Insurance Write offs vs lowering rate for insurance?

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Stephanie Dalsheim

• November 01, 2022 19:43

 

Hi Community! I am new to billing with insurance and apologies if this is an obvious question. When I have a client utilizing insurance that I am paneled with, am I accurate in thinking I change the session fee to match what the insurance company codes as what they cover? For instance, if an insurance covers 120 but my private rate is 150, do I set the rate at 120 to avoid balance billing? I have also heard about the idea of keeping the rate the same and utilizing as an insurance write off, but am coming up short as I try to figure out what that means. Thank you for collective guidance!

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  Beverly Ward

  • November 17, 2022 17:33

  I would love information on this as well.   What exactly is an insurance write off?  I don't think we can write off the difference between the insurance companies payment to us and our hourly rate.  Are we talking about a tax write off?  Uncollectable debt would not fit this scenario. Is it a business loss?  Confused here, can anyone help me understand?

  I am also not sure about determining the billed amount.   If my stated rate for a 60 minute session (53 clinical minutes) is $150 and the client pays a $25 copayment, then I should ethically only bill $125, correct?  Otherwise I am billing more than my stated rate.  But, I am told by a colleague with insurance billing experience that, regardless of what I bill, the insurance company will pay the allowed amount for that service (based on IPC code) whether it is more than or less than what I have billed.   Again, I am confused and would appreciate any wisdom.

  Finally, could SimplePractice please make the forum easier to access?  Maybe an icon on our dashboard?  It is hard to find and hard to get to.  It is an awesome idea and could be a great support to your clients, but we need to know it is here and be able to get to it easily.

  Blessings to all!

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  Nicole Walsh

  • January 29, 2023 23:48

  Agreed. I am confused as well. Can someone answer this? 

  Thanks!

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