Direct billing insurance and reimbursement for dietitians: Pros & ConsApr 23, 2021
If you run a private practice, you may have asked yourself whether or not you should set up direct billing (also commonly referred to as "accepting insurance").
What is direct billing? Direct billing means that you are listed as a provider with insurance companies, so clients don't have to pay out of pocket for your services. You bill the service directly to the insurance provider, instead of the client. Then, the insurance provider reimburses you for the service.
So should you set up direct billing for your private practice?
Let's review some of the pros and cons...
Pros & Cons of Direct Billing
- You are listed as a provider through insurance companies, so consequently, you have visibility to all of the people that would be looking for an RD through their provider. So it's almost like free marketing for your business (however, the "price" you pay is accepting lower rates).
- It's clearly more accessible for clients who can't afford to pay out of pocket for your services. If you're working with a population group who may not be able to afford to pay out of pocket, this is a great way to ensure that they are able to receive care.
- Setting up direct billing insurance and reimbursement can be a great way to get recurring clients through the door, especially if you are just starting out in your practice. This is one of the biggest challenges when you're first starting your business since you haven't established yourself in the community yet and haven't had the opportunity to benefit from client referrals. Clients referring their friends and family to you is one of the MOST effective marketing tactics.
- Let's face it, it's time consuming to set up and can be tedious to manage for each client. The process for getting credentialed with some insurance providers in the US can take up to 6 months.
- Note: some EMR (also referred to as EHR platforms or Practice Management) platforms have direct billing integrated into their platforms to speed up the process, like Jane.app and Healthie. Check out our blog post on this topic here.
- The rates you are paid will be lower than cash paying clients, as you have to negotiate a rate with the insurance company.
- There is a time delay between seeing the patient and getting reimbursed by the insurance provider, so you don't get paid as quickly as when you are working with cash-paying clients.
So, how do I know if direct billing is right for me?
Direct billing might be right for you and your practice if:
- You are a dietitian who is just getting started in your practice and you're looking to get consistent, recurring clients. As mentioned above, this is the most challenging part about being a new practitioner and establishing yourself in your community takes time. If you're looking to start bringing money in quickly, this might be a good option for you. You can always transition out of direct billing once you build up your online presence and start attracting cash paying clients from your website or social media platforms.
- If your target audience is likely to choose practitioners who offer direct billing and may not be able to afford out-of-pocket, then this might be something you want to implement.
However, even if you do offer direct billing, it's imperative that you continue to put consistent time and effort into marketing your practice to attract cash paying clients in the long run.
Need help setting up direct billing?
With our Basic + Business membership, we offer step-by-step instructions for how to set up direct billing insurance and reimbursement for Canadian and US dietitians. Plus, we have courses, community and live trainings to help you start and grow your practice!
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