Why Substance Abuse Billing is Important
Substance addiction is very common throughout the world. But it is not something that should be taken lightly. When people regularly consume “substances” in excessive quantities, they’re called addicts. But substance abuse and addiction are two different things.
Substance abuse refers to the use of alcohol or any other drug, be it legal or illegal, in large quantities. Substance abuse can be cured with proper rehab facilities. On the other hand, addiction is harder to get rid of.
Rehab centers and other healthcare facilities help individuals with substance abuse and addiction problems. But these rehab centers also need an income to run properly. To get stable revenue, they need to make proper billing. Even the slightest bit of mistake in billing can cost rehab centers a lot of money. Hiring a substance abuse billing consultant can help.
Rehab Centers vs. Insurance Companies
There is always an ongoing battle between rehab centers and insurance companies. Generally, rehab centers are paid via insurance money for the patients. A patient rarely pays out of their own pocket.
But getting the money from insurance companies is no less than a headache. Reimbursement is often very difficult for rehab centers and other similar healthcare services. Moreover, some insurance companies send the reimbursement directly to the patients rather than to the healthcare facility.
Even when they send the money to the healthcare company, there are many hurdles along the way of receiving money. To start with, insurance companies delay payments without specifying a reason. Furthermore, the billing process is complex. Mistakes in billing can cost rehab centers a lot more than they can earn. Some rehab facilities even ran out of business because of this particular reason. But if you hire a third party for billing, you can get the payments in time.
Rather than opting for in-house or incompetent third-party billing companies, rehab centers must hire a reliable billing company with in-depth knowledge about billing procedures. Simply knowing the codes isn’t enough to create bills.
Reasons for Rejected Claims and Delayed Reimbursement
Here are some of the main reasons why insurance companies reject claims or delay reimbursement to rehab facilities:
False Claims and Caution Against Fraudulent Acts
Many healthcare facilities made false claims to get insurance money in the past. That’s why a lot of insurance providers are cautious of fraudulent claims. This is one of the biggest reasons insurance claims are either rejected, or the reimbursement is delayed.
But effective billing can help get detox centers and rehab facilities their rightful money in time.
Lack of In-Depth Knowledge
Another reason for delayed reimbursement is that billers don’t have enough knowledge. This can happen more commonly with in-house billing systems. It’s important to address the receivables of the last 90 days if you want to get your money quickly.
Lack of knowledge on how to get past money can make it lost forever. But if your third-party billing company knows how to tackle lost money, they might be able to get you your money very easily.
Reevaluation of Service Providers
Another reason rehab facilities and detox centers fail to get their money is that they don’t bother reevaluating their service providers. Reevaluation will help you understand whether or not a service provider is beneficial to your business. If it’s not, you should seek a new service provider. This is important for regaining your money. But this is one of the most overlooked factors.
Payments Made to Patients
Many healthcare workers fail to realize that the money would be paid to the client directly. Before you take on a client, it’s important to understand how and who the insurance company will pay the reimbursement. When a rehab facility finds out, there is no way to get the lost money back. Often, many rehab facilities are left with millions of unclaimed dollars. For one reason, these unclaimed dollars remain lost, and rehab facilities fail to recoup the lost money.
The Bottom Line
The bottom line is to have in-depth knowledge about substance abuse billing. A competent substance abuse billing consultant can guide you and even save your rehab facility from shutting down permanently.
Some laws have mandated sending the payments to healthcare facilities rather than paying the patients in some states. If you’re not aware of all the codes, regulations, and tactics for getting the payment yourself, you should forget about in-house billing. Instead, you should hire a third-party substance abuse billing company that can do the job for you.
Get in touch with Integrity Billing by calling (800) 683-5640 or visit Congress Professional II 1630 South Congress Ave., Suite 102, Palm Springs, FL 33461 for further details.