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Let’s get direct: Discussing the concerns of third-party insurance billing


August 18, 2020
By mindZplay Solutions Staff

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Photo: @ zimmytws / Adobe Stock

Third-party insurance billing has become an in-demand service for healthcare practitioners to offer their patients. Third-party billing is when a healthcare provider submits insurance claims for qualifying treatments directly to a patient’s insurance company. The practitioner then receives the payment directly from the patient’s insurance provider – removing the patient from the submission loop. While dentists, for example, have been providing payment directly services for many years, it is only recently that this has become a common practice for massage therapists. This is primarily due to recent innovations that have streamlined the claim submission process. Today, submitting insurance claims can be virtually effortless and paper free, as more and more insurance providers offer online services for electronic claim submissions.

That said, there are still a lot of misconceptions out there that are causing some practitioners to hesitate when considering adopting this service into their practice. The intent of this article is to set the record straight and clear up some of the misunderstandings surrounding third-party insurance billing.

Since announcing the integration of third-party insurance billing into our practice management software, we have received some interesting comments and questions from our clients and potential clients. Of course, there were many practitioners that were already offering third-party billing services to their patients, who were thrilled that this new integrated approach would make it even easier for them to manage their insurance billing. Yet, there were also those who were happy to know this integrated billing feature would now be available for them “when they were ready to offer the service” – as if their practice had not yet reached some perceived level that would allow them to offer direct insurance billing.

How do you know if you are “ready”?
Online insurance billing can be an intimidating subject for many, but if you are reading this wondering whether you are ready – chances are you are more prepared than you realize.

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The truth is, if you are a licensed practitioner and have an active practice, you are more than prepared to offer this valuable service to your patients. You do not need advanced technical skills or an accounting background. If you have Internet access and can navigate websites, you will have no trouble submitting insurance claims online for your patients.

It is important to note that if you are not offering third-party insurance billing in your practice, you may be losing opportunities to other practitioners in your area who do. When looking for a massage therapist, many patients view direct insurance billing as highly beneficial and may see this as an offering that sets practitioners apart. Today more massage therapy clinics, including single-therapist practices, are offering the benefit of third-party insurance billing to their patients – so you don’t want to be left out of the running.

Other concerns we often hear that are causing practitioners to hesitate are:

I have heard it takes forever to get paid by insurance companies. I can’t afford to always be waiting for payments to come in.

Claims submitted online are approved immediately. Payments can be set up to be deposited directly into your bank account by the insurer, and typically are deposited within 3 business days – no different than when you accept a credit card or debit payment for your treatments.

I am busy and do not have the time to take on another billing process.

When using practice management software that has truly integrated support for third-party insurance billing, there are no extra steps. The submission process is built into the invoicing system – a treatment that is billed to an insurance company is no different, from a workflow perspective, than processing a cash payment.

I have no way to know if patients have exhausted their coverage and I can’t afford not to get paid for treatments if it turns out that they were not covered.

When submitting an insurance claim online, you will know immediately whether or not a treatment is covered. Before your patient leaves your practice, you will know exactly how much is covered, and will be able to collect the remainder (if any) from your patient before they leave. In fact, some insurers allow you to run a “predetermination” check, where you can determine what a patient’s coverage will be without submitting their claim. You can even do this before you provide the treatment!

I don’t have a bookkeeper to manage which payments I have received and which are still outstanding, how am I supposed to keep track?

When using a practice management system that has support for third-party insurance billing, most systems will track insurance payments that are outstanding, making it easy for you to identify and reconcile insurance payments as they come in.

I don’t have time to go through a long, involved application process right now.

Signing up for most insurance billing services can be done quickly and easily online. If you are a qualified practitioner, no one is judging the size of your practice and there are no other prerequisites to apply. It may take a few days to process your application, though.

So, how can you get started?
As mentioned, some insurance providers offer their own online claim service. This means that you can setup a practitioner account with that provider and submit claims directly via the insurer’s website. This is easy to do but requires you to navigate through different insurers’ websites for each submission.

For this reason, many practitioners get their feet wet by using an insurance aggregator service, like TELUS Health eClaims, for example, that allow you to submit claims to many popular insurance companies from a single service. It’s a good place to start and you can always expand from there if you feel the need. Simply complete the quick sign up form and wait for them to send you your account details.

Once you have an account setup, you can begin submitting insurance claims for your patients. In addition, if you are using a practice management system that has integrated support for third-party insurance billing, you will not need to change anything in your regular billing workflow when submitting an insurance claim – It is that easy!

We hope this helps to reassure those of you who are not yet offering this extremely valuable service in your practice!


mindZplay Solutions Inc., a provider of massage therapy websites and practice management solutions. To learn more, visit massagemanedger.com.


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