How To Fill Out A Claims Form For Out of Network Reimbursement
This tutorial explains how to submit for reimbursement when receiving cash based pediatric physical therapy services from an out of network provider using a humana claims form as an example.
Your provider may have different information so please refer to your specific form (superbill) for the values you need for your own reimbursement. Not all insurance plans have out of network benefits so please consult your specific insurance prior to receiving any out of network care.
This post contains affiliate links, please see my disclaimer for more information.
Lauren is the owner of Dr. Lauren Baker In Home Pediatric Physical Therapy and provides paid 60-minute online parent consultations for individuals with additional questions internationally. For scheduling please click here.
This video will teach you:
How to fill out an out of network claims form generally
How to fill out an out of network claims form for pediatric physical therapy services
What each section of a claims form means and where to put each code
What a superbill looks like and what each part means
Tips to help you receive your out of network reimbursement quicker and easier
find what you’re looking for
0:45 example superbill and explanation of parts of the form
2:21 medical vs rehab (PT) diagnosis ICD-10 codes
3:16 evaluation codes for physical therapy
3:39 place of service code explanations 11 (clinic) vs 12 (home based)
4:22 CPT code / service codes
5:12 treatment code / service code / CPT code examples for physical therapy
5:40 GP modifier on CPT codes
6:14 multiple code examples
6:52 differences in reimbursement per code
7:32 make payments to section of superbly
7:55 fill out claims form with me Humana claims form example
9:55 fill out the PT section (CPT codes, service description, POS, date of service, etc)
10:18 further explanation difference between POS 11 and 12 (clinic / home)
10:55 CPT code / service description
11:34 multiple codes per date of service example
12:24 provider information
13:44 do not miss adding this specific piece of info for provider section
15:44 tips on being organized to make sure you get payment from insurance company
LINKS IN VIDEO:
Simple Practice which autogenerates my super bills (for therapists) - https://www.simplepractice.com/?p=b2f...
Link to Humana claims form - https://docushare-web.apps.cf.humana....
Get a gorgeous NC landscape print like the one behind me - https://rachelcarterimages.com/buy-pr...
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