Medical billing is quite overwhelming. However, when it comes to managing billing for a Mental Health Practice, it is a different subject matter. This is because if one fails to handle it properly and professionally, it can lead to loss of revenue and can also risk payer security.
Mental Health Medical Billing is quite complex when compared to other areas of the healthcare industry in terms of services, scope, and time constraints placed on the mental health treatments.
For example, if you visit a doctor for a routine check-up, you will most likely go through the typical series of exams and tests. It mainly includes height and weight, blood pressure, or blood test. For the majority of the time, the series of tests are normally standardized for majority of the patients.
But the same doesn’t imply for mental or behavioral health treatments as these services tend to differ from other services. These services mainly depend on session length, therapeutic approach, age, and location of the patient. Thanks to these variables, one cannot standardize the treatment and thus the billing. In an effort to reduce the majority of the payments, the insurance providers tend to standardize mental and behavioral health billing by dominating how treatments can take place and the number of treatments involved.
This brings us to the questions most Mental Health practitioners commonly ask: How to streamline the billing process?
Here are a few tips that should be taken care of while billing mental health services:
- Double-check the patient’s insurance and coverage-
You need to be aware of the patient’s insurance plans and benefits before each session. Even though it might be pretty time-intensive, the step cannot be neglected as you need to make sure you know the insurance coverage of all the patients before you provide them the services.
To see the content, you need to know about the verification of benefits that checks the insurance holders’ policies regarding the service they are visiting for. Above all, you can ensure that the person is eligible for the services they need and know how much the insurance company will pay for the same.
- Learn about the CPT codes
CPT codes, also known as standard procedural technology, are mainly used by insurance providers to see the reimbursement amount which is given to the healthcare facilities. It is essential to understand the services when one has to deal with behavioral health billing.
It is vital to understand the CPT codes to reduce the risk of claim rejections and also on how to use them. For behavioral healthcare practitioners, the two types of CPT codes to be used are E/M Codes and Psychiatric Evaluation Codes. It is necessary that one takes care that correct codes are used or else there are chances of a claim being rejected.
- Learn to submit the claims properly
If you want to receive a claim, you have to file the correct code to the right insurer and submit the claim in the valid billing format, which tends to vary from company to company. Hence you need to learn the preferred billing method.
The claim form that is used by most of the insurance companies for specialized health centers like rehabilitation clinics and mental health clinics is the UB-04 form. Hence it is important to be well-versed with this form. The UB-04 form can be filled out on both paper and electronically.
Mental health services billing is also challenging because there are lack of validated resources for mental health providers. Often, small group practices or solo practices are operated with very few or no administrative procedures. In such scenarios, the physicians carry the burden of billing on their shoulders. In such scenarios, it makes sense to outsource the mental health practice billing services to the experts like 24/7 Medical Billing services. Many efforts go into streamlining the billing process, such as following up on claims, appeals for denied insurance claims, and more. To get in contact with 24/7 Medical Billing Services, contact +1 888-502-0537.