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mental health billing for dummies

This isn’t one of those industries where you dive right into it and learn as you go. If you went this route it would take you a few years to get a grasp on all of the jargon. Not to mention the fact that mental health billing is a specific niche within the space. After all, there are differences between the types of claims that hospitals submit compared to those coming from mental health facilities.

  • As already mentioned in this article, Verification of Benefits is a crucial aspect to ensure the patient’s insurance coverage details and the kind of services that they have intended to encounter.
  • If you are contracted with a particular insurance company, you cannot “balance bill” your clients.
  • However, with patience, perseverance, and maybe even a little training from someone who has done it before, you can tackle your practice’s medical billing.
  • Here are some tips to help mental health practices bill for services more effectively, with more funds, more time for patients, and fewer denials.
  • This requires intimate knowledge of behavioral health coding, as well as access to comprehensive resources on the subject.

It also usually has a series of pre-established connections to insurance organizations to streamline submission. A clearinghouse is usually a service offered by a third-party organization that acts as a central repository and middle-man to your claim submission process. Every insurance payer has a series of requirements required to receive reimbursement for claims.

Outsource Mental Health Billing Services

We wish it were easier, as the whole process causes revenue loss, frustration, and inefficiency in our health care system. You will received EOBs in the mail along with a check for those dates of service. Many clearinghouse solution providers will ask you what EHR your organization utilizes during initial deliberations. Well, in this alternative we have to call this number again and figure out the status of the claim you submitted.

mental health billing for dummies

A VOB can help you avoid rejected claims from the insurance company as well as unpaid bills for the services you provide for your patient. If you are struggling to find out the place of service code or modifier to use for your insurance claims, this is something we provide as part of our billing service free of charge. Having the customer service phone number isn’t essential for submitting claims, but is necessary to gather eligibility and benefits information and to verify claim status and payment amounts. However, you’re in a unique scenario within the mental health space where you have to deal with MCOs, mental health EHRs and state-level government ordinances.

It’s time to protect your bottom line.

The company is tech-focused and allows clients round-the-clock access to information such as claim status, client balances, authorization status, and more. In the mental health field, patients and insurers are billed primarily for therapy, medical management and psychological testing services. Insurers have rules about how long a session they’ll pay for, how many they’ll pay for per day or week, and often a maximum number of treatments that they will pay for. Mastering mental health billing is pivotal for seamless access to quality care while maintaining financial equilibrium.

Then, log in to the insurer’s provider portal and determine whether the patient’s insurance covers your services. Both medical and mental health billing require the use of ICD-10 (International Classification of Diseases, 10th update) and CPT (Current Procedural Terminology) codes. The latter is more important because ICD-10 codes indicate the patient’s diagnosis, whereas CPT codes denote how you’re treating the diagnosis. You can’t bill payers for a diagnosis, but you can bill them for your treatment services. 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.

The Definitive Step-By-Step Guide to Mental Health Billing

For instance, after you provide a service, you should expect to receive a reimbursement from a claim. 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. Our Beginner’s Guide to Mental Health Billing is for the brand new and having-no-clue outpatient therapist mental health billing for dummies looking to learn how to bill insurance companies. You will learn what client information you need, how to verify mental health benefits, create and submit claims, and account for EOBs. This mental health insurance billing for dummies guide is just simply not the place to explain the vast number of ways that billing plays out.