Medical billing is a complicated process as it is, in which medical billing for mental health services is more complicated than ever and comes with a bunch of unique challenges. Several services are covered under mental health such as pre-authorization, unbundling concerns, and the size and availability of office staff, mental and behavioral health billing cater more disadvantages when compared.
Paying more attention to patients is one of the best factors in understanding the mental and behavioral health billing process. This is one good reason why denial management strongly uplifts the prominence of medical billing off of medical professionals. In this blog, we will see how and why mental health billing is complex and challenging to deal with and what can be done to reduce denials for billing claims.
Why is Mental Health Billing so difficult?
Look at other areas of medical billing. You can see some standard procedures followed because of its definite treatment and recovery period, whereas it may not be the case with mental and behavioral health. Factors such as time, service variants, scope, and restraints imposed on treatments for mental health make it more complicated and indefinite.
Since the consultation and billing differ from patient to patient, the provider may find it difficult while billing and submitting claims because the reasons may vary multiply across patients.
Best Practices for billing Mental Health Services:
Though it is hefty to handle the billing process of mental health services, providers can follow these tips to make their approach and system easy.
#1: Check twice on the insurance and coverage of your patients
Since your patients carry their insurance card, you can quickly check their policy benefits and whether the service they undergo is covered in the policy. This is how you do VOB. It also lets you know how much the insurer pays the patient for the service delivered.
#2: Understand CPT codes:
If the CPT codes are not appropriately mentioned, then there is no point that you do the entire process right. These codes show you the amount of reimbursement for a specific healthcare service when delivered to patients. Unlike other medical billing processes, you may not be able to find CPT codes for mental health and billing so easily. No standard CPT codes are used for cognitive and behavioral health billing; instead, it should have E/M codes specified along with the respective CPT codes.
Your payer looks at the claim form of mental health billing in three ways: history, examination, and medical decision-making.
History contains the details of present illness, past family and social history, and review of systems. The examination section includes the type of examinations/tests conducted, the nature of the problem, and the patient’s record. The medical decision-making column comprises the number of diagnoses or treatment the patient has undergone till, the data complexity, and the risk of complications.
CPT codes play a prominent role in reducing denials of mental health billing claims; therefore, the practitioner/hospital should be aware and updating their system with CPT codes instantaneously can help overcome the grievances with the mental health billing.
#3: Know how to submit claims properly
Like how codes are essential in a claim form, similarly, understanding how to fill each column in the claim form also makes sense. You should go through the entire way thoroughly at first and before filling, in case of doubts, clarify it with an expert who has been into the claim submission and then proceed towards form filling and submission.
To ease your mental health billing process and get your reimbursements without any claim denials, outsourcing your medical billing and coding process is a wise option. You can approach 24/7 Medical Billing Services, the best medical billing and coding outsourcing company that carries extensive quality, support and achieving maximum reimbursements in medical billing and coding.