Out of Network Providers: Help Your Clients Get Reimbursed — With No Effort on Your Part!
(By Barbara Griswold, LMFT September 10, 2019)
It is likely that you have clients whose insurance you don’t accept, either because you’ve chosen not to accept insurance, or you haven’t signed a contract with that plan. While being a “out of network” (OON) provider is nice for the therapist, clients may drop out of treatment as therapy expenses mount.
The good news is that clients with a PPO or POS plan can typically get some reimbursement when they see Out of Network (OON) providers. The bad news is that historically this hasn’t been easy. Clients may not know they have this benefit, or how to submit a claim. They would need to take your invoice, find and fill out a form from their plan to attach, research where to submit it, and handle claim problems. And depressed or overwhelmed clients may never submit them.
What could be Better? Because of this, providers were thrilled to learn about Better.com (www.getbetter.co), which helped clients submit OON claims dealt directly with plans when there was a problem. But Better charged 10% of the reimbursement and went out of business as of August 15, 2019. 1 (getBetter.co website)
Enter Reimbursify. I was recently introduced to Reimbursify, a mobile app which launched in 2018. Free to download, this app allows clients to submit out-of-network claims to any insurance plan from their mobile devices in moments. “We are now the only app out there providing this service,” said Vatsal G. Thakkar, M.D., Reimbursify Cofounder, in a phone interview. “This app came out of my own practice experience. I didn’t take insurance, and when it came to reimbursement I’d tell clients, ‘that’s between you and your insurance plan.’ But this didn’t feel right — they were paying in full out of pocket and were confused by insurance. So I began filing invoices for them. While this actually attracted new clients who saw on my website that I would handle claims for them, this was a lot of extra work for me. So, I developed a client-centered app.”
How does it work? Clients pay you, then according toDr. Thakkar, “simply hand your clients a Reimbursify information card with their superbill and say ‘you can download this app and file a claim for reimbursement with your phone in about a minute.” Clients only need to answer a few questions, take a picture of the invoice, and click to submit the claim. Clients no longer have to fill out, copy, print, fax, or mail forms to their plan. The client will receive notifications when the claim is received by the plan. Reimbursify allows group or individual providers to register themselves without charge so that the client can simply select them without having to enter the provider’s demographics, NPI or tax ID.
Improves claim acceptance rates: Dr Thakkar states “incorrect diagnosis or CPT codes would be caught by the app. Since clients enter data, legibility issues aren’t a problem.”
What if a claim is rejected? Reimbursify has a customer care team. They may ask for a copy of the denial EOB and may even reach out to plan, if needed.
Other features include
- A Smart Dashboard to manage claims, enter new claims, and track pending reimbursements.
- Notifications to help the client stay updated on the status of reimbursement
- HIPAA-Compliant: Reimbursify states it “exceeds all HIPAA security guidelines” and will “never share protected health information except as needed to process claims.”
How much does it cost? There are three payment options (keep in mind one claim = one session date):
- Any client can use the app, even if the therapist is not registered. The client gets one free claim then pays $1.99 per claim (or a 10 pack for $14.99)
- If you register your practice, you’ll receive Reimbursify info cards to give to clients, including a promo code for their first five claims free. After that, clients pays $1.99 per claim (or a 10 pack for $14.99).
- Provider Pro: Pay a monthly fee, and all your clients can file for free up to 200 claims a month. Right now, the promo rate is $79.99 per month (down from $99.99/month) for solo providers. Groups are $79.99 for the first practitioner and $59.99 for each additional provider.
What’s coming?Dr. Thakkar states they are working growing the app in some exciting ways, such as helping to check coverage, estimating reimbursements, and a provider version of the app.
Conclusion: These folks seem to have found a way to help clients in a very meaningful way that doesn’t mean more work for therapists. The concept seems a terrific win-win to me. Helping clients get reimbursed for treatment can entice new clients to choose you, and can mean current clients can afford to stay longer. Check out Reimbursify at http://reimbursify.com (or here to register your practice for free: Practitioner Registration.
Disclaimer: Not a recommendation, as I have not used this service.