Your clearinghouse should also keep a record of your denials and place them within work queues to kick off the appeal process. The claims that come back to you with a denied status are particularly important. Hopefully, you’re using at least an Excel spreadsheet in tandem with this process to record your results.
- This communication is meant to help get rid of emotional disturbances, change patterns of behavior, and help the individual live a more normal healthy life.
- Any given time over 24 hours is too long for what competent, effective mental health billing services should provide.
- If insurance refused to cover the entire cost of services, you’ll have to bill your patient for the difference.
- Happy to do this whole process for you as every other billing service should.
- Although troubling, receiving a denial from a payer for a claim you submitted isn’t the end of the world.
- For example, Medicare Part B will cover mental health services as long as they are medically necessary for the diagnosis or treatment of an illness or injury.
- Call the same company using the same eligibility and benefits number and ask for claims processing and EOB accounting.
This step happens simultaneously with step 4, but it needs mentioning because it’s another added benefit of choosing the “most ideal” alternative. You see, every payer has a different web portal mental health billing for dummies design and user experience. It’s likely the main reason why you clicked on this blog post in the first place. Lucky, it’s a pretty straightforward process…you just need to know where to start.
More Ideal: PM/EHR and Clearinghouse Integration
Third-party billing services should provide you with regular status reports. A clean claim is formatted correctly, contains accurate information, and is free of mistakes or typos. Mental health billing’s distinctions arise from the nuanced characteristics of behavioral health services. Acknowledging these differences is essential for accurate reimbursement, effective treatment, and continued progress in destigmatizing mental health care. Explore the core elements of mental health billing and master best practices for precise coding and documentation, empowering practitioners and stakeholders alike.
- This service is sometimes considered for payment by the insurance company, depending on the situation, and documentation that it was a medically necessary service.
- You use this tool every day, so why not make it a habit to check the “claim status” section that’s included with and provided by your clearinghouse?
- Both EHRs serve different niche’s within the healthcare industry so they probably also have different features.
- After all of this and even after Medicare’s electronic submission requirement, some payers STILL don’t have claim submission web portals.
- Mental health billing is more difficult than medical billing, largely because of service variations not found in primary or specialty care.
You also want to be wary of working with a company that isn’t very communicative. Not only are you personally assigned a billing manager at ePsych Billing, you are also free to call Alex for whatever questions or concerns you may have. Knowing that your billing service is always there for you is one of the most important and underestimated aspects when shopping for mental health billing companies. Some mental health billing services lock you into long-term contracts, have sliding scales based on total revenue, and don’t let you try out the service before diving full in.
Verify patient benefits:
Although it seems straightforward, it’s worth mentioning that you bill for the first appointment first and then refer to the other codes based on session length. Your NPI is a 10-digit number that’s used to identify you to other healthcare partners and payers. If a client comes to you and the organization you work for isn’t contracting with their insurance provider, it’s referred to as an “out of network” visit. Once scrubbed, your claim is ready for submission to a payer for reimbursement. ANSI 837P is the accepted electronic format for practices that have to submit under the CMS1500 form.
- When considering whether to join a network or accept payment from insurers, it’s important to evaluate their pre-approval rules and their limits for payment.
- ANSI 837I is the accepted electronic format for facilities that have to use UB-04 claim submission forms.
- In the new codes, greater distinctions are made between whether the assessment is being given by a mental health professional, such as a psychologist or neurologist, or a technician.
- The process your clearinghouse runs your submitted claim through before sending it to the payer.
- If you are a mental health professional working in private or group practice, you have your work cut out for you.
At the time that was an all-time high and the survey that that statistic came from suggested that denial rates weren’t slowing down. The CPT indicates a 45- to 55-minute session, and the CPT code indicates longer sessions. We understand that it’s important to actually be able to speak to someone about your billing.
Re-File Insurance Claim As Corrected with a Billing Service
For example, some insurance will only cover mental health services by specific providers, such as physicians, psychiatrists, clinical psychologists and clinical social workers. Additionally, some independent mental healthcare providers can only diagnose the patient with a mental disorder because insurance will not cover the actual treatment. Many providers find managing their own billing to be outside of their job parameters. If you want to spend less time doing your billing and more time working with clients, getting paid, then consider hiring our mental health insurance billing service. On the contrary, collecting from government programs like Medicare makes up a lot of business for billing companies.
