Tuesday, March 8, 2016

Insurance: Is Your Treatment Center Suffering Because Of It?

By Mindy Counsel


If you have been surfing Google lately, you may come to realize that many treatment centers are closing down and simply going bankrupt. Insurance today is a confusing industry for a lot of people. In the past, insurance companies almost always paid out on your claims. Today, ICD-10 is in effect and treatment centers are finding it harder and harder to turn a profit. Today, there is no guarantee that you are going to get paid for treating a patient once they are at your facility. Many treatment centers are finding out that they cannot get paid on services that they used to offer in 2015.

Many clients that come to your facility will not have good enough insurance to turn a profit for your facility. Many insurance companies are not going to pay you $20,000 to treat someone. Instead, they will give you a much smaller amount. You will often be shocked that you had to pay $25,000 out of pocket and only receive $15,000 in return. A lot of treatment centers today are asking themselves if they can afford to stay open if this continues to happen.

For starters, you are going to need a person that understands and is certified in ICD-10. Most people today are not ICD-10 certified and have no prior education in this coding. The new codes were released on October 1 of 2015. It is important to understand that you must get your books straight. If not, you will find yourself closing your business down.

Today, marketing is king when it comes to getting good clients. Your treatment center must have a good reputation. Many people will come to your treatment center because of someone else that had gone to your facility. If you want to be successful, everyone in the industry must respect you as well. Before dumping lots of money into a fancy 5 star facility, make sure that you have enough money to market your business. It is estimated that a pay per click campaign can cost as much as $150,000 a month for a 30 bed facility. You will spend roughly $5,000 to recruit just one client with good enough insurance to come to your facility. If you want to run television ads, it will cost even more. You also need to pay field marketers that work in the streets knocking on doors for you. It is important to have an entire team working for your success.

It is important to not let the new rules and regulations get you down. In reality, you can have good profits in your treatment center if you plan ahead accordingly. For starters, don't keep in house billers if they are not ICD-10 coding experts. You will fail at getting your claims back in time. Most coders today don't get their treatment centers paid on time. This often leaves business owners angry and frustrated.

Having knowledge today matters. If your claims are not 100% correct, you will see a high rejection from the insurance companies. Many insurance companies are tired of seeing careless billing. You may not receive payment on your claim even though you have submitted it 5 times. You will get no leniency from the insurance companies. Today, insurance companies are expecting you to do your billing correctly. If you can't do it correctly, then outsource it to someone that can.




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