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We dedicate a team of experts with niche experience in mental health billing processes. They are aligned with the latest codebook changes, regulations, and industry best practices pertinent to this specific practice. Backed by billing software solutions, we simplify and expedite mental health billing processes for you. Here’s how we do it:
- Implement a coding and billing software system integrated with digital tools (EDI, EHR, EMR) to ensure accurate electronic claims submissions and faster reimbursements.
- Verify patient insurance details, including policy numbers, SSNs, coverage dates, effective dates, expiration dates, payer fee schedules, and any prior authorization requirements.
- Process pre-authorization documentation summarizing the medical necessity of services and seek prompt approval from the payer.
- Maintain code specificity while billing for procedures, including psychiatric evaluations, psychotherapy sessions, medication management, group therapy, psychotherapy, electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and counseling/assessment for mental various mental disorders (anxiety, psychotic, substance use, trauma-related).
- Implement a multi-tier quality audit process to ensure accurate assignment of billing codes (ICD-10-CM codes, CPT codes, E/M codes, HCPCS Level II codes, Place of Service Codes) to aptly capture aspects like psychiatric diagnostic evaluation, service site, medical services necessity, services timings and duration, etc.
- Submit claims electronically to relevant insurance payers, including government programs (Medicare, Medicaid), private insurance companies (Anthem, Aetna, Humana), employer-sponsored health insurance, veterans affairs (VA), Tricare, health maintenance organizations, and others.
- Review claims thoroughly by analyzing Explanation of Benefits (EOBs), identifying reasons for denials, resolving disputes, and initiating the appeals process as needed.
- Analyze EOBs to calculate out-of-pocket expenses such as copayments, deductibles, non-covered services, out-of-network services, co-insurance, etc.
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