see clients who have nutrition counseling provided by their nutrition insurance, then you can create and send them a superbill that the client can submit to their insurance carrier for reimbursement.

A superbill is simply a detailed receipt of the services provided in a specific format. It will include all of the information an insurance company will need to file a claim including:

- Client name and address

- Provide name, contact information, NPI, and tax ID#

- ICD-10 code and description

- Office procedure with date, CPT code, description, units, and fee

- Total charge

Clients can then use this information to submit superbills to their own insurance company for reimbursement. Like a CMS 1500 form, a superbill provides the same information. However, it's a way to avoid billing insurance while still allowing your clients to take advantage of insurance.

2. Use an Insurance Billing Platform

If you're interested in a way to easily bill insurance, then an insurance billing platform offers a great option. There are a variety of platforms available and the services provided by each vary slightly. However, through this platform, dietitians will be able to chart on their clients, generate CMS-1500 claims and submit claims online. Claims can then be printed and submitted directly to insurance companies or processed through a clearinghouse to track and manage claims. This is a great way to stop wasting time on the phone.

How Does It Work?

Once you sign up to use an online billing platform, you'll have to onboard new clients to your practice that want to use insurance. You'll want to provide intake forms that collect the following data:

Client contact information

Client insurance information

Basic demographics: gender, height, weight

Referring provider information- you may need physician name and NPI number as some insurance plans require a physician referral

Many of the online forms create their own intake form but you can probably create your own. The forms that you create can be put in your own intake flow. Once you have this form created, you can capture your client's insurance and billing information. The good news is that once you have this information in your system, you can often choose to have the information collected to auto-fill on other forms. After you've created the first CMS 1500 form online, any subsequent forms will also be pre-filled with the information needed to submit the claim.

3. Setting Up Insurance Coverage

Regardless of how you decide to manage insurance and claims, you'll want to ensure that clients have coverage before setting up an appointment. Once you have their intake information, you can contact the insurance company directly. If a client is covered, you'll want to know what billing codes are covered for the client, how many hours they're covered to receive counseling, and if there is an authorization number required for the initial session. Once you've obtained this information, you'll be able to enter this information into the online claim software program or simply keep track of it yourself. One of the benefits of a billing platform is that it usually contains a tracker to monitor how many sessions a client has remaining.

4. Collecting Co-pays

In order to avoid running into problems of no payment, you'll want to collect co-pays at the time of the session. This will allow you to obtain a client's credit card to keep on file for co-pays or to make sure that you receive payment even if a payment is denied. In order to keep track of co-pays, the online billing program will allow you to edit the completed CMS 1500 claim as needed.

5. Monitoring Claim Status

Now that you have a method to submit claims easily, you'll still need to keep an eye that they're being covered. With an online platform for claims, you'll be able to run reports related to claims and financials. These reports will allow you to see which claims have been reimbursed and which ones are still pending.

6. Streamlining the Process

In addition to using these two options, there are a few other ways to streamline the process of taking insurance. Keep in mind that dietitians who only see a few patients a month may not find it worth their time to take insurance. However, for dietitians interested in expanding their business or going full-time with their private counseling, then taking insurance is the smart option. There are a few options to help make the process easier that don't involve using an online service.

I. Conduct Work in "Batches"

When you have to contact insurance companies to determine eligibility checks, it may be easier to do this in batches rather than one at a time. Some dietitians have streamlined their process by making a single call at the beginning of the week to check for verification of CPT and diagnosis codes, the number of units and visits covered, and if clients need co-pays or referrals. This will still require a dietitian to contact insurance companies but will decrease the time spent on the phone and also decrease denied claims in the long run.

II. Collect Limited Insurance

For dietitians who want to accept insurance but don't want to call or contact multiple insurance companies, they may decide to only accept a limited number of insurance companies. For dietitians who see the same type of patients each time, it may be smarter to work with only one or two insurance companies. If you choose to work with only one insurance company, then learning the coding will likely be well worth your while.

III. Hiring an Assistant

This option is a great way to get rid of coding and billing on your own. However, hiring an assistant to manage billing, scheduling, and more will likely only be worth the cost if you are full-time in private practice. Some dietitians who work together sharing an office may find that hiring an assistant as a group can also be cost-effective and time-effective at the same time. Depending on the needs of your practice or group, you may be able to hire an assistant part-time. However, be prepared to pay for this professional's time as it may take more time to take on even basic office tasks. If hiring someone already familiar with insurance billing, it may be worth paying a higher salary as this individual will be better versed and work more efficiently.

7. Improving Efficiency

While all of these options provide a great way to improve efficiency when it comes to working with insurance, one of the best resources for dietitians is their colleagues. With online communities as well as local dietitian organizations, dietitians can easily network with each other. Consulting with dietitians who have gone through the billing process is a great resource. For example, if considering using an online billing and claims program, talking through this process as well as the various options available will make it easy to find the right option for your practice. Additionally, other tips and advice for streamlining the process are easier with an expert opinion. Make the time to meet with other dietitians and learn what works best in this practice area.

8. To Claim or Not to Claim?

All of this information can be used to determine whether or not to accept insurance. Like previously mentioned, it may not be worth taking insurance for dietitians who only see the occasional client. However, with the Affordable Care Act in place, this has improved access for nutrition services and nutrition counseling is widely covered by many insurance plans. Additionally, dietitians who move from self-pay to accepting insurance often find that they see growth in their practice. If your goal is to become a full-time private practice dietitian, then it's well worth taking the time to learn how to efficiently bill with insurance companies.

The downside to taking insurance is that it will require an initial investment of time, regardless of which method you choose to use. Even online billing platforms require some initial learning of billing and coding. Ultimately, what method you choose to use ultimately depends on your goals as a private practice dietitian. Use these resources to learn about your options and what works well. Although the process of taking insurance can be daunting when starting off, there are many resources available to streamline the process today.

9. Automate The Process With Office Ally

Office Ally is a full service clearinghouse offering a web-based service where providers can submit to Participating Payers for FREE*. Our Online Claim Entry allows you to create CMS1500, UB04, and ADA claims on our website; or use your existing software to create and submit claims electronically.

Link: https://cms.officeally.com/Pages/Products/Clearinghouse.aspx

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