Episode 9: Billing & Credentialing in Private Practice (with Jeremy Zug)

Billing is the most important financial function in a practice. If there’s no money coming in, then you really don’t have a business. Today’s guest is Jeremy Zug, owner of Practice Solutions, LLC, a billing and credentialing firm for mental health private practices. He talks about when it is a good time to DIY, outsource, or bring in-house billing and credentialing. Episode Highlights: Practice Solutions: Started small and has grown significantly in mental health space TherapyNotes: Electronic Health Record (EHR) experts effectively impact billing Biggest billing mistakes: Incomplete progress notes mean claims don't go out or get paid Adding too many insurance companies/payors at a time Start with one insurance company, then add more over time Consider clinical objectives Research reimbursement rates for profitability and sustainability Determine ease of use working with an insurance company In- or Out-of-Network Insurance? Structure caseload that makes financial sense Discipline Processes: Go from good to great to meet expectations and avoid mistakes Benefit Checks: Call insurance company to determine eligibility and collect from clients Credentialing Methodology: Plan Gather Information Submit and track application Finalize contract and initial billing Solo and Group Practice Credentialing: Differences between EIN, NPI, and AIN models QuickBooks vs. EHR: Where to put financial and patient details for HIPAA compliance Accounts Receivable (AR): Cash or accrual basis for insurance write-offs and deductions Problems/Solutions: Call insurance company to understand claim denial or non-payment Links and Resources: Practice Solutions, LLC Practice Solutions Blog: Your Private Practice Credentialing Process TherapyNotes Good to Great by Jim Collins Chris Hogan Affordable Care Act (ACA) Employer Identification Number (EIN) National Provider Identifier (NPI) Alternate Identification Number (AIN) QuickBooks HIPAA Privacy Grit by Angela Duckworth GreenOak Accounting Therapy For Your Money Podcast