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3 Ways to Know If Insurance Reimbursement is Worth Your Time


One question we are asked is if insurance reimbursement is worth going through the hassle of credentialing, contract negotiations, and then subsequent billing. The answer to this question can be complicated, but hopefully it doesn't have to be.

Here are 3 ways to know if insurance reimbursement is worth your time.

1. Your Margins Are Safe

Many of our clients look at the reimbursement rates only. They think, "Insurance X pays $60.00 an hour, that's great!". But when it comes to services, it is important to keep your margins in mind.

If you get paneled with an insurance company and you aren't making at least 30-40% of that money (after expenses) then it isn't worth your time. Let's go back to that $60.00 for more explanation.

Insurance X pays $60.00. It takes a 15 minutes for note writing (i.e. $15.00) and maybe you bill Insurance X and it gets rejected. You call the insurance and that takes 30 minutes (i.e 30.00). In time, you spent $45.00 in administrative costs. This is definitely not worth it!

2. You Will Receive More Referrals

One of the best reasons to get paneled is to get more clients. If you are fortunate enough to build a private pay practice then you wouldn't need to get paneled. But if you are in an area where it would be difficult to build a self-pay practice, then paneling for insurance would be a great idea.

Keep in mind that you want this to be a value-adding activity, so if you will only get 1-2 referrals from a panel it might not be worthwhile.

3. The Insurance Company Treats its Providers Well

When considering a specific panel be sure to talk to your colleagues who might be on the same panel. Ask questions pertaining to following-up on claims, average days to payment, and how their customer service is.

You find out really fast whether the reimbursement from that insurance company will be worth your time, energy, and stress.

Conclusion

Do your homework when determining if reimbursement is worth it. Make sure your margins are still good, that you will recieve more referrals, and that the insurance company treats its providers well.

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