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392: Insurance Denials and Rejections: Why Do They Happen, and How Do You Fix Them?

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Manage episode 480044420 series 2869057
Content provided by Melvin Varghese, PhD and Melvin Varghese. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Melvin Varghese, PhD and Melvin Varghese or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://staging.podcastplayer.com/legal.

Are you a clinician in private practice who has considered taking insurance–but you just aren’t sure? Maybe you already take insurance, but are overwhelmed with navigating denials and rejections. Either way, today’s session is packed with helpful information and strategic tips. Join us to learn more!

Our Featured Guest

Jeremy Zug

Jeremy Zug is a partner at Practice Solutions, which offers support and insurance billing for therapists and private practices. Their mission is to partner with and empower providers to focus on patient care by removing the burden of billing. Jeremy shares information about denials and rejections, the difference between the two, and how to fix them. He also shares the top three reasons for denials and rejections. We are thrilled to welcome Jeremy as a returning guest to STC!

Practice Solutions

You’ll Learn:

  • What is a denial?
  • The tricky layers of denials
  • What is a rejection? (This is better than a denial and is usually fixable in a short amount of time.)
  • Assessing your risk tolerance (low, medium, or high?)
  • Fact: Some insurance companies are easier to work with than others. (Check their denial rates!)
  • Insurance companies’ tactics to “control the spend”
  • Jeremy’s advice about denials and appeals, especially for solo practitioners
  • The top three reasons for denials: duplicate claim and service, coordination of benefits, and “denied for medical necessity”
  • The top three reasons for rejections: credentialing issues, patient demographics, and “modifier inconsistent with place of service”
  • The top actions therapists can take to fix denials and rejections: track them, look for a pattern/cause, and manage your insurance mixture
  • An overview of Practice Solutions and their services (book, billing, and billing department support) Use this link for 20% off any of their services for STC listeners!

Resources:

Interested in becoming part of our affiliate program? Learn more!

Want to launch your online course?

Please check out our free 7-Day Course Creator Starter Kit for Therapists at https://sellingthecouch.com/coursekit.

If you are a seasoned therapist who wants to move from clinical to online course income, we have a specific mastermind for you. We meet together to build, grow, and scale our online courses. You can learn more at https://sellingthecouch.com/mastermind.

Mentioned in this episode:

Try Quiet Builder!

If hustle culture makes your soul itch. You'll love the quiet builder. It's for folks building businesses with heart, not hype. You can take a peek inside at https://sellingthecouch.com/builder.

  continue reading

300 episodes

Artwork
iconShare
 
Manage episode 480044420 series 2869057
Content provided by Melvin Varghese, PhD and Melvin Varghese. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Melvin Varghese, PhD and Melvin Varghese or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://staging.podcastplayer.com/legal.

Are you a clinician in private practice who has considered taking insurance–but you just aren’t sure? Maybe you already take insurance, but are overwhelmed with navigating denials and rejections. Either way, today’s session is packed with helpful information and strategic tips. Join us to learn more!

Our Featured Guest

Jeremy Zug

Jeremy Zug is a partner at Practice Solutions, which offers support and insurance billing for therapists and private practices. Their mission is to partner with and empower providers to focus on patient care by removing the burden of billing. Jeremy shares information about denials and rejections, the difference between the two, and how to fix them. He also shares the top three reasons for denials and rejections. We are thrilled to welcome Jeremy as a returning guest to STC!

Practice Solutions

You’ll Learn:

  • What is a denial?
  • The tricky layers of denials
  • What is a rejection? (This is better than a denial and is usually fixable in a short amount of time.)
  • Assessing your risk tolerance (low, medium, or high?)
  • Fact: Some insurance companies are easier to work with than others. (Check their denial rates!)
  • Insurance companies’ tactics to “control the spend”
  • Jeremy’s advice about denials and appeals, especially for solo practitioners
  • The top three reasons for denials: duplicate claim and service, coordination of benefits, and “denied for medical necessity”
  • The top three reasons for rejections: credentialing issues, patient demographics, and “modifier inconsistent with place of service”
  • The top actions therapists can take to fix denials and rejections: track them, look for a pattern/cause, and manage your insurance mixture
  • An overview of Practice Solutions and their services (book, billing, and billing department support) Use this link for 20% off any of their services for STC listeners!

Resources:

Interested in becoming part of our affiliate program? Learn more!

Want to launch your online course?

Please check out our free 7-Day Course Creator Starter Kit for Therapists at https://sellingthecouch.com/coursekit.

If you are a seasoned therapist who wants to move from clinical to online course income, we have a specific mastermind for you. We meet together to build, grow, and scale our online courses. You can learn more at https://sellingthecouch.com/mastermind.

Mentioned in this episode:

Try Quiet Builder!

If hustle culture makes your soul itch. You'll love the quiet builder. It's for folks building businesses with heart, not hype. You can take a peek inside at https://sellingthecouch.com/builder.

  continue reading

300 episodes

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