I remember fuming at an insurance company’s response when I was attempting to get reimbursement for work I had done with a client: “you did not submit a request for authorization.” I had the paperwork in front of me, signed and dated, when I actually had made the request. Re-submitting the request was not allowed due to the next barrier being in place: “it’s past the time allowed to send to appeals.”
Most of my work with mental health therapy had been on a fee for service basis since I did it part-time and also had a full time benefited position. When I decided to “retire” from organizational work and go full time to private practice, my own therapist suggested that I get on a few medical substance abuse insurance panels to “keep the wolves away.” I was able to do so and began to learn what many of my colleagues who had been utilizing medical billing insurance panels had been frustrated about: more of my time was being used to manage the complex insurance rules than providing care for my clients. Doing the work of therapy was where my passion was but it was dwindling due to the on-going struggle of trying to get reimbursed by the client’s insurance.
That’s when I began look into the possibilities of hiring someone to help with medical billing. A colleague told me about the person she used so I met with this person and we began a business relationship. It wasn’t long before I had even less money coming in than when I was trying to manage it! First lesson learned: Do your homework before depending on others to manage your income!
I became aware of a new company who was looking for people willing to engage with them on the venture of optimal client insurance billing management. I sat down with the owners at the new company, and learned what sets it apart in the medical health billing industry. Here is what I've gathered:
What To Expect From A Mental Health and Insurance Billing Organization
- Despite being a new medical insurance billing company, the owners had been doing the same work for other companies for some time and could demonstrate a history of successful outcomes; I had not asked for that on the initial hire;
- A contract that gave both of us clear understanding of rights and responsibilities was reviewed; I felt more protected, and, a part of a team, their fee was reasonable and fair;
- There would be someone available to answer questions, if not immediately, within the same day; the prior experience of not being able to get a response from the first person for over two months was a nightmare;
- Prior authorizations, including specifics like number of visits, deductibles and if they were met, co-pays and co-insurance, all the ins-and-outs of coverage would be done by them, taking some of the fear out of being reimbursed for the work I was doing;
- Clients could call them directly if they had questions about their statement, freeing up my time for care;
- Their knowledge in collections was also reassuring as I had a number of outstanding accounts;Their office space was professional which demonstrated their commitment to the work.
I think another factor that helped was the calm and attentive way in which we spoke of what mattered for both of us as business owners: “If I succeed, then so do you.” It was that team approach, and value for each other’s goals that supported my decision in going with this new company, Elevated Billing.
They met each of my expectations over time and we both faired very well. I encourage anyone who is considering trying a billing company or thinking about upgrading to a very successful team in billing, to call Elevated. You will enjoy talking with the owners. Their spirit for successful business outcomes is contagious!