MODULE 1: PRE-CREDENTIALING

1. Identify the importance of an NPI Type 1 & NPI Type 2
2. Determine how to obtain an NPI Type 1 & NPI Type 2
3. Identify the importance of Malpractice Insurance & purchase the one that best suits the needs of your practice
4. Successfully complete the CAQH application

MODULE 2: CREDENTIALING

1. Determine which insurance companies to apply to become credentialed with based on your state
2. Understand the importance of building your insurance provider number ‘database’
3. Apply for credentialing
4. Evaluate an insurance contract & fee schedule

MODULE 3: BILLING AND CODING 

1. Determine which CPT codes dietitians can bill insurance with to maximize their reimbursement rates
2. Identify the ICD 10 Codes dietitians can use to maximize both their patient’s MNT benefits and their reimbursement rates
3. Define the necessary modifiers to be used on claims to ensure they get paid promptly
4. Explain Z codes and identify the common Z codes RDs bill with
5. Define the application of the Affordable Care Act (ACA) for dietitians
6. Interpret preventative coding in the setting of the ACA
7. Summarize the preventative policies for all the major insurance companies 
8. Explain the 8-minute rule for billing insurance 
9. Define exactly how each insurance company requires telehealth claims to be billed 

New module 2022: What to do while you are waiting to get credentialed 

While you are waiting (60-90 days) to get your contracts I created a series of actionable steps and activities you can be doing in your practice. This way you are utilizing this time to properly set up your practice and establish a rock-solid foundation. This module includes information about: 

• Superbills
• HSA/FSAs
• Setting your cash rates 
• Selling programs/packages and a la carte services 
• Marketing your insurance-based practice 
• Setting up automations for making your practice as efficient AF
• Licensure 101 for RDs
• Suggestions for personal growth 

MODULE 4: VERIFYING PATIENT MNT BENEFITS

1. Define the importance of verification of a patient’s MNT benefits
2. Identify the information needed to verify a patient’s MNT benefits
3. Summarize how to document a patient’s MNT benefits
4. Define medical necessity 
5. Identify the information needed to collect from the patient at the initial visit to successfully bill insurance
6. Determine which insurance companies typically require a referral for MNT

MODULE 5: INSURANCE BILLING BASICS 

1. Identify what services you can bill insurance for
2. Identify what services you can bill the patient for 
3. Summarize the typical fees collected at an insurance-based patient visit 
4. Define balance billing 
5. Describe prompt pay rates 
6. Define the term usual and customary insurance rates 
7. Define the term balance billing 
8. Describe scenarios when a co-pay, deductible, or co-insurance may be applicable for your patients 

MODULE 6: THE CMS 1500 FORM 

1. Identify the important areas on a CMS 1500 form 
2. Successfully electronically fill out a CMS 1500 form 

MODULE 7: SUBMITTING INSURANCE CLAIMS 

1. Identify the 3 different places where you can submit insurance claims 
2. Identify the major EMRs designed for RDs
3. Describe the benefits of signing up for an Availity account if your state participates 
4. Successfully set up an account in Office Ally [if you choose not to use an EMR]
5. Submit claims using Office Ally [if you choose not to use an EMR]
6. Understand how to successfully determine the next steps for insurance claim rejections [if you choose not to use an EMR]

MODULE 8: HOW TO SET UP, BILL & CORRECT REJECTIONS IN SIMPLE PRACTICE 

1. Determine how to set up the back-end of Simple Practice 
2. Identify the 3 main reasons why Simple Practice is a good choice for insurance-based practices
3. Understand how to correct rejected claims in Simple Practice 

MODULE 9: HOW TO READ AN EXPLANATION OF PAYMENT (EOP)

1. Define the importance of an EOP
2. Identify the critical components of an EOP
3. Determine where/how to locate an EOP
4. Recognize what to do with an EOP once you have read it
5. Determine how to set up electronic payments with each of the major insurance companies 

MODULE 10: HOW TO MAXIMIZE YOUR PATIENT’S INSURANCE BENEFITS – GROUP COUNSELING, CORPORATE WELLNESS & REFERRAL NETWORKS

1. Explain how to utilize group counseling in your practice to maximize your reimbursement rates using a health-insurance based model
2. Identify how to develop key alliances with local businesses to administer corporate wellness programs using a health-insurance based model
3. Build strong alliances with local doctors who treat your target patient population

MODULE 11: Medicare Basics

1. Identify who qualifies for Medicare
2. Identify what RDs can bill Medicare for
3. Summarize the 3 different Medicare enrollment applications 
4. Recognize the 6 unique billing factors of Medicare 

MODULE 12:   DOCUMENTATION OF AN INSURANCE CLAIM

1. Identify the key criteria required for insurance-based documentation 
2. Identify the critical mistakes not to make when documenting in your insurance-based practice 

IN ADDITION TO THIS TRAINING, YOU WILL RECEIVE THE FOLLOWING:

• 3-4 live calls per month, offered in an office-hours format 
• Plus, you will receive immediate direct access to my Reimbursement Starter Pack with every possible form you may need for your practice
• Full access to my standalone Medicare course 
• Additionally, you will receive resources on telehealth, licensure, basic info on taxes & what is expected from a documentation standpoint. 
• Access to important reimbursement resources like referral forms, verification forms, and scripts that save you tons of time & money
• Peer networking and ah-mazing support within our Private Facebook Reimbursement Group Coaching Community for the duration of your 6-month program
• Killer advise and guidance on common reimbursement topics  in our Facebook Community
• Access to the training platform for 6 months after the end date of your group