Office Hours with Angelique and Toby
Office Hours episode 28: The Dao of Medical Insurance Billing with Eoin Gregory
Insurance billing can be one of the most frustrating and financially consequential aspects of running an acupuncture practice. In this episode of Office Hours, Dr. Eoin Gregory of Family Billing Solutions explains what practitioners need to know before they sign an insurance contract, submit a claim, or hand their billing over to someone else. Eoin draws on his background as a retired chiropractor and former educator to explain when to bill yourself, when to hire help, and how to avoid the documentation and compliance mistakes that can trigger denials, recoupments, or audits. We discuss what providers should look for in insurance contracts, why medical necessity matters so much, and how to protect both your practice and your patients when dealing with payers. Key topics Dr. Eoin Gregory shares why he moved from clinical practice and teaching into medical billing after an injury ended his chiropractic career. He explains why new solo practitioners should often bill themselves first, at least long enough to understand coding, documentation, and the real workload involved. Eoin breaks down why submitting a claim is the easy part, while appeals, benefit checks, follow-up calls, and payer inconsistencies create most of the burden. He warns providers to be careful with advice from other clinicians, especially when it comes to noncompliant or potentially fraudulent billing strategies. The conversation covers how to read payer participation agreements, fee schedules, reimbursement caps, and payment policies before signing anything. Eoin stresses that providers should understand whether a plan is regulated by the state or by ERISA, since that changes who can help when problems arise. He outlines what to look for in a billing company: transparency, acupuncture-specific experience, availability, manpower, and clear pricing. The episode highlights why every claim matters for small practices, especially when insurers misstate benefits or recoup money later. Eoin explains medical necessity in practical terms and why treatment plans, re-exams, and functional goals help support coverage. He cautions against using mental health diagnoses casually, noting that inaccurate diagnoses can follow patients for years and affect future coverage. The discussion closes on the importance of educating providers and patients about what insurance actually covers versus what a practice can ethically provide. Link https://www.familybilling.com/
