This process requires accuracy and attention to detail, from verifying client benefits to coding sessions correctly. Submitting claims in mental health billing involves several key steps to ensure that your claims are processed efficiently and accurately. Start by gathering all necessary documentation, including detailed session notes, diagnosis codes, and CPT codes for the services rendered.
How to Stay Current on CPT Codes
Your clearinghouse should be able to help with the denial recovery process by explaining what happened, pointing out errors, and generating appeals letters or resubmitting corrections to payers. Health insurance organizations don’t make this entire process easy, but they have their rules. Your clearinghouse’s sole purpose is to “have your back” when it comes to mental health billing. After all of this and even after Medicare’s electronic submission requirement, some payers STILL don’t have claim submission web portals. If you asked the USPS, they would tell you that first-class mail is one of the most secure ways to send anything sensitive. Although it’s the most tried and true method for claim submission, it adds another manual step to the process PLUS additional days for delivery.
The A – Z: Mental Health Insurance Billing Terms
- Insurance companies must be able to reimburse you promptly for services you rendered.
- There will be many links to other resources, scripts, and templates to help do mental health billing for dummies.
- It explains how the claim was processed, the amounts paid by the insurance company, and any remaining patient responsibility.
- Efficient mental and behavioral health claims processing is vital for balancing quality care and financial sustainability.
- In fact, one study found that healthcare professionals spent twice as long on administrative paperwork as they did with patients.
In some instances, various payers have different rules (e.g., over 45-minute sessions or multiple sessions for one client in a day). When you start working for a new client, always check if preauthorization is required before providing any non-standard session. Proper submission and follow-up are essential for maintaining a smooth billing process and ensuring that your practice receives the compensation it deserves. To give you an example, there are public payers for every county in the state of Ohio that handle alcohol, drug addiction and mental health services (ADAMHS).
Strategies for Clean Claims Submission
- Learn how to offload your mental health insurance billing to professionals, so you can do what you do best.
- Staying updated on these changes is crucial for maintaining billing efficiency and compliance.
- This type of form replaced UB-92 forms in 2007 and it’s also sometimes referred to as CMS 1450.
- We wish it were easier, as the whole process causes revenue loss, frustration, and inefficiency in our health care system.
- We recommend using one EHR software, ideally custom built only for mental health providers, to manage all your clients in one place, and to submit all your appointments through one website.
A group of patients is chosen to get interactive treatment in an effort to alter behavioral patterns. If their diagnoses are curable, health insurance ought to pay for them. The CMS1500 requires client demographics, practitioner identification details, procedures and charges, and insurance plan identification information. When taking on a new client, the more information and demographics you can gather, the better, making the process more streamlined in the long run. As a mental health practitioner, the chances are that billing clients isn’t your favorite part of the day and is also probably something you don’t feel that confident doing. Also, audit claims often and stay updated on insurance and coding rules.
- We’re going to help you figure out the outline of mental health insurance billing.
- Another effective strategy is outsourcing billing tasks to a professional billing service that specializes in mental health.
- Once credentialed, therapists must ensure they fully understand the insurance policies they work with, including reimbursement rates, session limits, and coverage requirements.
- At the heart of mental health billing is the use of accurate CPT (Current Procedural Terminology) codes.
- Combined with insurance policies that may have unique rules or limitations for mental health coverage, navigating the billing process can be a daunting task for many professionals in the field.
One or more of these problems — and many other variables — can make it difficult for mental and behavioral health providers to operate their practice efficiently. A lot of time and energy goes into filing a claim with medical billing for mental health services, taking away time from patients. Learning more bookkeeping about the behavioral health billing process can make it easier for you to spend more time and energy on your patients and less on inconvenient discrepancies. Many health insurance plans also require pre-authorization, which means that patients must get permission before receiving coverage for some mental health services. This procedure can prolong insurance billing and prevent a patient from receiving the treatment they need. Mental healthcare providers can also become frustrated with medical billing because of the lack of resources.
Step 7: Recording and Reviewing Denials
It’s our goal to ensure you simply don’t have to spend unncessary time on your billing. Your access portal for updated claims and reports is secured via our HTTPS/SSL/TLS secured server. We understand that it’s important to actually be able to speak to someone about your billing. Every provider we work with is assigned an admin as a Certified Bookkeeper point of contact.
- Providers face big obstacles that can mess up revenue cycles and patient care.
- Failing to maintain accurate and orderly documentation can result in common mental health mistakes, ultimately affecting your practice’s financial health.
- If your claim looks right, the clearinghouse sends the claim directly to the insurance company you have selected.
- Performing a VOB can also help you determine the amount that your patient’s insurance company will pay for the services they are seeking.
- Since you and your staff work within your PM/EHR daily, the most ideal process to submit mental health claims to all of your client’s payers is through it.
After this process, you have all of the information required to file claims, what to charge your client when they come in for a visit and how to file their claim via online or otherwise. This is a key step in the process, verifying eligibility early helps stop this type of denials months before you would receive them. Although this isn’t a requirement, it’s not out of the ordinary and a best practice to photocopy the insurance cards of your clients and store them in a safe place.
In addition, note writing will help you stay more organized with your patient notes if you see a large number of clients regularly. Our Beginner’s Guide to Mental Health Billing is for the brand new and having-no-clue outpatient therapist looking to learn how to bill insurance companies. You will learn what client information you need, how to verify mental health benefits, create and submit claims, and account for EOBs. This mental health insurance billing for dummies guide is just simply not the place to explain the vast number of ways that billing plays out. We recommend seeking professional help online research, a colleague, course, or through delegation.
