Billing & Coding:HMO and PPO Insurance

Welcome to your billing and coding weekly solutions by H.J. Ross Company where getting your bills paid is what we do best!

Are you looking for ways to diversify your income and expand your cash flow?

Success in a chiropractic practice can be measured in many ways, and as with all business, generating income to maintain the practice is important.

There are several ways a chiropractic office can be paid and one of those avenues is becoming an ‘in-network’ provider with an HMO and/or PPO insurance plan.

Here are some things to be aware of as an in-network provider:

HMO and PPO plans offer chiropractic benefits; however, as an in-network provider you are obligated to see the patient, bill their insurance, and accept the contracted rate.

HMO and PPO plans often limit reimbursement per visit from $30 per average visit (visits with exams and X-rays would be higher) and up to $60.

As an in-network provider you cannot bill the patient beyond their set allowance.

Many PPO plans contract with several payers and will allow you to pick and choose the plan you wish to participate in.

Remember, billing with incorrect chiropractic CPT codes can lead to claim rejections and delays in payments, which can have a devastating impact on generating revenue and keeping you in business. 

If you are experiencing insurance claim denial, staff spending too much time trying to get claims paid, and patients asking why their claims have not been paid then H. J. Ross Company is your solution.

H.J Ross Company stays ahead of the curve on the latest trends and changes in billing and coding by utilizing their direct channel of communication with the insurance companies and organizations that set the guidelines.

There is a reason chiropractors have trusted H.J. Ross Company with their business for over 40 years.