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2011 Health Insurance Payer Report Cards: Disturbing Trends to Watch!
2011 Health Insurance Payer Report Cards: Disturbing Trends to Watch! avatar

Written by Tom Necela, DC, CPC, CPMA, CCP-P on July 6th, 2011
Topics: chiropractic billing, chiropractic business, chiropractic coding, Collections, Insurance

The 2011 edition of the National Health Insurer Report Cards were recently released and illustrated some disturbing trends.

In case your not familiar with the NHIRC, it’s the 4th annual report sponsored by the AMA looking into financial waste, timeliness and accuracy of claims due to common insurance payer tactics.  This year’s segment analyzed claims data from a randomized sampling of over 2.4 million claims. (You can get the full version of the NHIRC here).

Many of the big payers are represented in the report cards – Blue Cross, Blue Shield, Anthem, Aetna, Cigna, United HealthCare and Medicare.

From the findings, it’s likely one or more of these payers are causing you trouble (whether you realize it or not).  The report cards allow a glimpse at who is notorious for paying claims late, requiring mounds of paperwork, using underhanded tricks to under-pay contracted fee rates when you’re not looking and more.

Don’t be a victim!  Here’s the Executive Summary of what the NHIRC found out: Read More

5 Verification Mistakes That Chiropractors Make That Put Their Income at Risk!
5 Verification Mistakes That Chiropractors Make That Put Their Income at Risk! avatar

Written by Tom Necela, DC, CPC, CPMA, CCP-P on March 22nd, 2011
Topics: Billing, Business, chiropractic billing, chiropractic business, chiropractic collections, chiropractic practice management, Collections, Insurance

As we discussed in my last post, Expedited Agreements and Other Fee Negotiation Scams Waged at Chiropractors, insurance payers are continually rolling out new tactics to avoid releasing claim payments or to minimize reimbursements.

Accordingly, your standard operating procedures may longer be sufficient to get you paid for all the good work you do. One overlooked but vital tool to accomplishing this is your Insurance Verification Form. As such, now may be time to enhance your verification of benefits to insure that emerging claim processing tactics are identified and thwarted.

Unfortunately, most chiropractic offices are employing few, if any, of these tactics. Instead, they are doing insurance verification, “the way we have always done it” and getting the same (or worse) results. Read More

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