Managing Health Care Insurance Paperwork

If you decide to accept clients who apply to use third-party payments through their health insurance companies, you are agreeing to take on more paperwork than you need for cash-paying clients. You may consider hiring a third-party vendor to complete your requests.

Set Up a System

Filing insurance claims and tracking receipt of payment is manageable if you organize files to help you. Keep the following documents in yopclient's folder:

  • the client's insurance card(s) copies of front and back
  • the prescription and/or other referral document from the client's doctor
  • the insurance preapproval request
  • for workers' compensation, the Statement of Injury form
  • an authorization, signed by the client, that allows you to release medical information. Be aware that some states set time limits on how long the signature is valid.
  • a statement, signed by the client, stating that the client will pay any charges not covered by insurance. Be aware that some types of insurance plans do not allow you to collect any amount above what the insurance pays you.
  • SOAP notes
  • the reports used to update the referring health-care provider
  • HIPAA compliance documents

In a "billed but not collected" file, keep the following documents:

  • any claim form you file with the insurance company  
  • any correspondence, notes of conversations, and forms related to inquiries about or denials of claims
  • a log of outstanding insurance claims. The log should show the name of the client; name of insurance company; invoice number, amount and date billed; and any partial payment and date paid

Insurance Reimbursement Forms

Insurance reimbursement forms can be found through health care insurance websites. Alternatively, there are companies that will complete and submit all required insurance billing paperwork for you. Perform a Google search to find companies in your area.

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