Medical Billing: How to deal with the slowing of reimbursements

Medical Billing slowing reimbursement

Insurance companies historically slow down their reimbursement of insurance claims towards the end of a year. They also continue to see this trend into the first few months of a new year.

Some Reasons:

  • Insurance companies’ adjusting contracts and resetting fee schedules (even if it does not pertain to you, changes in an insurance company and year-end practices, slows down all operations of the insurance company).
  • Addiction treatment centers are adjusting to the “Clinical” criteria set forth in a diagnosis and procedural codes in the New ICD 10.
  • Insurance companies granting employee vacations at the end of the year causes a slow in claims processing
  • Likewise, holidays occurring on weekdays along with insurance companies and treatment providers recognizing the day prior to a holiday as partial holiday time. For Example, 2015 Thanksgiving, Christmas, and New Years occurred on weekdays. Many companies also close early or entirely the day prior to the holiday.
  • Some Insurance benefits, co-pays, and deductibles are carried over or follow the calendar year, causing changes and delays.

OVERCOME THE CHALLENGES OF SLOWING REIMBURSEMENTS!

  • Implement a strategy for financial planning (Keep money in reserves)
  • Understand client’s insurance policies and effective dates
  • Re-Verify ALL client’s insurance benefits
  • Monitor documentation (Psychosocial, Psychological/Psychiatric Evaluation, Treatment plans, Clinical notes, Medical Notes and more)
  • Review and update credentials of medical and clinical staff
  • Report all changes to your medical billing company
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About Karen Corcoran-Walsh

Karen Corcoran-Walsh, CAP, ICADC, MFT, ASAM is nationally known as an expert in the treatment of mental health and drug or alcohol abuse and addiction, also known as Dual Diagnosis, with a specialty in working with teenagers. Renowned as an adolescent addiction treatment center professional, she has worked in the professions of education and drug treatment for approximately 20 years. Karen is the co-founder of Inspirations For Youth And Families, LLC an adolescent treatment program and The Cove Center For Recovery, LLC an adult addiction treatment center.