New Client Needs Help With Fee Schedule

by Tracy
(New Jersey)

I recently obtained my first client. I am new at this so I need all the help I can get. The APN is just starting out and does not know anything about billing (how much to charge for services). How do I get access to the fee schedules, benefits and eligibility from the insurance companies. I your assistance will be greatly appreciated.

Response:

Each insurance company has their own fee schedule for what they pay a provider depending on their contract. There are so many and they change so routinely that any links to the major insurance payers would soon be out of date.

You typically have to get it from their website which usually involves creating a provider account. If your provider already has a contract with them, they may already have an account.

Medicare posts their fee schedule on their website (cms.gov). Just go to their website and search for "physician fee schedule" to get the latest. They also have a fee schedule look up tool.

Hope this helps - Thanks!