Look for an EHR explicitly tailored to the behavioral health providers. However, there are often issues with mental health billing that can hinder the treatment process, such as inaccurate documentation or preauthorization. Mental and behavioral health providers may stumble upon one or more of these problems – and many others – which make it hard to run their practice effectively. The more specific your providers and billers can be about services rendered and diagnoses made at clinical encounters, the more you’ll get paid. This requires intimate knowledge of behavioral health coding, as well as access to comprehensive resources on the subject.
- Sometimes the patient’s plan simply doesn’t cover a particular treatment and there’s little you can do.
- Most mental health experts aren’t trained to navigate the medical billing landscape.
- Hopefully this guide was a helpful introduction to mental health billing claims.
- Everything transpiring between a patient and the mental healthcare provider should be in the medical record.
You want to understand how to bill claims online, digitally, because it’s the fastest way to submit claims and the easiest to track. Use the allotted information to get a quote for “outpatient mental health office visit services”. If you have a different license, odds are high you are not eligible to perform a diagnostic evaluation, and as such you are not able to specify a mental health diagnosis for that client. — Psychiatric diagnostic interview performed by a licensed mental health provider for 20 to 90 minutes in length. These codes can also differentiate whether the test was administered by a healthcare or mental health professional or a technician. With the new codes, clinicians can better describe the exact amount of time they spend performing psychotherapy services.
Our Definitive Guide to Mental Health CPT Codes
You will received EOBs in the mail along with a check for those dates of service. When payers speak with you, they’ll give every conversation a reference ID and indicate the representative with whom you’ve spoken. You should do the same – just ask your contact for the reference ID and their name. This way, if you have to contact the payer again (and you almost certainly will), you’ll have a traceable record of all billing steps you’ve taken to date.
We offer a solution to the many complexities in the healthcare environment that make your job more difficult. ICANotes is the premier EHR for behavioral health specialty, and we work mental health billing for dummies with all clinical disciplines to deliver an intuitive charting solution for your practice. As a behavioral health practitioner, billing can get confusing between ICD and CPT codes.
Mental Health Billing for Dummies [2023 Guide]
If you want to focus on providing healthcare rather than processing claims, you can hire a billing company to handle your claims. Aside from billing and claims submission services, some outsourcing billing companies also take care of prior authorization, VOB, claim denials, and follow-ups. Reports on submitted, aging, and rejected claims will help you keep track of items to follow up on.
- You need a patient portal that notifies patients when an outstanding balance accrues and allows them to pay online.
- Also, in the case of psychological testing, you always need to obtain an authorization.
- Proper note writing and documentation also play a huge role as a communication tool used between mental health providers and professionals.
- Common Procedural Technology (CPT) codes are also necessary for billing for therapists and other mental health providers.
- If you are out of network and do not have a contract with an insurance company, then you can bill the patient for the remainder.
- You’ll receive this data whether or not the claims you submitted went through or came back as a denial.
This is a reason why mental health billing becomes complicated for providers, as it’s challenging to offer standardized treatment for all patients — making billing just as complex. It’s important to know the types of covered mental health services for your patients who may have varying insurance or medical coverage. 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.
Tips for Mental Health Billing
It also usually has a series of pre-established connections to insurance organizations to streamline submission. A clearinghouse is usually a service offered by a third-party organization that acts as a central repository and middle-man to your claim submission process. Every insurance payer has a series of requirements required to receive reimbursement for claims.
Eligibility checking also falls under the category of must-have reporting features. If you can run eligibility checks and reports right through your EHR, you’ll catch coverage problems earlier. Collect the patient’s copay at the time of the visit whenever possible. The odds of obtaining that payment shrink once your patient has left the facility. In addition, billing for multiple copays at a later date may add up to an unexpectedly large price tag that the patient isn’t prepared to cover in a lump sum. Good billing practices begin the moment you initiate a new patient record.
Once you have gathered all of this information, save it in a secure location for future processing.
Thus, ensure that your claim is properly filed to spend less time on it. The first tip is to know your patient’s insurance plans and benefits before each visit. However, making sure you understand the coverage available for each patient before receiving any services will lead to a larger return. While mental health billing isn’t easy, it can certainly be achieved with the right strategy and skill set.
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. UB-04 is the standard paper form for claim submissions that mental health institutions have to use. A timely filing limit is one of the most common requirements placed on claim submissions.