Insurance billing presents several complexities, so many integrative health practitioners have difficulties navigating the processes. For example, many of them make mistakes using the 97810 CPT code. Thankfully, the services of holistic billing companies can come to the rescue in the following ways:
- Accurate & Faster Insurance Billing
- Increased Reimbursement Rates
- Regulatory Compliance
- Reduction in Administrative Work
- Billing & Coding Support for Several Modalities
- Improved Cash Flow
All these come in handy given the several processes entailed. For more information on the processes, you can see: https://www.bryantstratton.edu/.
To especially help integrative health practitioners understand the importance of holistic billing services, some common mistakes to avoid when billing with the 97810 CPT code are discussed here. So, read on to stay well informed.
CPT Code 97810 Billing Issues that Holistic Billing Services Helps Avoid
For starters, you should know that this CPT code is for acupuncture services. Furthermore, it is for the first fifteen (15) minutes and without the use of electrical stimulation. Some of the complexities of billing insurance companies using this CPT code are why some integrative health practitioners make mistakes.
Delayed payments, claim denials, and financial losses at large are some of the possibilities when these mistakes are made. Some of the said mistakes include the following:
Incorrect Use of 97810 CPT Code
Besides the fact that it is designed for acupuncture services, its eligibility is further determined by a timeframe of 15 minutes and the sort of services offered. More service time requires additional codes. For example, the CPT code 97811 is one of the other codes that may need to be used.
Failure to Verify Coverage
Integrative health practitioners need to bear in mind that not all medical insurers and plans cover acupuncture services. Furthermore, even those that cover such medical services may have restrictions that could impact the billing process.
For this reason, quite several things need to be verified. Coverage, limitations, as well as pre-authorization requirements, are some of the things to be verified.
Incorrect Documentation
Insurance companies are well known to work by the letter. As a result, payment approval is not likely to happen until there are clear & accurate records to back up claims. By the way, this is one of the leading reasons for claim denial by insurers. You can click here for further insight on this.
As a result, clear and accurate documentation of especially key details is a necessity. That includes documentation of key details such as the patient’s session length, diagnosis, and treatment plan.
Billing 97810 Even with Electrical Stimulation
Some integrative health practitioners are well aware that this CPT code is for acupuncture services and that it covers the first 15 minutes. However, some are unaware that it does not apply if electrical stimulation is used. Rather, the right CPT code to use would be 97813, instead of the 97810 CPT code.
Forgetting to Use the Right Modifiers
For starters, this is an insurer issue. So, it is majorly about understanding expectations from insurers as some of them require the use of certain extra codes (modifiers) for claims processing. For example, some insurers require the use of the “-GP” code for patients using the Medicare plan.
Late Submission of Claims
Proper claim filing is not just about presenting a well-documented claim to insurers. It is equally about adhering to some other set guidelines. For example, late submission of claims can result in outright denial.
In light of this, integrative health practitioners should make sure they are aware of the ideal timeline for claim submission. Informed decisions should then be made based on this knowledge. By the way, submission within 30 days of the service being rendered is what is usually considered ideal by insurers. However, make sure to find out.
Charging the Wrong Amount
For the record, avoidance of certain common mistakes prevents the chances of making some other mistakes. In this case, thorough verification of the patient’s insurance coverage, limitations, as well as pre-authorization requirements prevents/reduces the chances of charging the wrong amount.
Integrative health practitioners often make this mistake by charging the insurer the full-service amount. This is without taking note of agreements such as deductibles/co-pays to be sorted out by the patients themselves.
In essence, these healthcare practitioners are supposed to confirm the payment agreement between the insurer and patients. This ensures that financial losses do not happen as a result of having to bear the cost of such a mistake.
Conclusion
Integrative health practitioners need billing services. The sort of services offered also needs to be holistic, which is where the likes of Holbie come in handy. This is because they understand the complexities of using Acupuncture CPT Codes such as 97810 CPT Code and several others. Engaging such billing services prevents these practitioners from making the mistakes discussed above and several others.
However, make sure that you do your due diligence in the spirit of choosing the best billing service provider. To this end, your choice should be influenced by yardsticks like expertise in service offering, technological integration, customer support, security & compliance, and fees & pricing.