Mental Health Billing Detailed Guide: What Every Therapist Needs to Know

If you’re new to the concept of billing for mental health you might feel overwhelmed, confused or worried about the procedure. Don’t worry; that’s normal! Mental health professionals do not have the necessary training to navigate the world of medical billing. Since billing is more closely tied to finance and administration in business than to health care disciplines.

Yet, behavioral health clinics across the country manage to master the best billing methods to keep the cycle of revenue moving and you could also. This is what every therapist needs to be aware of prior to entering this world of bill-paying.

Returns of mental health billing

What exactly is “returns?” Quite simply, it’s the process of earning money starting from securing a paying client until you receive the money into the bank account of your choice. There’s a lot to learn about this process but for now this is a brief overview of the fundamental steps

Data to Gather

A good billing practice begins at the time you start an account for a new patient.

Why? because the majority of claims that are rejected by insurance companies are a result of simple errors like a spelling error or a mistake in the insurance ID number or a blank field etc. In order to create what’s known as”a “clean” or mistake-free claim it is essential to have precise accuracy in the details such as:

• Patient’s Name
• Birth date
• Current address
• Identification number of insurance member

If incorrect information or mistakes get into the patient’s initial documents, these errors will be evident on every invoice until you recognize that there’s a problem. Because behavioral health professionals see patients on a regular basis, you could have several bills to fix and file again due to one error at the beginning.

Also, double-check any details of new patients for accuracy. It is also important to verify the insurance coverage of their mental health billing services immediately. Making sure you are covered prior to the time is an easy way to avoid problems in the future.

Roll on the claim as appropriately

A clear claim is formatted properly, has accurate data and is free of errors or errors. You can create this form electronically, then fill it out on paper or hand the entire operation over to third-party billing service.

If you have billing software that is in-house, your software might produce claims in the right format and pull pertinent patient information from your patient records, depending on how integrated it is. When you use EHR billing, it is possible to send claims directly from your software or through the claims portal offered by the clearinghouse or payer.

Paper-based insurance claims have become less popular as insurance companies increasingly abandon their paper claims in favor of digital. Make sure to check the policies of any clearinghouse or company before sending out an original claim.

To bill third parties, it is necessary to have an encrypted way for billers to gain access to your claim information. One way is to grant billers login access to the HIPAA-compliant, secure software you use in your clinic. Whatever method you decide to choose, it is your obligation to ensure the security of the patient’s documents.

Monitor Appeals and Denials

Insurance companies refuse to accept claims due to many reasons. Certain are related to coverage and others involve simple fixes including missing or out of date data.

Clearinghouses look for errors and discrepancies before the claim is sent to the insurance company. Therefore, your claim could be denied by the clearinghouse before it is approved. Most of the time, you can fix the issue and submit. To determine if the claim is hanging up at the clearinghouse, or in the hands of the buyer, look in the software used by your clearinghouse for claim rejection. If the claim is cleared the clearinghouse checkpoint, you’ll be required to contact the payer to inquire about why there’s a delay in the payment.

After clearinghouse approval the request for coverage has to be approved by the payer. Rejections and denials during this time should be thoroughly examined to find out the reason and the possible solutions. Contact an insurance agent directly to get ideas about how you can fix and resubmit denied claims. They may be able to help you in determining the best solution to bring about a reimbursement. Sometimes, the insurance plan does not cover a specific treatment and there’s nothing that you could do.

Final Words

Billing isn’t necessarily intimidating. The right tools can help you get it done and receive the money you’re entitled to.

Preferred billing streamlines your revenue cycle and assists you in recovering overdue payments faster. The fully-integrated system eliminates unnecessary steps out of your process, and includes auto-generation for claims, and reporting on old bills.