Sunday, February 14, 2016

Should Doctors Be Forced To Tell Insurance Companies More About Their Patients Health?

By Wile Longertons


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?

Insurance company's today are growing in power against the medical community. A good medical biller is what every medical practice needs. Without a good medical biller that understands ICD-10, your clinic may indeed fail. It seems as though doctors are losing their grip on their battle with insurance companies. Around 50% of doctors are said to be closing their private practice in order to work for a hospital that pays them a weekly salary. Some doctors see this as being a better fit because of the uncertainty of being reimbursed from the insurance company's.

Learning how to work with the insurance companies and the medical billing company is what is going to see your success. Simply put, the medical codes are now longer. You need to invest in new software because of it. It actually may be cheaper to just let the medical billing companies do the tedious work for you. Doctors spend more time filling out paperwork than they do with their clients. This is always a tough battle and topic to talk about for licensed physicians.

Medical billers today should understand a lot about anatomy and how conditions are treated. In order to send in a correct claim to the insurance company, the biller must know how to do it correctly. Document what had to be done in detail. Today, the more detail that you give the insurance company the better. You will often see a higher return on your claims in the end. It requires much more work. However, this is why you need someone to do this full time for you. Forget ICD-9. It is a thing of the past. Instead, focus your attention on what needs to be done.




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