Why you should consider offering third-party billing to your patients

Jessica Foster
December 22, 2017
By
Third-party billing is when a health-care provider submits claims on behalf of patients to health insurance providers (the third party). The purpose is to manage and direct payment for treatment and services rendered to the patients.
When you provide this direct service to your patients, it offers them a much better client experience. It could also mean more business for you, as patients may be more likely to book regular appointments to maximize their yearly benefit cap.

Some practitioners are firm in their resolve to not offer third-party billing options to patients. They may have a variety of reasons for doing so, including cash flow considerations, the extra effort required to perform the claim submission, and possibly the fear of denied claims that result in having to chase their patients for payment. These are all valid concerns. Furthermore, some believe that they have built solid relationships with their patients and that the additional overhead required to offer the third-party billing service is not warranted.

While it is common practice for dentists, chiropractors, physiotherapists and certain allied health-care professionals to routinely offer direct billing to extended health insurance providers, it is only recently that RMTs have started to offer this service. This is because patient expectations are rapidly changing. Many patients would now prefer to only pay the amount not covered by their insurance plan, and have the practitioner collect the balance directly from their insurance provider. In today’s world, consumers are used to real-time banking, tap payment processing, and electronic funds transfer. When given the choice of making an appointment with a RMT that offers direct third-party billing and one that does not, the convenience factor could well outweigh all other considerations.

If you don’t offer direct billing, you may wish to reconsider and investigate the benefits of offering third-party insurance billing to your patients.

The methods for practitioners to submit third party claims to extended health insurance providers have become more streamlined. Insurance providers are rapidly tipping the scale toward having health-care practitioners perform the claims submissions directly at the time of treatment. They have made it much faster and easier for practitioners to instantly verify coverage and submit insurance claims on behalf of patients. In most cases, practitioners can now go online to inquire about a patient’s insurance coverage status, submit claims electronically and then receive prompt payment directly from the insurance provider.

In addition, insurance providers are increasingly integrating their e-claims systems with aggregators such as Telus Health to increase their clients’ satisfaction. Not only does this improve fraud detection, it also verifies the practitioner status, and reduces their cost per claim transaction. Large claim aggregators provide an integrated and secure access to a number of insurance companies’ e-claims processes. In most cases, these systems are free for RMTs and other health-care providers to use. This saves the practitioner from incurring credit card and other transaction fees and allows direct deposit to your bank account.

As an added benefit, some insurance providers are even promoting participating practitioners to their clients. They are including search tools on their websites for their insured clients to find practitioners in their geographic area that are registered with their e-claims third-party billing service. This gives practitioners more exposure to potential new patients and a clear competitive advantage to capture new patients.

If a RMT has been around long enough, they have witnessed the business side of their practice evolve from a paper system, to desktop computer software, and finally to cloud-based practice management solutions that offer a variety of amazing tools to manage their practice. These include online appointment scheduling, patient database, patient billing, charting, financial, and other day-to-day practice management functions. Direct third-party billing is another progression to this evolution. One could view offering third-party billing in a similar light to offering credit card payments to your client. Claims are easily processed and payments are regularly deposited to your bank account by the provider – the same way they are with credit card transactions, but without the transaction fees.

The green movement has also driven the paperless office and this extends to third-party billing options as well. While allied health-care providers are relatively new to offering direct billing options, they can very quickly embrace technology to improve their competitive offering, with respect to patient experience and office efficiency.


Jessica Foster writes on behalf of mindZplay Solutions, provider of massage therapy websites and practice management solutions. To learn more, visit www.massagemanedger.com.

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