Use digital claims processing when possible for better tracking of your claims and data and faster claims submission. Normally digital options to have a cost, for EHRs, so consider your options in choosing an online tool. We help our providers by managing their data in an easy to use free EHR software, and communicating via calls, texts, and email. If you don’t know which CPT codes to use for billing, refer to our popular and easy to read guide here. You need to gather your provider information, the client’s demographic information, and the client’s insurance card information.
Consider these mental health billing tips that can help make the process smoother. Essentially, an incomplete or inaccurate medical record would reflect that medical and mental health services are unnecessary mental health billing for dummies for the patient. This error often results in insurance companies not paying for the service, making it difficult for behavioral health providers to do their job and patients to get the treatment they need.
Create and Submit Your Claim
You should also understand the type of information required in each section of the form, since different payers may require different information. 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 point of contact. Be exhaustive with comparing what information you have on file and what they need.
- Once scrubbed, your claim is ready for submission to a payer for reimbursement.
- Submit appointment dates with the requisite CPT codes and diagnosis codes.
- You see, some clearinghouses (like ours) can automatically accomplish multiple claim submission process alternatives exactly for this unique scenario.
- Some software solutions include the option to receive alerts on aging or rejected claims, an invaluable feature for busy practices.
- However, undercoding and upcoding can easily result from an untrained employee who doesn’t have adequate coding knowledge.
- Usually, you receive a notification of the claim denial through your practice management (PM) system and your clearinghouse.
- Be exhaustive with comparing what information you have on file and what they need.
Now that you know how ICD codes are relevant to insurance billing, CPT codes have a similar role. ICD codes are used primarily for diagnosing a patient, whereas CPT codes are used to support the diagnosis with the necessary medical treatment. However, regardless of the services you provide, it’s always a good idea to check that your patient is covered for the mental health services they need. Performing a VOB can also help you determine the amount that your patient’s insurance company will pay for the services they are seeking.
Claim Denial
We recommend seeking professional help online research, a colleague, course, or through delegation. 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? It’s already integrated https://www.bookstime.com/articles/what-is-salvage-value with practically every payer that exists in the mental health billing world…so it can pull up the claim status for everything you’ve submitted through it. This is yet one more reason why mental health providers choose billing services like TheraThink to help.
You want to know you can call your billing admin, a real person you’ve already spoken with, and get immediate answers about your claims. 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. Submit the claim as corrected claims so they act to reprocess the original claim. Make sure to submit the claim id number with all of the changes you need to make on your claims.
Step 2: Information Verification and Eligibility
You are to charge them after the fact for their patient responsibility payment per session as listed on the completed EOB your receive from filing your claims. — Psychiatric diagnostic interview performed by a psychiatrist for 20 to 90 minutes in length. CPT Code is typically billed for the initial intake appointment a client will have. Subsequent sessions will be billed with procedure codes and 90837, depending on the appointment duration. Create a written report for the patient and referring healthcare professional.
Though this practice is often done intentionally to help save patients money for their services, it is illegal. When submitting a claim, you must ensure that you do so in the correct billing format based on the insurance company you are filing with. To make this process easier, identity the insurance company’s preferred filing method and the window of time they allow for filing claims. You will certainly want to file your claim within that window of time, or you run the risk of a prolonged claims process. To stay ahead of this, you can ask the insurer about their preferences for receiving claim filings when you go through the VOB procedure.
Best practices for billing mental health services
Speak with an insurance representative directly for ideas on how to fix and resubmit denied requests. The representative may be able to assist you with the solution that will result in a payment. Sometimes the patient’s plan simply doesn’t cover a particular treatment and there’s little you can do. Pay special attention to aging claims, those that aren’t being processed within the typical timeframe.
Well, each of those payers has a different web portal for claim submission. 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. There are also many systems that can check eligibility on your behalf in a more efficient manner than making phone calls. This technology could be supplied by your EHR, clearinghouse, or a different third-party.
Medical Billing: Filing a Clean, Error-Free Claim
Thus, if you’re using an eligibility solution provider, you still need to determine that yourself using the information presented to you. You’ll receive this data whether or not the claims you submitted went through or came back as a denial. In other words, it’s like a second set of eyes reviewing your claims before you submit them so that you don’t receive a denial. Essentially, you submit your claims to a clearinghouse, it runs your submission through a series of automated tests and alerts you to any errors.
- The last step in the mental health billing process is to rework your denials and submit them for an appeal.
- Managers of behavioral health practices operate under unique and challenging circumstances when compared to other specialties.
- When you start working for a new client, always check if preauthorization is required before providing any non-standard session.
- Luckily, we’re going to learn together by breaking down the essentials of mental health billing in this definitive step-by-step guide.
- Third-party billing services should provide you with regular status reports.
- Make sure you’re filing claims to the right place, with the right information.