Greetings and Happy Holidays!

Wanting to bill insurance with your program? Do you know what you need to do to be compliant? This blog talks in brief about compliance surrounding insurance programs you are associated with as a provider.

First, for •profit and non •profit agencies can be on provider panels. So lets ask an obvious question: do you want to accept insurance for service? This is a very individual decision.  It may be based on your mission and whom you want to serve or it may come down to a regional or state preference. For example, we are a Medicaid provider. However, in other states it can be more difficult to be granted "preferred provider" status. In the end you need to decide what works for your business.

When you apply to be a "preferred provider" or to be on a "provider panel" with an insurance company, you will be asked, what I call "demographic questions". These questions center on the "who, what, where, and how" of your business. Some applications are set up as check boxes and are very straightforward. Others may request descriptive information of what you do.  This is the number one stumbling block I hear within the field: the description of what you do. I promise I will cover that on another blog very soon.

From a compliance standpoint, the number one "offense" falls under documentation. You must document thoroughly. To read more about this topic and about some common errors in documentation, click here.

That is it for now. Contact me with questions.

"Til next time,

Lisa
Practice Administrator