Published: 2009-11-01 20:08:55
Author: Marty Kotlar | Chiropractic Economics | May 2008
Should my CA ask for insurance information when a patient makes initial contact with the office?
Many
years ago, it was not common to ask about insurance coverage because
insurance reimbursement and claims processing were a lot simpler.
Nowadays, it is common to ask for insurance information on the initial telephone call. Most chiropractors who instruct their staff not to ask about insurance on the initial telephone call do so because they do not want the patient to think that all their office cares about is money.
Recommendation: Ask your front-desk clerk to gather the information on the initial phone call:
• Patient’s name, address, and telephone number;
• Insurance company’s name, address, and telephone number;
• Insurance ID/policy number or Social Security number;
• Patient’s date of birth; and
• Chief complaint.
Another important question is, “How did you find out about our office?”
If the patient was referred to your office by another healthcare provider (such as an MD, DO, or another DC) requesting your opinion and advice, you may be able to bill a higher level CPT code known as a “consultation” code (CPT codes 99241, 99242, 99243, 99244, and 99245).
Consultation codes have a higher RVU (relative value unit) and fee range than regular new-patient codes (99201, 99202, 99203, 99204, and 99205) and may be used with new or established patients.
In a consultation situation, the patient is not being transferred to you. Instead, the requesting doctor is asking for your opinion or advice.Full story