Mental Health Medical Billing: A Strange Beast

2018-11-16T20:22:59+00:00 November 16th, 2018|

There are many different areas of coding and billing that medical billers get into. This can range from general billing to medical billing, to radiology billing, and mental health billing. Sometimes it can be complicated when it comes to the filing of mental and behavioral health benefits, as the codes differ when compared to more general procedures such as x-rays. Getting your claims approval rate up requires a strong amount of diligence and a keen eye for the types of services offered and provided, pre-authorizations that are needed, and effective communication between all professionals involved.

Mental Health Billing: How Does it Differ from Other Medical Billing?

When it comes to the sector of mental health, counselors, psychiatrists, and psychologists provide services that are inherently different than other medical professionals. Rather than bill for a specific task, such as an eye exam, surgery, or x-rays, medical billing usually bills for long sit-down therapy sessions. This can range from a first visit evaluation sessions to a regular refill/check-up session with a psychiatrist, to an hour-long therapy session with a psychologist. The insurance companies and policies they write will ultimately determine how long these treatments can last as well as how many sessions can take place in a given day or week. These stipulations can create quite the rift in a healthcare professionals ideal medical plan-of-action and the reality of the situation. Balancing adequate treatments while also having an economical billing plan can be quite a challenge for both the medical biller and the healthcare professional.

Billing can be less straightforward in mental health billing when compared to traditional non-mental billing. There are a few processes that medical billers follow to quickly process claims:

  • Always check to see if treatments need pre-approval from the insurance company
  • Always double check the spelling of addresses and names
  • Always double check the correct medical codes have been used
  • Policy numbers should be on the claim
  • Do not procrastinate! Each insurance plan has a different allotment of time for claims processed
  • Make sure you are using the required billing format

Mental Health Billing Concerns

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There are a few steps you can take to reduce the number of denials you have for your billing department. Most practices have at least a 20% denial rate for claims, which is money that should not be left on the table. Try incorporating these methods to improve the cash flow for your medical billing department:

  1. Always double check patients’ insurance and possible policy lapses or changes
  2. Always ask insurance companies what their preferred filing methods are (paper vs. digital)
  3. For patients with no insurance or limited coverage, encourage cash payments
  4. Always double check your work

Remote Mental Health Billing Services

If you are looking for medical office support and billing, but at a fraction of the cost of an in-house team, consider hiring The Psych Biller for all of your remote mental health billing needs. We are the one-stop remote solution for medical billing, psychology billing, and mental health office support for any and all of your small business needs. Let us put 18 years of experience to work for you and your private practice! Contact us today to learn more about what we offer.