Outsourced Mental Health Billing Services can be beneficial for medical practices, as the billing companies have better control over the Revenue Cycle processes & are aware of any changes to the regulations and how that may impact the practice. Outsourcing provides operational benefits, increased control, quick resubmission of claims, and faster payment collections.
Constant improvement in the Mental Health specialty is making things transparent and easy to understand by insurance and medical billing experts. But unfortunately, these complex and ever-changing codes are making it difficult for Mental Health healthcare service providers to bill on their own or through an in-house billing team.
In the Mental Health Billing Services arena, patients and insurers are billed primarily for therapy, psychological testing & medical management services. Commercial insurances and state programs (Medicaid) outsource their mental health claims to third-party programs that’s why while submitting claims the Insurance selection is important to avoid rejections and to make sure that the claims are submitted to the correct payer to avoid payment delays. If you’re a mental or behavioral health provider, you know that billing and collections can be a real challenge.
Insurance has different rules and regulations based on their programs/coverages. We should understand that how many visits are allowed, and the maximum number of treatments the insurance will pay as per the Plan Coverage.
It is important to understand the types of covered Mental Health Services. For example, some insurance payers will only cover services by specific providers, such as physicians, psychiatrists, clinical psychologists, and clinical social workers. The services offered are
- Family medical psychotherapy
- Group psychotherapy
- Psychiatric therapeutic services
- Psychiatric diagnostic review
Medical record management is Essential in Mental Health Billing Services, an incomplete or inaccurate medical record would reflect that services are unnecessary for the patient. This issue often results in delayed payments from insurance payers, making it difficult for behavioral health providers to maintain their cash flows. Proper medical record documentation is a vital communication tool used between mental health providers and insurance Payers. Accurate and up-to-date medical record documentation reduces the risk of denials, administrative litigation, and penalties. The clinical records include:
- Patient Treatment & Mental Health / Medical History
- Diagnoses & Test Results (Any revisions of the diagnosis)
- Physical Exam, Assessment & Clinical Impression
- Plan of Care for the Patient, Patient’s Progress, etc.
At PhysicianRCM, our medical billing solutions enable us to apply our resources and business expertise to meet the unique needs of each individual client. Whether you are a psychologist, psychiatrist, CNP-certified nurse practitioner, CNS-clinical nurse specialist, APRN-advanced practice registered nurse, counselor, or therapist, we know how to bill for Mental Health Services, which elements can speed up insurance billing and ensure a decrease in errors — benefitting mental health providers and patients. Like few Mental Health billing tips can help to make the process smoother and increases profitability.
- Check if pre-authorization is required (especially for non-standard therapy sessions)
- Update patient Insurance Eligibility / Demographic information regularly
- Timely Filling of the Insurance Claims
- Identify inaccuracies/denial Reasons to improve Clean Claims
We have a long history of providing expert medical billing services to mental and behavioral health providers. We understand the complexities of billing for these services, and we are committed to helping our clients get the reimbursement they deserve. We work closely with insurance payers, verify patient insurance eligibility, and know their process, resulting in faster revenue recovery for clients.