Episode 9: Billing & Credentialing in Private Practice (with Jeremy Zug)

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Therapy For Your Money

Nov 06, 2020 Season 1 Episode 9

Julie Herres

Billing is the most important financial function in a practice. If there’s no money coming in, then you really don’t have a business.

Today’s guest is Jeremy Zug, owner of Practice Solutions, LLC, a billing and credentialing firm for mental health private practices. He talks about when it is a good time to DIY, outsource, or bring in-house billing and credentialing.

Episode Highlights:

Practice Solutions: Started small and has grown significantly in mental health space
TherapyNotes: Electronic Health Record (EHR) experts effectively impact billing
Biggest billing mistakes:
- Incomplete progress notes mean claims don't go out or get paid
- Adding too many insurance companies/payors at a time
- Start with one insurance company, then add more over time
- Consider clinical objectives
- Research reimbursement rates for profitability and sustainability
- Determine ease of use working with an insurance company
In- or Out-of-Network Insurance? Structure caseload that makes financial sense
Discipline Processes: Go from good to great to meet expectations and avoid mistakes
Benefit Checks: Call insurance company to determine eligibility and collect from clients
Credentialing Methodology:
- Plan
- Gather Information
- Submit and track application
- Finalize contract and initial billing
Solo and Group Practice Credentialing: Differences between EIN, NPI, and AIN models
QuickBooks vs. EHR: Where to put financial and patient details for HIPAA compliance
Accounts Receivable (AR): Cash or accrual basis for insurance write-offs and deductions
Problems/Solutions: Call insurance company to understand claim denial or non-payment

Links and Resources:

Practice Solutions, LLC
Practice Solutions Blog: Your Private Practice Credentialing Process
TherapyNotes
Good to Great by Jim Collins
Chris Hogan
Affordable Care Act (ACA)
Employer Identification Number (EIN)
National Provider Identifier (NPI)
Alternate Identification Number (AIN)
QuickBooks
HIPAA Privacy
Grit by Angela Duckworth
GreenOak Accounting
Therapy For Your Money Podcast

Billing is the most important financial function in a practice. If there’s no money coming in, then you really don’t have a business.

Practice Solutions: Started small and has grown significantly in mental health space
TherapyNotes: Electronic Health Record (EHR) experts effectively impact billing
Biggest billing mistakes:
- Incomplete progress notes mean claims don't go out or get paid
- Adding too many insurance companies/payors at a time
- Start with one insurance company, then add more over time
- Consider clinical objectives
- Research reimbursement rates for profitability and sustainability
- Determine ease of use working with an insurance company
In- or Out-of-Network Insurance? Structure caseload that makes financial sense
Discipline Processes: Go from good to great to meet expectations and avoid mistakes
Benefit Checks: Call insurance company to determine eligibility and collect from clients
Credentialing Methodology:
- Plan
- Gather Information
- Submit and track application
- Finalize contract and initial billing
Solo and Group Practice Credentialing: Differences between EIN, NPI, and AIN models
QuickBooks vs. EHR: Where to put financial and patient details for HIPAA compliance
Accounts Receivable (AR): Cash or accrual basis for insurance write-offs and deductions
Problems/Solutions: Call insurance company to understand claim denial or non-payment

Links and Resources:

Therapy For Your Money

Episode 9: Billing & Credentialing in Private Practice (with Jeremy Zug)

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