Secrets: Clinical

Insurance Portions

   What to do when say…

• “It’s being processed”
• “Collect from the patient”
• “We never received it”
• “It wasn’t medically necessary”
• “It’s not usual, customary, or reasonable.”
• “You filed untimely”
• “You owe us money”

   What to do when they…

• Deny a claim
• Write poor language on the explanation of benefits statement
• Stall from paying you

• Are there tools to make it easy to collect from patients?
• What should I do when a patient won’t pay their bills?
• Is it illegal for me to discount or waive patient portions?
• Should I ever send a patient to collections?
• Do I have to verify benefits with EVERY patient?

• Why do attorneys always cut my bill?
• How can I collect the full amounts?
• How do I better negotiate with attorneys?
• Should I charge for medical record requests?

• How much should I charge for those disability reports?
• What’s the max I can charge?

• How do I see HMO patients if I’m NOT contracted?
• How much should I charge?
• I do have an HMO contract, how do I increase my pay?
• How do I increase my reimbursement?