Paperwork for out of network

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This topic contains 3 replies, has 2 voices, and was last updated by   Douglas Stam April 28, 2018 at 2:05 pm.

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  • April 26, 2018 at 9:14 am #5273

    Matthew Ellerbrock
    Participant

    I have dropped quite a few insurance contracts lately and I have found they continue to create issues.  Even if the patient pays cash and then submits it on their end, the patient shows that we need to ‘pre authorize’ (pre authorize after the treatment has been done… go figure on how effective that is) the tx by filling out some forms… and we have to send notes… of course its generally approved.  Still a pain.

    1.  Can I just hand the notes and not fill out any extra forms?  Can I charge something to fill out any extra paperwork?

    2.  We get some not a lot of AFLAC, disability paperwork requests.  I am sure I could charge something for this, but wanted to see what everyone else does.

    April 27, 2018 at 9:46 am #5274

    Christopher Stepien
    Participant

    In NJ, we get paid pretty well out-of-network.

    My perspective is: “You pay $75. IF (again, “if”) your insurance reimburses us more than $120, we’ll make it so you just pay a copay.”

    For the most part, I do some pre-authorizations and narratives. But it’s not too much of a hassle for me.

    If it was a hassle, I’d just tell the patients up-front, “You pay $75. If we get reimbursed, you’ll get reimbursed. It’s our policy to not do any pre-authorizations or hand any notes.”

    When they ask why, I’d say, “Because we have better things to do than prove our care to health insurance companies.” Then, I’d smile really fucking wide and slap them in the face and say, “I’m Rick James bitch”. LOL.

    April 27, 2018 at 3:16 pm #5275

    William Brady, DC
    Participant

    For a cash practice they get a receipt at the time of service and a copy of the file upon request. That is all you routinely provide.

    If they want or need more they pay your hourly rate. When hearing this they say “No thanks.”

    They (the insurance company and the patient) still want you to work for free. If you need to justify this have your staff say “We provide healthcare services not insurance administration.”

    April 28, 2018 at 2:05 pm #5276

    Douglas Stam

    Right there witcha Rick James!

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