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The Essentials of Insurance Billing for Therapy
Introduction to Billing
Class overview (0:43)
Billing terminology
Managing the billing process (9:41)
Different types of payers (6:39)
The flow of the billing process (7:52)
In Network vs. Out of Network (9:39)
Credentialing Providers
What is provider credentialing? (1:38)
How to start credentialing providers and/or organizations.
NPI registration
Working with a Clearinghouse
What is a Clearinghouse, and what do they do? (4:39)
Enrolling with payers for claims and remits
Setting Pricing for your Services
What services can you bill for?
How much should you charge for a service? (18:36)
Types of billing codes (and how to use them) (9:51)
Payer Verification
Gathering patient information
Verifications (4:55)
Authorizations (14:59)
Working with Professional Claims (CMS-1500)
Claim overview and requirements (7:13)
Medicare Functional Reporting (G-Codes) (15:59)
Automatic field adjustments (claim rules) (7:36)
Submitting your first claims to a payer
Reviewing Claims - What to check before you send (13:09)
How to handle a claim rejection (2:44)
Receiving your first remit from a payer
What is a remit? (11:07)
How to read remittance advice (6:27)
How to handle a claim denial
What is a denial? (3:16)
Common claim denial reasons
How to contact a payer about a denial
Resubmitting claims
When should you resubmit a claim? (4:23)
Submitting secondary and tertiary claims
Preparing to send a secondary or tertiary claim (4:24)
Remit expectations for coordination of benefits (6:34)
Patient Responsibilty
Determining patient responsibilty (6:23)
Collecting payment from your patients (12:53)
In Network vs. Out of Network
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