Ensure payment for noncovered services

With reimbursement levels shrinking, you may begin looking toward elective procedures for added income. But how can you be sure you'll get paid for these noncovered services? The best solution is to open communication with insurance companies and managed care plans and have the patient sign a form that states he or she understands that the procedure may not be covered.

Some plans never cover certain services or cover certain procedures under specific plans. In either case, know what is and isn't covered by each insurance company and plan with which you participate. Further, know what services require authorization before being performed. If you believe a service may not be covered, first verify its coverage status with the insurance company or plan. Then ask the patient to sign an agreement to make payment in full before you provide the service.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.