Ultimate Guide to Mental Health Billing

Simplify your ABA service’s billing process and enhance the practice’s financial efficiency with our comprehensive solution. Moreover, insurance providers typically require thorough documentation to support claims for reimbursement. Without adequate documentation, claims may be denied, leading to financial setbacks for the practice.

Patient Copay

• Mental health billing is subject to a robust legal and regulatory framework.
• If you asked the USPS, they would tell you that first-class mail is one of the most secure ways to send anything sensitive.
• Throughout this article, you will learn the right mental health billing tips and guidelines.
• Some limit the number of sessions per year, require prior authorization, or exclude specific providers or diagnoses from coverage.
• This is one reason why provider productivity can be so critical; they not only bring in revenue but help cover the cost of the staff needed to support them.
• Timely claim submission improves cash flow and reduces the risk of timely filing denials.

Mental health practices can leverage the technology to carry out the VOB process. Even though there are limitations to these options, this might save up a lot of time for the medical staff. Valant software simplifies your revenue cycle and helps you recover overdue payments sooner. Our fully integrated system trims unnecessary steps from the process, with auto-generation for claims and tracking/reporting on aging bills. You can ensure your claim is not denied at the clearinghouse by calling the insurance company and asking if they have the claim on file. Once claims are verified as received, it’s time to hurry up and wait until payment.

Benefits of Outsourcing Mental Health Billing Services

You can run a verification of benefits (VOB) to see if your patient is covered. You will have a greater understanding of your patient’s insurance program after this process enabling you to treat and serve them appropriately. A group of patients is chosen to get interactive treatment in an effort to alter behavioral patterns. If you can bill patients for their portion of expenses online, you’re more likely to collect payment. You need a patient portal that notifies patients when an outstanding balance accrues and allows them https://opciones.com.ar/current-kansas-city-job-openings-bookkeeping-all/ to pay online.

• Some involve coverage issues, others are easy fixes, like outdated or missing information.
• Detoxification, outpatient SUD counseling, and dual diagnosis treatment are often covered as part of behavioral health benefits, although authorization requirements and limitations may vary.
• Experience the most intuitive, clinically robust EHR designed for behavioral health professionals—built to streamline documentation, improve compliance, and enhance patient care.
• Now it’s time to check eligibility and benefits to ensure they have coverage that will reimburse you.
• If you have tons of time and need to save money, use an EHR system without a billing team and submit and follow up with claims on your own.

Explanation of Benefits (EOB)

There’s plenty to know about this cycle, but for now, here’s an overview of the basic steps. We cannot and will not advice you to use a single diagnosis code, even though it is a very common practice for therapists to use one code for all of their patients (e.g. anxiety or depression). You can fill out the UB-04 electronically or on paper, and several software programs have a current version of the form and instructions on how to complete it. It’s always best to check benefits before the first session and re-validate at the start of the year when coverage renews or if your client’s insurance changes. While mental health billing isn’t easy, it can certainly be achieved with the right strategy and skill set.

Sometimes the patient’s plan simply doesn’t cover a particular treatment and there’s little you can do. For example, mental health services often use different coding systems, such as ICD-10 codes for mental health disorders, which are distinct from those used for physical ailments. It’s likely that the bulk of the solution provider’s clients are doctor’s offices. A telltale sign that mental health billing for dummies who you’re evaluating isn’t a leading mental health clearinghouse is if they don’t have experience integrating with the EHR your organization’s using. You see, MCOs are usually still large insurance payers, making it hard to get through to them regarding a specific claim from one of your clients. So, your clearinghouse should have direct contacts to reach out to on your behalf regarding any issues with your claims.

Ensure that the patient information is true. Double check!

• Be exhaustive with comparing what information you have on file and what they need.
• Additionally, the reimbursement rates for mental health services can be lower or more variable compared to other medical services, creating financial uncertainty.
• Nevertheless, behavioral health practices across the nation manage to learn best billing practices and keep the revenue cycle churning, and you can, too.
• Gather if they have a copayment to make per session, or a deductible and coinsurance that you will need to bill them for after their sessions are billed to completion.
• Larger practices will need to carefully consider their budget and the number of full and part-time staff they can afford to hire based on their provider numbers.
• Go back to your EHR, online portal, or paper claims and refile these claims.

Choose service and diagnosis codes that reflect what actually occurred during the session. For example, if you provide a 60-minute individual therapy session, use CPT code 90837, and ensure your documentation supports both the time and clinical complexity. Before the first appointment, confirm the client’s mental health coverage, copays, session limits, deductible status, and preauthorization requirements. This prevents surprises and ensures you’re billing within the scope of the client’s benefits. While telehealth is widely accepted, billing rules for virtual sessions still vary by payer.

Eligibility

Or hire a billing service, submit your weekly appointments in 10 minutes, and focus on your private practice. If you have tons of time and need to save money, use an EHR system without a billing team and submit and follow up with claims on your own. Refile claims that have been received and rejected, you normally have a longer time to refile claims as corrected. Perhaps you submitted online, check your portal to see if claims are accounted for in your account. You’ll want to do this for each date of service (DOS) that you have submitted to ensure they are processing.

Therapists and counselors often need to use specific codes for each diagnosis and treatment, which can vary widely and change frequently. Additionally, the reimbursement rates for mental health services can be lower or more variable compared to other medical services, creating financial uncertainty. You have all QuickBooks the necessary patient and session information to file claims. Now it’s time to check eligibility and benefits to ensure they have coverage that will reimburse you. Thus, understanding the billing process’ complexities and finding ways to solve them can speed up the billing process and help you get paid faster for providing behavioral health services.