After my last post, I had some follow up questions about the specifics of the self-claim receipts I provide my patients. Given that my treatments are all one hour long with the majority of the time dedicated to Manual Therapy and always at least a review of the HEP, here’s what my receipts include (along with the obvious business and patient identifying info):
- Business Tax ID/EIN #
- ICD9 diagnosis codes
- CPT codes
- 3 x Manual Therapy (15 minutes each) at $30 each
- 1 x Therex (15 minutes) at $30
- My credentials, Texas License number, National Provider ID #, and signature
Author Note – Jan 2013: in addition to the above info, please also include:
- Location of Services: Outpatient Clinic (stand alone), code = 11
- A note at the bottom (in bold large font) that the patient has already paid in full for the services, and that any payment should be sent directly to the patient
Here is a template you can work from:
Please note that the receipts your patients need for a successful self-claim may be very different from what I’ve outlined above. You know those insurance companies … they’ll do whatever they can to deny a claim. With that said, the above format has been accepted by most insurance companies when my patients send in self-claims. There are of course times when a company will say info is missing, and after 20 minutes on the phone, they admit that everything needed is actually all there. If time on the phone becomes a common issue with a particular patient and his insurance company, I inform the patient that this is one of the reasons I don’t deal with insurance; and that more of my time on the phone will need to be paid for. It’s tough to say these things but you have to protect your time. After all, you didn’t move to a private-pay business model to continue spending time on the phone with insurance companies.
Over the past year, I’ve spent less than three hours dealing with insurance companies or insurance-related issues. Take a moment to imagine how nice that is … no research or meetings to figure out how to comply with the latest Medicare reimbursement changes, no (re)negotiations of low-paying contracts with insurance companies, no more reports from your salaried billing staff (or outsourced billing company) on why you only received 45% of the enormous bill for Mrs. Jones. It’s awesome.
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