A Guide to Filing Insurance Claims for Therapists: A Step by Step Process

Filing insurance claims can be time consuming, but don’t worry we are here to help! In this section, we will go step by step through everything that relates to therapy insurance claims in order for you to not lose money and minimize frustration along the way. Discover strategies to improve claim approval rates and ensure timely payments. Read our guide on Medical Billing for Therapists: Insurance Reimbursements today!

Insurance Claim Process: What Therapists Need to Know

Why Your Insurance Claim is Important As a Therapist

Correctly billing and insurance claims are essential to the revenue of therapists that are on insurance panels. Claims paid in a timely manner ensure that your accounts receivable collections are maximized, which is great for your cash flow and practice. 

Learn about the most frequent errors in medical billing and how to prevent them. Read our expert tips on Common Billing Mistakes Therapists Make.

Common Hurdles in Therapy Billing:

Some of the most common issues include claims not paying, payments being held for a long period of time, or issues with coding. Knowing these issue existing will help guide you through them properly.

Claim Submission Preparation: Recommended Steps

Necessary Documents for Your First Submission

Prior to filing a claim, ensure that you have the following:

Client’s insurance card (both sides)

Completed intake forms

Session notes

CPT and ICD-10 codes

Client consent and insurance release forms

CPT And ICD-10 Understanding

CPT refers to the service that you provided while the patient was is session with you.
ICD refers to the diagnosis the patient has.

Example: 90837. (CPT code) would be for a psychotherapy procedure for 60 minutes.

Checking Client Insurance Eligibility

Always check benefits before the initial session to prevent claim denials. Check the insurance company for coverage, copays, and out-of-pocket expenses.

How to Execute Insurance Claim Processes

Step 1: Collect Client Information

Collect pertinent information such as the client’s full name, date of birth, and the insurance provider, along with the policy number.

Step 2: Decide on the Billing Type. Agreed. Paper Or Electronic.

Paper claims involve completing and mailing out forms such as the CMS-1500.

Electronic billing is quicker and is the preferred method. Many therapists who utilize billing services or clearinghouses tend to use one.

Explore top-rated billing solutions to enhance efficiency and accuracy in your therapy practice. See our latest review of Best Medical Billing Software for Therapists.

Step 3: Complete the CMS-1500 Form

This is the specification form for particular insurances claims. You must accomplish the following:

Have the correct provider NPI number.

Place the right diagnosis and service codes.

Include the insurance ID of the client.

Check the document thoroughly for typographical errors and mistakes before you submit.

Step 4: Present the Claim to the Insurance Provider

After the forms are prepared submit them using:

Insurance portals for (electronic claims)

Clearinghouses (third party processors)

Units via direct mail (for paper claims)

Step 5: Monitor Claim Status and Follow Up

Post submission:

Track claim status via the internet.

Check with the Insurance Company for further information if you need more.

Prepare yourself for a 30-45 day turnaround timeframe.

Remain patient and keep a claims tracking spreadsheet for easier follow up.

Step 6: Handle Claim Denials and Appeals

In case your claim gets denied, re-evaluate the denial reason once more.

Eliminate errors from the claim and resend.

Appeals can be submitted if necessary and supporting documents are available.

Reach out and speak to the insurance company regarding things that were misunderstood.

Best Practices for Smooth Insurance Billing

How to Avoid Claim Rejections

• Check to see that every patient detail corresponds with the provided insurance records.
• Accurate inclusion of CPT and ICD-10 codes.
• Deadlines for provider claim submissions should be met.
• Be aware of changes in policy terms.

Importance of Accurate Documentation

• Make sure that your notes on the session are as detailed as possible.
• Comply with HIPAA regulations and keep client information safe.
• Establish a uniform approach to billing documents.

Using a Medical Billing Service

Therapists can benefit from partnering with a medical billing service such as Global Tech Billing LLC, which simplifies the claim process, minimizes errors, and speeds up reimbursement. This is especially crucial for those new to medical billing for therapists, as outsourcing helps streamline the process and reduces administrative stress.

Learn about the most frequent errors in medical billing and how to prevent them. Read our expert tips on Common Billing Mistakes Therapists Make.

Outsourcing Vs In-House Billing: Which is Better?

• Outsourcing: Less administrative burden, errors, and improve reimbursements.
• In house billing means taking control, but also dealing with more training and purchasing of the necessary software.
• For physicians more concerned with patient care, Global Tech Billing LLC is recommended for handling claims.

Staying Compliant with Insurance Regulations

• Constantly monitor state and federal law changes.
• Educate staff on best billing practices.
• Eliminate billing fraud to avoid audits.

Conclusions

Claiming insurance need not be burdensome. Adhering to these precise processes will guarantee organized practices, timely payments, and effortless claims filing. Medical billing for therapists requires careful attention to detail, proper documentation, and compliance with insurance regulations. Global Tech Billing LLC is a phone call away to help automate your claims and improve your productivity. Being current with industry trends, documenting them carefully, and equipping the right tools will guarantee the financial success of the practice. Discover strategies to improve claim approval rates and ensure timely payments. Read our guide on Medical Billing for Therapists: Insurance Reimbursements today!

Frequently Asked Questions

What is the duration for processing insurance claims?

Insurance companies take, on average, 15-30 days to settle claims. Electronic submissions take less time.

What can I do if my claim is denied?

Look for reasons for denial, make the necessary changes, and resubmit the claim. If required, try appealing with the needed documentation.

Can I charge the insurance for a therapy session that was not attended?

No, therapists cannot bill insurance for sessions that were not attended. However, therapists may charge clients a no-show fee based on their customary fee policy.

Is using a billing service for insurance claims more effective?

A good number of therapists believe that opting for Global Tech Billing LLC saves them a lot of time and minimizes mistakes.