Office Management of Insurance In today’s world, insurance is big, big business, and insurance coverage is no longer an inalienable right if premiums are paid. Coverage depends on what is stated in the fine print of the individual’s policy. Medical necessity is in the eye of the beholder (i.e., the third-party payer) and ... Article
Article  |   September 01, 2003
Office Management of Insurance
Author Affiliations & Notes
  • Sharon K. Collins
    Cincinnati Center for Improved Communication, Cincinnati, OH
Article Information
Fluency Disorders / Practice Management / Professional Issues & Training / Articles
Article   |   September 01, 2003
Office Management of Insurance
SIG 4 Perspectives on Fluency and Fluency Disorders, September 2003, Vol. 13, 19-20. doi:10.1044/ffd13.1.19
SIG 4 Perspectives on Fluency and Fluency Disorders, September 2003, Vol. 13, 19-20. doi:10.1044/ffd13.1.19
In today’s world, insurance is big, big business, and insurance coverage is no longer an inalienable right if premiums are paid. Coverage depends on what is stated in the fine print of the individual’s policy. Medical necessity is in the eye of the beholder (i.e., the third-party payer) and must fit within the policy’s definition, no matter the actual severity of the problem. No longer can the speech-language pathology private practitioner approach patient care and third-party reimbursement by simply handing the patient an invoice to be submitted to his/her insurance company. Most patients, as well as many employers, are unaware of the limits of coverage for the policy they hold and, even after reading the document, most remain confused. Education of the consumer and the employer is needed, but such education will take time. While the education process is evolving, the private practitioner will get better results in terms of patient satisfaction, clarification of acceptable procedures to be followed, and coverage for services provided if he or she takes the matter in hand and coordinates all information concerning patient insurance coverage. The insurance companies view coverage as a contract, and so must the practitioner.
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