Behavioral health billing presents different challenges than other types of medical billing. The approach to therapy, the length of the session, and the patient’s willingness to contribute make standardizing treatment and, thus, billing far more complex. Furthermore, how insurance companies view behavioral health is noticeably different from how they view more traditional medical practices. Insurance companies can dictate how long treatments can last and how many sessions can be held per day, making it difficult for behavioral health providers to balance effective billing with adequate patient care. Furthermore, the pre-authorization requirement has increased the difficulty and complexity of behavioral health billing. It’s common in behavioral health to have a small group or solo practice with confined administrative support for billing and other office duties. Some providers will even try to do their own billing, but this will quickly become overwhelming and cause time management issues, not to mention lost revenue. All of this makes the billing process difficult for behavioral health professionals. They must ensure that income levels remain high while also ensuring that every patient receives the best possible care.
Let’s have a look at the different challenges faced in terms of behavioral health billing:
Challenge #1: Pre-Approvals
Patients seeking mental or behavioral health services are likely to have scheduled appointments and services regularly. Some people may have had the same insurance for years, making billing for services rendered relatively simple. Any change in insurance can cause your claim to be denied, leaving you with uncollected payments. Similarly, the insurance company will not cover the necessary care if you provide treatment to a patient who has yet received that pre-approval. This could eventually lead to a patient needing help to afford those services, resulting in missed appointments and revenue opportunities.
Challenge #2: Coding Bills Correctly
Mental and behavioral health coding can be more detailed, especially if a patient has multiple conditions. Coding errors can cause significant delays in claim approval or even prevent the claim from being approved at all. Traditional billing software is frequently not designed for mental and behavioral health practices. This can make moving your claim through the system more complex.
Challenge #3: Insurance Company Filing Preferences
Nowadays, most insurers use a digital billing model. However, this does not necessarily imply that every company will favor the same filing method. Your staff may feel compelled to keep up with an ever-changing set of preferences—and if you file incorrectly, you may struggle to collect payment from that insurance company.
Outsource your Behavioral Health Billing!
As you can see, a significant amount of work is involved in correctly filing claims for mental health providers. As a result, it is expected that many providers prefer to use a third-party medical billing company to handle claims so that they can focus on patient care and treatment. Some of the solutions provided by outsourcing behavioral health billing partners include:
Increased Practice Collections
Nothing is more concerning than a dispute with an insurance carrier over unpaid claims. When
you outsource your mental health billing, all claims are submitted on time, and any rejected or
denied claims are resubmitted. This ensures that all your sessions are correctly billed, and
follow-ups are taken to provide payment for every submitted claim. Only the behavioral billing company
is responsible for submitting accurate claims, taking follow-up, reading remittance advice,
working on claim rejections, finding a resolution for denied claims, and coordinating with
insurance carriers. The billing company’s timely activities will result in increased practice
Clean Claim Submission
An adequately submitted claim ensures you will receive insurance reimbursements on time.
Clean claim submission entails entering all claim-related details accurately for each claim.
Patient demographics, payable diagnosis codes, insurance information, date of service,
procedure codes, rendering provider details, number of units, and billing provider details are all
included in this claim information. Any errors in entering this information may result in your
claim being rejected. When your claim is denied, you must correct the details and resubmit the
claim, which causes insurance reimbursements to be delayed. Behavioral health billing company
experts are familiar with the clean claim submission process and crosscheck all submitted
claim information to ensure minimal rejections.
Your Ultimate Solution to your Challenges!
24/7 Medical Billing Services solves all your behavioral health billing challenges. The team
works with providers to provide pre-authorization, third-party medical billing, claims follow-
up, and assistance with insurance claim appeals. They want you to spend your time where it
matters most: on patient health, not insurance company disputes.