Let's Talk DPP

Medicare Diabetes Prevention Program

July 2022

Many of you may not be aware of the Medicare Diabetes Prevention Program (DPP). This program was created to reduce the cost ($104 Billion as of 2019) Medicare spends each year for diabetes care. Medicare is seeking the public, facilities, employers and community organizations to become a Diabetes Prevention Coach. To learn more about Medicare Proposed Policies for 2022 click the link below. .

How to Get Started with Reimbursement in 2022

Medical Billing for Doulas

August 2022

Many Doulas need help with Billing Process. The Billing Process is important because learning this will help you Get paid from health insurance carriers. Doulas who learn the billing process will learn the Billing Codes for their services to receives reimbursement from health insurance carriers.

In this post Doulas will learn the medical billing process.

Reimbursement Process - continue

Billing Process will help you . Each insurance carrier have different billing rules. Doulas who haven't done this will receive NON-PAYMENT for services.

Here's how you can get started:

  • Verifying patient eligibility, to ensure you get paid for each date of service.

  • Some states require patients to receive a referral from their health care provider ( MD, Midwife, Nurse Practitioner) for your Doula services. Please be sure to have this documentation in patient chart.

  • Place of service ( a big one you must know). Where the services rendered (patient home, office, doctor's office)?

Required for Reimbursement I've seen Doulas run into Denied Claims when they haven't done this:

We know the challenges Doulas may encounter during the billing process, so of course we cover coding in our Medical Billing for Doulas Training. You must have a CPT and Diagnosis ( ICD-10) code for each date of service you are seeking to receive reimbursement for. You can never bill one without the other. It's important to know the exact service codes for services rendered. If not, your claim will be denied and will be required to resubmit your claim(s). Claim resubmission may take up to 45 days. Clean claims are always best to avoid this process. Now do you want to delay your cash flow?

Forgetting Documentation Requirements can Return Revenue

In conjunction with ensuring you have the correct service codes, you must have documention to support your code selection. Documentation is very important and is key to receiving reimbursement for your services. You may receive an audit at any time from any health insurance carrier. No documentation, you will be responsible to return the monies back to payers. In our Medical Billing training for Doulas we teach you how NOT to do just that. Now who wants to return money! No one.

Performing the billing process, requirements for reimbursement, and documentation requirements will help you receive reimbursement from health insurance carriers and learn the medical billing process. P&C provides a Medical Billing for Doula training to educate Doulas the billing process and the tools, to ensure you receive reimbursement for each date of service. Click below to join our email list and receive a free copy of the 5 billing tools for medical billing.

Doula Workforce

Doulas do what makes you Happy!

August 2022

Doula services are in demand, the opportunity is now!

Doula Agency vs. Open a Doula Practice

Doula Workforce- continued

The Great Resignation

We are living in the world of the GREAT RESIGNATION. With that being said, doula care is on the rise which indicates the market needs your services. Employers are seeking to fill vacant positions. Most employers are offering incentives or a sign on bonus. Many of the perks are enticing, it's important to select which one will bring you happiness and enjoying what you do. Doulas in the workforce whether you work for an employer or open your own Doula practice, it's best to know the medical billing process for services rendered. P&C provides medical billing trainings to Doulas just for that reason.

Employee or Practice Owner

As a practice owner you must cover your expenses, pay yourself, and/ or pay staff. One way to maintain a steady cash flow is seek multiple revenue streams of income. This can be having additional certification(s) such as Becoming a Diabetes Prevention Coach ( another medical billing training we provide). You can address gestional diabetes or pre- diabetic with those individuals who have that have been diagnosed. Or hiring staff with specific credentials that is aligned with your service. This can be a Licensed Master Social Worker for postpartum depression services. Both services allows you to receive reimbursement from health insurance carriers. It's important to have a steady cash flow to ensure you can cover your expenses, staff and paying yourself. We are all familiar of how it works being an employee for an employer.

Decision Time

In making your decision weigh your options. Create a PROs vs CONs spreadsheet for both options. What are the pros of working for yourself? Identify what will it take to operate a practice. Do your research, and don't forget to jot down the cons. What are the pros of working for an employer as a Doula? No overhead expenses, just focus on patient care. Don't forget to jot down the cons of working for an employer. And again it's important to know which option will make you happy. Pursuit of happiness.

The Doula Workforce is needed, whether you decide to work for an Doula Agency or Open a Doula Practice your services is wanted. We believe all Doulas should know and understand the medical billing process, whether you are an employee or employer. This is why we provide a Medical Billing Training for Doulas. We are a resource to Doulas for the medical billing process.

As a Medical Coding and Billing entity, we provide Medical Billing for Doulas training and how to Become a Diabetes Prevention Coach ( billing component). Join our emailing list to be in the know of our upcoming training. Click below to join our email list and receive a free copy of the 5 must have Medical Billing tools.

It's Open Enrollment Time

Health & Benefits Money Mindset

September 2022

We partnered with Brittany Charles Mrs. Fiscally Responsible a Financial Coach, she has over 12 years experience in Human Resources. We decided to team up to share our expertise about health insurance plans. At this time we all are dealing with inflation and from the looks of things, we can be heading into a RECESSION.

This is the perfect time to have a MONEY MINDSET about your health care and how to save money utilizing your health insurance benefits. Here's the list of topics we will be covering.

It's Open Enrollment Time- continued

  • Total Compensation - Benefits Decision

  • FSA / HRA / HSA

  • Planning for a Newborn (dependent)

  • Turning 26

  • Preventive Services

  • Abortions/ Vasectomies

  • Price Transparency

  • Wellness Programs

  • Health Insurance Terminology

We are aware many consumers have questions, that does not always get answered by HR (human resources).

Here's what we need from you, your question(s), click here to complete the form. Your questions will be answered within the tips or insight shared. Be sure to follow us @mrs.fiscallyresponsible & on Instagram & Facebook. Thanks in advance for participating.