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Update on Insurance Statuses and Non Mandatory Reporting

Healthcare Insurance Update: What’s up?

As of February 1, 2021, I will no longer be registered with any insurer that does not accept patient reimbursement requests or otherwise mandates electronic billing in order to provide coverage.

If you wish to submit a request for reimbursement to your insurer, I’m more than happy to supply extra copies of your payment invoice if required. These are normally sent out the day of your session.

If your company does not reimburse you in full, I will not downwardly adjust my fee.

Why?

Several key insurers have decided to cap their fees based on a national assessment – meaning a £30 cap for a 30 minute session.  My sesssions are longer than that, and insurers would refuse to pay for that time. (Have you been to places where cash payers get longer sessions? This is why). This fee also represents half a session, which is unsustainable as I do not operate on a high volume 30 minute list.  I operate a high touch, high service practice, which is not supported by the insurance restrictions.

On top of this, many insurers are mandating the use of third party billing software in order to see their patients under their coverage. This third party software attracts a fee..

Insurers are increasingly requiring clinicians to do more in terms of reporting and submissions, which is also unbillable time.

It is not financially sustainable for me to either bill insurers or accept less than my full fee.

I understand that those who have their fee covered in full aren’t directly impacted by whatever my fee is, but it is unfair on my cash paying clients to subsidise those companies who are refusing to reimburse a fair rate for professional services.

Non Mandatory Reporting Update: What’s up?

As announced this last year, I must charge a fee for adminstrative work that is in line with what other medical professionals (including NHS GPS) charge for non-mandatory non-clinical related administrative work.

This includes insurance reports, disability letters, and the like. I cannot do them at all unless you are a recent client, in order that my reporting is accurate.  These fees will be a minimum of £30 per item ranging to £110 for more complex reporting for 2021.

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