cash based pt, insurance, claims form lauren baker cash based pt, insurance, claims form lauren baker

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...

transcription coming soon

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DISCLAIMERS: The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. By watching this video you release Dr. Lauren Baker, PT, DPT, ATC, MTC and all related parties from any and all liability. *As an Amazon Associate I earn from qualifying purchases. The links listed above are 99% affiliate links (amazon or other programs), which means I earn from qualifying purchases at no extra cost to you.

Music from intro courtesy of: Campfire by Scandinavianz https://soundcloud.com/scandinavianz Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: https://bit.ly/_campfire Music promoted by Audio Library https://youtu.be/9Rfykh-YzCc

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