One of the biggest challenges mental and behavioral health clinicians face is billing for their services. The billing process consists of multiple components, leaving a lot of opportunity for error. Errors in your billing process can snowball and cause lasting affects on your cashflow and ability to operate. We’re here to help you understand the steps to mental health billing and the tools to help you achieve your billing goals in real-time.
Steps for Mental Health Billing
Mental health billing can be efficient and accurate when you follow the proper steps with the right tools. This can speed up the claim process and boost your revenue cycle smoothly. Here are the steps to follow.
Step 1: Collect Relevant Information
Begin by initiating new client records and collecting their details. This may sound easy, but it can be tricky because it involves multiple details. You should be careful when collecting the information because insurance companies can reject the claims if the claim information is incorrect. Collect the customer details below.
- Full legal name
- Date of birth
- Address
- Phone number
- Gender
- Social security number
- Email address
- Insurance member ID number
- Insurance claim address
- Insurance authorization number
You will also need to provide a tax ID, provider license, individual provider NPI, and employment Identification Number. Once you get the details, double-check them to ensure they are correct to avoid having to re-file rejected claims.
Step 2: Collect Copayment from the Patient
Copayment or copay is the fixed amount the patient pays to the mental health clinician before receiving treatment. It is best to collect the money immediately because you may not recover it once the patient leaves. This can also help you avoid billing multiple copays at once, which would increase the invoice amount and become more intimidating to clients.
Step 3: CPT Code Recording
You should also include CPT codes (Current Procedural Terminology) during mental health billing so that the insurance payer understands what transpired during client visits. It is essential to record the codes after the appointment. Remember to bill the first appointment and refer to the rest of the codes per the session length.
Step 4: Submit Your Claim
Now is the time to click the submit button. The form will have the patient’s information, insurance details, and treatment data. This could include the location of the service, the kind of services offered, your tax ID, and other information.
There are several ways to submit a claim. While mailing claims used to be the norm, it is no longer the most efficient way. Many insurance companies allow you to submit claims through their personal claim’s portal. However, submitting claims through billing software is the most efficient as it ensures accurate and efficient claims processing, allowing you to get paid faster.
Step 5: Monitor Claim Process
Follow up on the claims after sending them to ensure they go through the system. Without following up on claims, you could potentially be losing thousands of dollars.
The easiest way to track your claims is by using a third-party clearinghouse. Your clearinghouse will let you track electronically submitted claims and will support through the process by correcting any errors automatically. If the billing software has claim-tracking features, you are good to go. Using a third-party solution enables you to regularly get status reports and claim processing feedback.
Step 6: Record, Review, and Manage Denials
Insurance companies can reject claims for various reasons, such as missing details and outdated information. This isn’t a good experience because you can lose revenue in the long run. But don’t worry. You can correct the mistakes and appeal if you get a claim denial.
You can check your clearinghouse tool to follow up to check the claim’s progress. Once the claim passes the checkpoint, you can call the payer to determine the reasons for the delayed payment.
Always follow up to the end, even if it means reworking, resubmitting, and appeals. The good news is that you can learn several tips to avoid insurance claim denials and have a seamless process.
Step 7: It is Time to Get Paid
Once you’ve successfully submitted the claims and the insurance approves, you will get paid through a check or an EFT. The confirmation comes with details about the benefits explaining the payment amount. Some insurance companies do not pay the entire cost. In this case, your patient will need to pay the difference.
Tools to Manage Mental Health Billing
Several mental health billing tools can transform the billing process and make your work efficient and accurate. If you do not want to outsource your billing services to a third party, you should consider investing in technology for seamless billing processes. Here are the essential tools you need.
Practice Management Systems
Generating bills can be smooth with integrated practice management tools. This tool automatically generates bills with accurate information and formatting. It’d be best to invest in quality tools to boost automation. You should also invest in a secure tool to protect patients’ sensitive details from a data breach.
Reporting Tools
When claims get rejected, you will need to report, keep track and follow up. This can be effective with a reporting tool. Investing in quality software solutions with a reporting feature enables you to receive alerts on the rejected or aging claims from the insurance company.
Coding Solutions
It is imperative to learn about behavioral health coding to increase the chances of getting the claims paid. You should also know that codes may be different for telehealth services. However, the in-built coding database in the Electronic Health Record (EHR) can make the processes smooth. It is best to contact the insurance company to know the acceptable codes.
Optimize Your Mental Health Billing with Logik Solutions
Mental health billing can be seamless if you invest in the right tools. Logik Solutions offers quality mental health billing tools that enhance your revenue cycle and optimize your billing process. We provide a secure and fully integrated system that makes the claim process seamless. Get a free demo and find solutions to your mental health billing concerns.
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