Insurance Companies Are Gaining More Power With ICD-10 Medical Billing
Years ago, a PhD in medicine meant respect, knowledge and honor. Today, medical doctors are having a harder time with insurance company's respecting them for their expertise. Insurance companies are cracking down on medical doctors and blood labs. The new ICD-10 allows them to do that. Under ICD-9, a doctor could tell the insurance company that their patient needed two blood tests that week without having to explain a whole lot. The medical biller would simply put in the code and the doctor would expect a check in the mail a couple of weeks later. Today, this is not the case. Insurance companies are constantly asking the question of why. Why should I write you a check because you are claiming that your patient needed two blood tests? They want you to document why this was necessary before paying you.
Now, medical practitioners know that those days are over. In the past, this is how things were done. In today's world, insurance company's want to know specific details about what you are trying to claim. Are you in fact trying to "get over" on them? Do your patients really need the services in which you are claiming?
Most people don't know that you need to learn 5 times as much information now than you did under ICD-9. You better believe that more study and experience is required. You need to document everything when you submit it to the insurance company. Insurance company's want to know why you are sending them a bill for a certain amount of money. Why should they pay you for the services that you performed? Was the service really necessary in the first place?
Licensed Medical doctors often have to go to school for 8 years or more. Their expertise for patient care should be enough for insurance companies to write them a check when they take care of a patient. However, this is not the case. Some doctors are even refusing to take any insurance at all. Many prefer to have their patients do cash pay. Many doctors complain that they must do this in order to keep their practice open. The insurance battle will only get worse.
Through the years, insurance companies have written checks to doctors because the system was set up that way. You tell the insurance company the ailment using correct codes and they submit a check back to you within a couple of weeks. Now, you must document everything to the insurance company. Your coder must know what to put down. Are you documenting the success or your patients or just submitting a claim for reimbursement? It is clear that insurance company's today wants to know more about your patients and if you are healing them. Many insurance companies are asking the question of why? Why does your patient need 2 x-rays instead of one? Why do they need 2 follow up appointments instead of the standard 1? It The system is basically forcing doctors to be more honest and open with why they are treating a patient to begin within a certain way.
Now, medical practitioners know that those days are over. In the past, this is how things were done. In today's world, insurance company's want to know specific details about what you are trying to claim. Are you in fact trying to "get over" on them? Do your patients really need the services in which you are claiming?
Most people don't know that you need to learn 5 times as much information now than you did under ICD-9. You better believe that more study and experience is required. You need to document everything when you submit it to the insurance company. Insurance company's want to know why you are sending them a bill for a certain amount of money. Why should they pay you for the services that you performed? Was the service really necessary in the first place?
Licensed Medical doctors often have to go to school for 8 years or more. Their expertise for patient care should be enough for insurance companies to write them a check when they take care of a patient. However, this is not the case. Some doctors are even refusing to take any insurance at all. Many prefer to have their patients do cash pay. Many doctors complain that they must do this in order to keep their practice open. The insurance battle will only get worse.
Through the years, insurance companies have written checks to doctors because the system was set up that way. You tell the insurance company the ailment using correct codes and they submit a check back to you within a couple of weeks. Now, you must document everything to the insurance company. Your coder must know what to put down. Are you documenting the success or your patients or just submitting a claim for reimbursement? It is clear that insurance company's today wants to know more about your patients and if you are healing them. Many insurance companies are asking the question of why? Why does your patient need 2 x-rays instead of one? Why do they need 2 follow up appointments instead of the standard 1? It The system is basically forcing doctors to be more honest and open with why they are treating a patient to begin within a certain way.
About the Author:
We are a medical billing company in West Palm Beach Florida. We have physicians billing services for treatment centers, rehabs, hospitals and clinics. When a doctor decides to outsource their billing to us, we give a great approach to getting higher returns. Our clients tell us that we get them faster returns on their claims. We also offer services such as revenue cycle management and utilization.