Insurance Billing Made Easy, Update News


Yes, you may have thought I dropped off the face of the earth while in fact, I've been hard at work managing a busy practice, 2 kids and a mother with dementia, ha! I've also been hard at work updating Insurance Billing Made Easy for ICD-10, but unfortunately the fates have aligned against me and I have some bad news.

Insurance Billing Made Easy v2 will not be out this year. 

I am so close to having the edits completed, but my mother's health has been declining this year and, after a stroke just a few weeks ago, it is clear that I cannot make the necessary time to complete my book update.

So, on October 1st the price of the book will drop by 50% to reflect the non-ICD-10 ready nature of the guide.

The process and information in my book is still relevant and viable, however, so its still a good and worthwhile read if you want to understand insurance! I will be working on the update as early as I can in 2016 and publishing through Amazon with both a print and e-book version thereafter.

Where Do I Get ICD-10 Codes and Conversion Services EASILY??!

The GOOD news is that ICD-10 really does NOT have to be hard at all. Even if you've hardly prepared, you're in for a treat because there are great services for code conversion available and I'm going to tell you where to find them!

My favorite by far is the integrated ClientTracker Code Converter because I literally have to do nothing! If you use ClientTracker and you're in the cloud (recommended!) this is provided to you for free. You enter a diagnosis by name, or by the ICD-9 code and it automatically shows you the ICD-10 options. You pick, the system codes your SOAP note and invoice and voila! Coding is done.

Office Ally also has a free ICD-10 code search tool. You can choose to look up ICD-9 or ICD-10 codes by number or by description. It doesn't convert codes for you, but it will show them to you with a very simple search such as "pain" or "shoulder." Very handy.

Last recommend ICD-10 conversion tool is the AAC Network AcuCode Digital Coding Tool. For an annual fee, you have access to the website where you can enter a description or an ICD-9 diagnosis code and it will list all the ICD-10 codes for you. Efficient and accurate!

I'm afraid that is all the news for now. I have some very helpful updates planned for IBME - tables to help compare digital practice management systems, summary recaps of each chapter to highlight important points, an expanded section on charting, a print version and more! I'm very excited and very close to completion, but due to my mother's health and needs it just has to be on the back burner for a while.

I appreciate all of your patience and patronage! Please don't hesitate to stay in touch and submit questions. Since I am still editing, if there are specific things YOU want to see more of in my next version, let me know! I'll do my best to accommodate your requests.

Until next time, here's to you business success,

~Rebecca Hurwood, LAc

I blogged before about the changes to Regence BlueCross BlueShield's Acupuncture reimbursement - namely that they are contracting with a company called "Core Care" to administer CAM benefits.  This means starting next year, all CAM treatments require pre-approval through this administrator.

There has definitely been a lot of backlash, but no change in policy which is unsurprising.

Still, they are offering free webinars this month and next for Acupuncturists specifically to help illuminate how this process works.  You can go online to the Regence site HERE to sign up.

The times available are:

• Wednesday, December 18, 12 p.m. – 1 p.m. (PT) / Meeting Number: 734 116 661
• Wednesday, January 15, 9 a.m. – 10 a.m. (PT) / Meeting Number: 738 323 531
• Thursday, January 16, 12 p.m. – 1 p.m. (PT) / Meeting Number: 737 701 693

Check it out and sign up if you want all the details!

Best of luck with your insurance billing practices in the coming year!
~Rebecca

In case you hadn't heard the news, Regence Blue Cross Blue Shield is recommending pre-authorization for Acupuncture services for all members starting November 1, 2013 in Oregon, Washington, Idaho and Utah.  Starting February 1st, 2014 this will be a requirement, not just a recommendation.

The full details of this change can be found HERE on the Regence Oregon website.

It looks like the process will be pretty easy and handled by an organization called CoreCare National, LLC.  You will have to register your credentials with them and can either call or go online to obtain a pre-authorization for the specific diagnosis code and CPT codes you want to bill for.

A complete list of all the CPT codes required to get pre-authorization for is on the Regence site linked above, or HERE if you want to go direct.

Its been clear for the past year that Regecen has really been buttoning down on Acupuncture.  Regence used to have some of the best reimbursement rates in my practice and now it is one of the lower eschelon to be sure.  This move does not have me hopeful of a strong reimbursement rate in the future as the Affordable Care Act gets into full swing, but we'll just have to take it step by step and see what happens in the coming years.

For now, if you are a preferred provider with Regence in Oregon, Washington, Idaho or Utah its time to get signed up with CCN and start familiarizing yourself with the pre-authorization process.  Regence is offering several webinars about it this month.  They are free and you can sign up through the Regence page linked above.

Good luck all you Acu-Stars out there, lets keep fighting the good fight!
~Rebecca Hurwood, LAc

Its here!  The Affordable Care Act has gone into effect despite all the brouhaha in DC and the traffic on the exchange websites is high enough to cause glitches here and there is a good sign I think.

In Washington State, a minimum of 12 Acupuncture treatments per plan year is included in the essential benefits list, so ALL Washington State plans will include Acupuncture coverage starting in 2014.  How cool is that?

While I don't have time to review the plans online in every state, I did take the liberty of scanning all the Individual and Family plans in Oregon and compiled the best list I could of which plans include Acupuncture coverage:

• Bridge Span Health Plans - no Acupuncture coverage under any individual plans
• Family Health Care - Medicare and Medicaid Oregon Health Plans only. NOTE that Medicare does not cover Acupuncture at this time.  The OHP Plus plan does include Acupuncture services though the exact benefit is not listed on the OHP site.
• Health Republic Insurance Company - NEW!  Health Care Co-Op option.  All plans cover 40 combined Acupuncture + Chiropractic Visits
• Health Net - does not currently list acupuncture benefits in any of their individual & family plans but it looks like a glitch - they have traditionally covered Acupuncture and Chiropractic under all plans.  I talked to Provider Relations and they indicated Health Net was not dropping Acupuncture coverage but couldn't give me specific plan details.  They referred me to their Affordable Care Act information line but I have been unable to get through.  Group health insurance will most likely continue to cover acupuncture.  Confirm  benefits with a sales person if you are considering these plans.
• Kaiser Permanente - Plan details are not listed online at this time.  Traditionally all Kaiser patients (aside from Medicare only coverage through Kaiser) have access to Acupuncture through referral whether they have a "self refer" benefit or not.  Expect this benefit to continue, but speak to a sales representative to confirm if considering a KP plan.
• Lifewise - Acupuncture included in the Gold and Broze VA plans
• MODA Health - Acupuncture included in the Gold-Be Protected, Silver - Be Prepared and Silver - Be Smart plans.
• Oregon's Health Co-Op - another NEW health care co-op insurance agency!  Acupuncture included in SiMPLE Silver, Bronze and Gold plans as well as all Group plans
• PacificSource - Acupuncture included in the Balance Bronze 6350, Silver 2500 & Silver 1500 plans
• Providence - no Acupuncture coverage evident in any of the Individual & Family plans.
• Regence Blue Cross Blue Shield - Acupuncture is not currently listed as a covered OR an excluded benefit in their individual plan brochure so I cannot confirm or deny coverage, but traditionally BCBS has been good at providing alternative care benefits to members.
• Trilium - like Family Health Care, provides Medicare/Medicaid/OHP plans only.  As with Family Health, Medicare does not cover Acupuncture but the OHP plan does though again - the exact benefit isn't listed.

Since Group plans are subject to employer approval I did not review all of them, and I highly recommend working with a broker to compare plans and determine which one is right for your business if you are selecting something new or considering doing so.  The health care exchanges generally have qualified brokers who can help you review and compare group and individual plans - you can get referrals to them through your state's health exchange website.

If you are self-employed there may be some new benefits available to you as well.  Check out THIS PAGE on the Healthcare.gov site for an FAQ.  It isn't comprehensive in any way, it really just directs you to go to your state exchange, but it is still nice that the government addressed and highlighted this issue.

Lastly, I wrote a patient-centered blog post about this on my clinic website today and if you need a place to start for your patients to answer questions about ACA and Acupuncture, feel free to point them there or lift information and post it on your site or ezine.  All I ask is that if you reproduce something from my blog you link back to me as the source of information.

Enjoy Fall, everyone, and lets hope the government gets its act together and starts functioning again soon.  Hey, any LAc's in DC?  Can you go do some group treatments for Congress?

Until next time,
~Rebecca

Its only taken me 3 years, but voila!  Website update which was a long time coming!  Poke around and check it out - new look, new blog, new affiliate site, pretty sweet!

That's right, it is on its way slowly but surely so hold on tight and keep up the prep work.  Currently, ICD-10 isn't required until October 1, 2014 so we still have a long time to complete our coding changes, test our systems and prepare.  But the key is PREPARATION - don't wait until the last minute!  Start compiling your code sets now so that when October 1st 2014 rolls around you are well tested and ready.

I promise I will have a book update out by then too, so stay tuned!  I will include the basic codes necessary for Acupuncturists as I did in my first edition.  You can also peruse codes at the official CMS ICD-10 website but it is rather unwieldy to search through them all.

A great code set that's been parsed down for Acupuncturists is available from the American Acupuncture Council for about $50, but it is currently sold out!  I will endeavor to post when they are available again, or you can contact AAC direct and ask if they can notify you.

Okay, guys, this one is a biggie - beginning October 1st 2013 a NEW HCFA/CMS 1500 form called version 0212 will be required for insurance billing.  You can see a PDF version HERE and you can read more on the NUCC website HERE.  Undoubtedly, your clearinghouses are already testing this new form and will be prepared to process it.  I haven't heard or seen anything about availability at stores like Office Depot or the like for purchasing pre-printed blocks of these, as you can with the current CMS 1500, but we can only assume that is coming too since its kind of a necessity for compliance.

The only CAM friendly database system that I know is assured to have the new CMS 1500 0212 built into the system is ClientTracker by Ginkgo Software.  So if you're thinking of investing in a new system for your practice, I highly recommend this one - it is what I use and I wouldn't be without it.  They have a multi-user cloud system on its way that can be accessed using both your computer and your tablet devices which is pretty sweet.

Them's the haps, people.  Stay tuned for more insurance billing, practice building and Insurance Billing Made Easy updates - I promise there will be more to come!

Oh, and have you signed up for my ezine?  If not, you should! Free tips delivered to your inbox and not spammy, I promise!