As Audiology transitions to a doctoring profession, one point has never been more clear: the success (or failure) of an audiology practice will depend largely on the audiologist's awareness and understanding of billing, coding, reimbursement and compliance.

There is a difference between coverage and reimbursement. Coverage, in health care, is when a third-party is paying, in whole or in part, for the items and services provided. Coverage is a part of reimbursement. Reimbursement is when the audiologist or practice receives payment for services rendered. Sometimes that payment comes in the form of coverage from a third-party payer. While others times the payment comes directly from the patient themselves. As a result, not all reimbursement does or should come from a third-party payer.

Reimbursement is what brings revenue to a business, pays the operating expenses and pays for salaries. Even a busy practice employing state-of-the-art methods and products will suffer if it maintains antiquated office management and billing systems. A strong grasp of reimbursement issues and application of modern office management processes is necessary to run a profitable business. But profit is not the only benefit; a well-managed business creates a lasting impression of professionalism.

Health insurance is an integral component of American life; therefore, it is incumbent upon Audiologists to be active, knowledgeable and savvy participants in the managed care arena if they want to be part of a viable, autonomous health profession.

This reimbursement section is designed to offer tools and resources to help busy practitioners stay on top of this ever-evolving reimbursement arena.

Additional Highlights

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