Practitioners often ask us how others in their professions effectively use ABC codes and other coding-related resources 1) when their practices are primarily "cash pay" and rely on "out-of-pocket" payments from patients, 2) regional insurance companies do not yet rely on ABC codes for processing claims, and 3) local preferred provider organizations (PPOs) do not yet require use of ABC codes.

Business-Minded Practitioners Use ABC Codes, RVUs, Practitioner Identifiers and Legal Practice Guidelines to Manage Their Practices, Regardless of Insurance Reimbursement.

Practitioners who understand how to develop and manage profitable and customer-friendly businesses use ABC codes, relative value units (RVUs), practitioner identifiers and legal practice guidelines to better manage their time, their practice resources and their business profitability. ABC codes and RVUs give them a way to:

1. Characterize delivered care using consistent terminology
2. Establish defensible fees for the services and supplies they deliver
3. Document patient encounters and predict demand for different types of care
4. Identify the time and other practice resources needed to support that care to determine which types of care generate profits and losses
5. Address areas of care that do not result in favorable outcomes for patients or the healthcare practice
6. Negotiate contracts with PPOs and other managed care organizations

For more information on relative values associated with ABC codes, please click here.



Licensed Practitioners Use Practitioner Guides to Billable Interventions Using ABC Codes to Avoid Delivering Illegal Care or Submitting Fraudulent Claims

Practitioners risk fraud or criminal charges if they deliver care or bill patients or insurance organizations for healthcare services and supplies that are legally disallowed for their professions. Practitioner fines for fraudulent billing can be several hundred dollars per insurance code.Insurance organizations that reimburse such practitioners based on fraudulent claims face fines as high as $10,000 per coded line item. Practitioners avoid these liabilities by delivering care that is compliant with statutes, administrative regulations and case law in the states in which they practice.

Legally compliant interventions are listed in Alternative Link’s Practitioner’s Guide to Billable Interventions Using ABC Codes. More than 600 guides are available for each leading practitioner type in each of the 50 United States and the District of Columbia.

Each guide includes only those ABC codes and corresponding interventions that a particular practitioner can legally deliver and bill for in his or her state. For information about these guides, please click here. To purchase a guide, please click here.



Well-Organized Practitioners Use Superbills for Integrative Healthcare for Record Keeping and Billing

Healthcare practices benefit from good documentation and billing procedures. For this reason, many integrative healthcare practitioners use Superbills or encounter forms as an efficient means to document and bill for care. Alternative Link’s Superbills for Integrative Healthcare provide complete, accurate and precise documentation of patient visits to save practitioners time and money. Each Superbill reflects the specific kinds of care delivered in a particular practice and includes corresponding ABC, CPT, HCPCS II and ICD codes, as well as relevant RVUs. Each Superbill also reflects the practitioner’s legal scope of practice and supports the kind of detailed record keeping that is expected by today’s cost and quality conscious consumers and health plans. For more information about Superbills for Integrative Healthcare, please click here. To purchase a Superbill, contact Betty Haley at Betty.Haley@ABCcodes.com or call 505-875-0001 Ext: 224.