Uncovering Questionable Billing Practices by Community Behavioral Health Centers

Community Behavioral Health Centers (CBHCs) play a vital role in providing mental health and substance use disorder services to low-income and underserved communities. However, recent reports suggest that some CBHCs engage in questionable billing practices, putting them and their patients at risk of legal troubles and financial harm.

As a leading medical billing service provider, 24/7 Medical Billing Services has seen first-hand how these practices can negatively impact CBHCs’ bottom line and reputation.

Some of the most common questionable billing practices by community behavioral health centers:

Upcoding:

Upcoding is the practice of billing for a more expensive service than the one provided. CBHCs may upcode by listing more intensive services than were actually performed, in order to receive a higher payment rate. For example, CBHCs billing for an hour-long therapy session when only 30 minutes were provided. This practice is fraudulent and illegal. Not only can it lead to steep penalties and legal consequences, but it also undermines the integrity of the healthcare system and jeopardizes patients’ trust.

Unbundling :

Unbundling is the practice of separating procedures that should be billed as a single service and billing them separately. This practice allows CBHCs to receive higher payments than they would have for the combined service. For example, billing for medication management, individual therapy, and group therapy separately when they should be billed as one comprehensive services. Like upcoding, unbundling is fraudulent and illegal. CBHCs that engage in unbundling may face hefty fines and legal action, as well as reputational damage that can affect their ability to provide quality care in the future.

Inadequate Documentation:

Inadequate documentation is the practice of failing to properly document the services provided. CBHCs may do this to inflate the billing amount or to avoid providing proper documentation for services that were not provided. Inadequate documentation can lead to denied claims, delayed payments, and legal troubles. In addition, it can prevent CBHCs from providing quality care, as proper documentation is crucial for tracking progress and ensuring patients receive the right treatment.

How 24/7 Medical Billing Services Can Help?

As a billing service provider, 24/7 Medical Billing Services can help CBHCs avoid legal troubles and billing errors. Our team of billing experts is trained to identify and prevent questionable billing practices, such as upcoding, unbundling, and inadequate documentation. We work closely with CBHCs to ensure they are billing accurately and ethically, while maximizing revenue and minimizing denials. We also keep our clients informed of the latest billing regulations and best practices, so they can stay ahead of the curve and provide quality care to their patients. In addition, our billing services are designed to reduce administrative burden, allowing CBHCs to focus on what they do best: providing mental health and substance use disorder services to their communities. We handle everything from claims submissions to A/R follow-up, so CBHCs can save time and resources while improving their bottom line.

Final Thoughts- Billing Practices by Community Behavioral Health Centers

CBHCs play a crucial role in providing mental health and substance use disorder services to low-income and underserved communities. However, some billing practices Community Behavioral Health Centers that can harm their reputation, patients, and financial stability. By partnering with a trusted billing service provider like 24/7 Medical Billing Services, CBHCs can ensure they are billing accurately and ethically, while minimizing denials and legal troubles. Our team of billing experts is trained to identify and prevent questionable billing practices, such as upcoding, unbundling, and inadequate documentation.

We also offer customized billing solutions tailored to CBHCs’ specific needs and goals. Whether you’re looking to improve revenue, reduce denials, or streamline administrative tasks, we can help you achieve your objectives while providing quality care to your patients. If you’re a CBHC looking to avoid legal troubles and billing errors, contact 24/7 Medical Billing Services today. We’ll work closely with you to ensure you’re billing accurately and ethically, while maximizing your revenue and minimizing your administrative burden. And with our expertise and experience, you can rest assured that you’re in good hands.

See also: Billing For Community Behavioral Health Clinics