Strategies for increasing third-party reimbursement for nutrition counseling
| Autor: | L Dahl, I F Hunt, S Lacagnina, M Murphy, K L Bolonda |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adult
Counseling Male Gerontology medicine.medical_specialty Outpatient Clinics Hospital MEDLINE Psychological intervention California Surveys and Questionnaires Intervention (counseling) Ambulatory Care Humans Medicine Outpatient clinic Reimbursement Retrospective Studies Nutrition and Dietetics Third party business.industry Retrospective cohort study Middle Aged Family medicine Insurance Health Reimbursement Female business Dietary Services Nutrition counseling Food Science |
| Zdroj: | Journal of the American Dietetic Association. 94:390-393 |
| ISSN: | 0002-8223 |
| DOI: | 10.1016/0002-8223(94)90092-2 |
| Popis: | Objective and setting The purpose of this two-phase project was to determine whether specific interventions would affect third-party reimbursement for outpatient nutrition services at the Nutrition Clinic of the Los Robles Regional Medical Center. Design, subjects, and intervention In phase 1, the baseline reimbursement rate was determined by a questionnaire mailed to 191 clients seen in the clinic from January 1 to September 30, 1989. The survey was completed by 115 clients (60%). In phase 2, two strategies were used to increase reimbursement: instructing clients about how to file claims and providing clients with form letters of medical necessity to submit with their claims. The strategies were applied to 76 news clients from March 15 up July 31, 1991. Five weeks later, 67 of the 76 clients (88%) were interviewed by telephone. Outcome measures The primary outcome measures were submission rates and reimbursement rates. Results The results showed that in phase 1 (before intervention), 75 of the 115 client surveyed (65%) submitted claims to their insurance carriers, and 12 of the 74 clients (15%) whose claims were acted on received reimbursement. In phase 2, 47 of the 67 clients (70%) submitted claims, and 15 of the 36 clients (42%) whose claims were acted on received reimbursement. Of the 20 clients who did not submit claims, 8 did not apply because of time constraints, and 5 did not apply because of low expectations of reimbursement. Applications/conclusions Form letters of medical necessity increased the reimbursement rate, but client instruction did not increase the submission rate. Most of the clients who did not submit a claim said they did not have time to do so. Therefore, the Nutrition Clinic is attempting to submit insurance forms for the clients is attempting to submit insurance forms for the clients after clients have paid for the consultation. Other providers of outpatient nutrition counseling who follow this strategy may increase the reimbursement rate. |
| Databáze: | OpenAIRE |
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