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To further emphasize the importance of a clearinghouse partner who has relationships with MCOs, it should have connections on a county board level as well. Your clearinghouse should also keep a record of your denials and place them within work queues to kick off the appeal process. The claims that come back to you with a denied status are particularly important. Hopefully, you’re using at least an Excel spreadsheet in tandem with this process to record your results.
- Otherwise, you will be found to have coded incorrectly, leading to an audit or demands for refunds.
- We’ve helped physicians and therapists running solo operations, groups managing larger private practices, and non-profit organizations streamline their operations.
- This is a reason why mental health billing becomes complicated for providers, as it’s challenging to offer standardized treatment for all patients — making billing just as complex.
- With an extensive background as a coder, auditor, accounts receivable manager, and practice administrator, she has also served as an independent consultant to physician practices and as an assistant coding instructor.
- The list of codes that mental and behavioral healthcare providers must know is essential for billing purposes and services.
To avoid these situations, it’s a good idea to evaluate clients’ insurance coverage before each visit, if possible. By contacting insurers and making sure that clients’ coverage is still in effect and has not changed, mental health professionals can stay informed and avoid wasting time on rejected claims. This can be labor intensive, but the time it will save makes it worthwhile. If you are struggling to do each of these tasks for your insurance clients, considering hiring a mental health billing service like TheraThink to solve these problems for you. We at Practolytics process medical billing for Mental and Behavioral Healthcare including Ketamine and Esketamine (Spravato®).
How to Get on an Insurance Panel: Tips for Mental Health Professionals
For reimbursement on a claim, you have to file the correct claim code with the right insurer and submit the claim along with the correct billing format. If the insurance company has a preferred filing method, make sure you comply with it and the time frame set forth by the insurer. While validating coverage may take much time, it pays off because you can ensure your client is covered and determine how much the insurer is likely to pay. Depending on the insurance company, you can verify coverage online or by phone.
- You can run a verification of benefits (VOB) to see if your patient is covered.
- If you’ve filed a claim and had it denied because the client is no longer covered by his or her old plan, you’ll need to contact the client and get their new information.
- Make sure to submit the claim id number with all of the changes you need to make on your claims.
- To further emphasize the importance of a clearinghouse partner who has relationships with MCOs, it should have connections on a county board level as well.
- Well, in this alternative we have to call this number again and figure out the status of the claim you submitted.
- Make sure you’re filing claims to the right place, with the right information.
- This procedure code is used for diagnostic evaluation of new behavioral health concerns and or illnesses, or upon treatment of a new client.
Additionally, some independent mental healthcare providers can only diagnose the patient with a mental disorder because insurance will not cover the actual treatment. Our mental health insurance billing staff is on call Monday – Friday, 8am-6pm to ensure your claims are submitted and checked up on with immediacy. https://www.bookstime.com/ Learn how you can offload your billing headache with our mental health insurance billing service. We have offer mental health billing services exclusively for behavioral health providers. Common Procedural Technology (CPT) codes are also necessary for billing for therapists and other mental health providers.
Diagnosis Coding
There are also many systems that can check eligibility on your behalf in a more efficient manner than making phone calls. This technology could be supplied by your EHR, clearinghouse, or a different third-party. Lucky, it’s a pretty straightforward process…you just need to know where to start.
One of the best benefits of hiring BPS Billing to manage your mental healthcare practice’s back office is the way we can seamlessly integrate into your existing workflows and processes. We designed our software to complement your process and give your staff members the tools they need to do their jobs faster and better. If you want to focus on providing healthcare rather than processing claims, you can hire a billing company to handle your claims. Aside from billing and claims submission services, some outsourcing billing companies also take care of prior authorization, VOB, claim denials, and follow-ups. Psychiatric Billing’s exclusive focus on mental health-related billing ensures that its billing professionals have expert knowledge of the latest insurance rules, government regulations, and coding requirements. The company is tech-focused and allows clients round-the-clock access to information such as claim status, client balances, authorization status, and more.
Get Your Call Routed to the Right Eligibility and Benefits Line
However, if you file an incorrect code or accidentally file it to the wrong insurer, you can be denied or run into other billing issues. However, regardless of the services you provide, it’s always a good idea to check that your patient is covered for the mental health services they need. Performing a VOB can also help you determine the amount that your patient’s insurance company will pay for the services they are seeking. To do this, you can call the patient’s insurance company provider using their account number to get a better idea of their benefits. Both medical and mental health billing require the use of ICD-10 (International Classification of Diseases, 10th update) and CPT (Current Procedural Terminology) codes.
You see, some clearinghouses (like ours) can automatically accomplish multiple claim submission process alternatives exactly for this unique scenario. When these payers present themselves, it’s not the end of the world but it does present a process change. If your organization uses the “more ideal” claim submission process that I detailed above, these payers throw a wrench into things. If you asked the USPS, they would tell you that first-class mail is one of the most secure ways to send anything sensitive. Although it’s the most tried and true method for claim submission, it adds another manual step to the process PLUS additional days for delivery.
To find out if authorization is required, you’ll need to perform an eligibility and benefits verification on the client’s insurance plan. We provide this service for free as part of our mental health billing service. You already know that proper coding is of paramount importance if you want to be reimbursed quickly. Our therapist billing software starts by verifying the patient’s insurance coverage. Not only will your claims be clean the first time we submit them, but we’ll also drastically reduce the number of rejected and partial payments you get back.
Whether you’re a physician, psychologist, or technician, you need to understand the reimbursement rates for psychological or neuropsych testing in 2022. Drawbacks of using RCM software in your practice include financial liabilities because of the potential for greedy, unscrupulous employees to embezzle from you. Employees who are careless may leave sensitive information in plain view for unauthorized people to access, which is a major breach of privacy that you must strive to avoid. Behavioral health practice managers who prefer to have more financial control over their operations often turn to in-house RCM software. It simplifies billing and collection cycles, which means your revenue cycle should speed up, improving your bottom line. RCM software also serves to bridge the gap between electronic health record or EHR software and accounting systems.
Even though many patients possess active coverage, the services might not be reimbursed as a benefit, so this step is essential to make mental health billing smoother. The provider of the mental health services plays a crucial role in the mental health billing process. The services will be charged based on the type or qualification of mental health provider rendering them. Depending mental health billing on that, the insurance covers a part or in some cases the whole of the coverage. Mental health services aim at ensuring the personal well-being of patients on a more emotional level. Practices that render mental health services must incorporate several treatments and a huge variety of components in order to ensure smooth processing of both patient care and billing.
