Background: With the many changes in the healthcare market, practitioners would benefit from knowing the players, the payers, how they authorize and reimburse, along with the benefits to a mix of cash and insurance. Learn the secret behind obtaining increased coverage for various treatment services within your business, while maintaining profitability.
I. Payer mix – Who are the major insurance companies in the game and what is their reputation when it comes to approving treatment for eating disorders.
II. Insurance terminology – Understand in-network vs out of network, co pays and deductibles, the difference between having a benefit vs authorization, along with single case agreements and how to navigate.
III. Getting paid for your services – How to maneuvar denials by arming yourself with the patient’s plan document, American Psychiatric Association Level of Care Guidelines for Eating Disorders, and when all else fails determine cash rates for clients who cannot access their insurance for treatment .
Maintaining profitability is always challenging within a small business. With healthcare as a fluid entity, not all insurance policies are created equal from patient to patient. Learn how to navigate your way through the insurance system, while balancing insurance and cash payments in order to increase access to your services.
Beverly Price, RD, MA, E-RYT, CEDS is recognized for her distinctive approach to mindfulness-based eating disorder recovery using Mindfulness-Based Yoga therapy. In 2001, she sold her private practice -one of the largest private nutrition practices in the country—to a private nutrition consulting firm, and started Jump Start® Consulting, LLC, specializing in management and marketing strategies for healthcare professionals along with distance learning products for continuing professional education. Beverly currently owns and operates Inner Door Center, a free standing partial hospitalization program for eating disorders along with an outpatient mental health clinic.
