2025 - Group Reimbursement Coaching Program : Paid in full option

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: CPT CODES, ICD CODES & PREVENTATIVE 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. Define the application of the Affordable Care Act (ACA) for dietitians
5. Interpret preventative coding in the setting of the ACA

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. Identify the information needed to collect from the patient at the initial visit to successfully bill insurance
5. Determine which insurance companies typically require a referral for MNT

MODULE 5: INSURANCE BILLING BASICS 

1. Identify what you can bill insurance for
2. Identify what you can bill the patient for 
3. Summarize the typical fees collected at an insurance-based patient visit 

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 for where you can submit insurance claims 
2. Identify the major EMRs designed for RDs
3. Successfully set up an account in Office Ally 
4. Submit claims using Office Ally 
5. Understand how to successfully determine the next steps for insurance claim rejections 

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 business 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 my program, you will receive resources on telehealth, basic info on licensure, basic info on taxes & what is expected from a documentation standpoint.