No matter how you slice it, insurance can be confusing. Whether you are part of a clinic, large practice or a solo practitioner, odds are you have a lot of questions. It can be hard to know where to turn to get them all answered.
I have been doing this for a while and sadly, I still don’t have all the answers. Though with our type of work, I’d be wary of anyone who claimed to know it all.
So if no one knows it all, where do you go for answers? That’s a valid question that many of us have and I’d love to start unpacking that here.
Where Have All the Answers Gone?
In our field many of us are looked to as being experts, so it’s only natural that you would want to also be an expert when it comes to insurance. In order to be an “expert” we need information, knowledge, training and A LOT of practice. This can be hard to come by and obtain when it comes to insurance.
Learning what you can about insurance terminology, rules, and regulations can be remarkably helpful. There are some overarching rules, however, different insurances have different requirements. It can be difficult to know where to find this information.
When in doubt, start with the source. If you have questions about how to bill a particular insurance, check out the information they have put out to providers. Each insurance has a provider handbook complete with billing practices. While this may not be a “page turner,” it is invaluable when it comes to billing that particular insurance.
Another often-avoided resource is making a phone call. While some representatives may not know how to answer your questions, there are many who do. Even if they don’t know the answers to your questions, they can probably direct you to someone who does.
Keep asking your questions until you find answers.
Where NOT to Find Answers to Your Insurance Questions
There are plenty of places to look for answers just as there are plenty of places NOT to look for answers. Unfortunately, there is a lot of misinformation out there. The sharing of knowledge is a wonderful thing IF the information being shared is accurate.
Others can be well-intentioned in sharing their experiences and findings, though this doesn’t mean what they are saying is correct. Many turn to Listservs and social media discussion boards for information about insurance, especially when there are changes or things are confusing. These platforms can be amazingly helpful, though fact checking may not always come into play.
There are many times I’ve seen well intentioned providers share their own billing practices that were actually quite concerning. I don’t believe that questionable practices were ever their intention, however, if someone were to follow their recommendations they could end up in hot water.
Using professional resources and community platforms can be helpful in many ways. However, I’d caution you from using only these sources. It is always best to consult with the regulations of your licensure board, specific insurance, and/or ethical codes. While not an expert in billing, your liability insurance may also be helpful if you are concerned that certain practices may not be in line with ethical or legal regulations.
Contracting and Navigating Insurance
Sometimes navigating insurance on our own can be more than we bargained for. Being in practice as a solo provider can be overwhelming. Credentialing can be complicated and those complications don’t necessarily stop as soon as you are able to start billing.
Many providers prefer to be part of a group due to the confusing nature of insurance. Contracting with established practices can provide you with the support you need in navigating insurance and freeing up time for you to focus on the clinical aspects of your business.
You can also have your own private practice while receiving help with credentialing and billing. You don’t have to navigate the maze of insurance all on your own.
To Sum It Up
Insurance can be A LOT. If you are feeling overwhelmed with credentialing, billing and/or navigating insurance as a whole, you are not alone. Many providers struggle to understand the ins and outs of insurance.
There’s a great deal of information out there about insurance. Unfortunately not all this information is accurate. Use your best judgment when it comes to what sources to consult, though speaking with the insurance panel directly is often one of the best courses of action. Always consider the source.
Practice what you preach, my therapist friend. See you next time.
*If you are interested in becoming an independent contractor with CCS and you are a licensed therapist in North Carolina, send your cover letter and resume to the following email: Applicants@CarolinaCounselingServices.com
