Mental health billing

In addition, billing for multiple copays at a later date may add up to an unexpectedly large price tag that the patient isn’t prepared to cover in a lump sum. Good billing practices begin the moment you initiate a new patient record. ” Quite simply, it means the process of making money, from securing a new paying client to getting the check in your bank account. There’s plenty to know about this cycle, but for now, here’s an overview of the basic steps.

Proper documentation, accurate coding, and adherence to specific coding guidelines, including those for prolonged services, are key factors for success. During this approach, practices can look up details about your patient’s coverage that aren’t frequently listed on the insurance card. 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. Ensuring that all components of mental health billing are accurate and on time can be challenging.

Learn more about standard behavioral health billing models, the organizations involved in billing, billing authorizations, mechanisms, integrations, and the information needed for billing. The world of private practice encompasses many elements needed to be successful. Aside from patient care, private practice billing is the foundation of these elements.

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It can also save a large amount of money lost to billing & claim submission errors. Our team of behavior & mental health billers implement best practices to increase your revenue and decrease claim denials. For mental health providers, the billing process can be challenging but not impossible. If you dig into the points mentioned in this article, you will get where you want to be – having your practice receive the deserving reimbursements on time. It never hurts to look over something twice just to make sure everything is in place, and being a mental healthcare professional, it is always important to ensure that the patient information stays correct at all points. In fact, it is important to endorse double-checking in the billing process.

Mental health billing

No one gets into the mental health field because they enjoy wading through insurance industry bureaucracy. People become mental health professionals because they want to help others. However, providers cannot help others unless they collect sufficient funds to run their practices, and pay themselves. Some providers will even try to do the billing themselves but eventually this will become overwhelming and create time management problems, not to mention lost income.

Substance abuse facilities manage widely varying situations with heavy complexity. Due to regulations, laws, and insurance challenges, substance abuse billing can be very difficult. The sensitive nature of substance abuse treatment can also provide challenges. To bill properly, psychiatrists must know both mental health CPT codes and psychiatric diagnostic evaluation codes.

Reasons Why You Should Avoid Medical Transcribing Services

Our fully templated EHR offers many different features that can benefit you and your patients, such as patient portals, charting and automatic coding. Whether you work in an inpatient or outpatient setting, ICANotes can simplify your daily processes with our mental health billing solutions. Start your free trial today or request a live demo to see how we can help you get billing right. When submitting a claim, you must ensure that you do so in the correct billing format based on the insurance company you are filing with. To make this process easier, identity the insurance company’s preferred filing method and the window of time they allow for filing claims.

Mental health billing

This can be complicated as covered benefits differ between providers and insurance plans. Essentially, an incomplete or inaccurate medical record would reflect that medical and mental health services are unnecessary for the patient. This error often results in insurance companies not paying for the service, making it difficult for behavioral health providers to do their job and patients to get the treatment they need.

Prior Authorization for ASC: Need, Importance, and Challenges

Though mental health billing is complex, mental health needs are greater than ever. As a result of modern day stressors, living costs, and the COVID-19 pandemic, people globally have seen large impacts to their mental health. There are multiple sources to check for substance abuse codes, and regularly changing regulations. The nature of substance abuse and facility services create very unique billing procedures. In the mental health space, psychiatrists share the most similarities with traditional medical providers.

  • This office helps prevent many substance use disorders, including tobacco use.
  • Correct medical codes based on the time spent can avoid errors involving the number of units billed.
  • We provide credit card processing service for provider’s offices to collect patient payments, track patient balances, and automatically track office revenue.
  • ZMB has a track record in helping Behavioral & Mental health practices manage and improve their income.

This webinar and CPT are copyrighted by the American Medical Association. So without further ado, I am very pleased to introduce Leslie Prellwitz and Jacob Atlas. Leslie is the Director of CPT Content Management & Development at the AMA, and Jacob Atlas is a Senior Practice Manager of Psychiatry at Northwestern Medicine.

What Is Batch Billing?

And I know that when Jacob comes on, he’ll be talking a little bit about how they’ve worked in his practice environment. It’s also a good idea to regularly update clients’ personal information, like addresses and phone numbers. That way, you can ensure that claims are accurate and pre-authorizations are approved. Copyright © 2023, the American Hospital Association, Chicago, Illinois. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be copied without the express written consent of the AHA.

If they haven’t been received, verify their claims address and submit again. The cheapest option is to learn how to use “PracticeMate” by OfficeAlly to submit claims, even though it is made for hospitals. All questions or complaints regarding Behavioral Health Medicaid Managed Care should be submitted to the OMH Division of Managed Care using the OMH MC Question/Complaint Form. This ensures all questions or complaints submitted can be reviewed and responded to by appropriate staff within OMH and/or the Department of Health. People experiencing a suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress can call, chat or text 988, and speak to trained crisis counselors. I’ve got a separate set here, but the 421 visits, these are online visits.

With a variety of personalized and suite services to choose from, we’re here to help.

At Psyquel, our mission is to help you improve your patient care, streamline your billing, and build your practice. We’ve developed a user-friendly platform to assist you in managing your clinical, billing, collection, and telemedicine requirements. If you want to focus on providing healthcare rather than processing claims, you can hire a billing company to handle your claims.


The growing pressure placed on mental health professionals by insurance companies is widely acknowledged as one of the most financially and emotionally stressful elements of their careers. There has never been a more urgent demand for high-quality Mental health billing software that’s easy to use and understand. This list gives you detailed descriptions of over 50 billing services nationwide that specialize in mental health billing. Your order includes a list of important questions to ask when hiring a biller, and advice from others who have hired billers.

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. We provide credit card processing service for provider’s offices to collect patient payments, track patient balances, and automatically track office revenue. The same day you see a patient, Electronic Data Interchange (EDI), can submit a claim to their insurance company through Psyquel.

Value-based reimbursement billing adjusts fee-for-service rates based on the outcome for each individual. It can also modify a PMPM or capitation billing model based on the average outcome for a group of people. Better outcomes increase the PMPM reimbursement from Medicare, Medicaid, and other organizations.