According to the National Institute of Mental Health, more than 23% of US adults live with a mental illness. Luckily, behavioral health treatment rates have increased in the past several years, especially among young adults, whose treatment rates have jumped by 45%.
As demand and treatment rates continue to grow, it is important for mental health providers to optimize their billing practices to ensure fair and timely reimbursements, enabling them to continue delivering high-quality patient care.
Strategies to improve your mental health reimbursements
1. Accurate coding is key
Accurate medical coding is one fundamental aspect of maximizing reimbursements. Mental health providers must ensure they correctly navigate different diagnosis and procedure codes for time-based therapy, telehealth, group sessions, and collaborative care models. Any errors can lead to denied or delayed claims, negatively impacting cash flow and patient satisfaction.
It’s imperative that behavioral health provider groups stay informed of the latest coding changes and guidelines to maintain accuracy. Leveraging electronic health record (EHR) systems incorporating up-to-date coding resources can significantly minimize coding errors and improve billing efficiency.
Additionally, outsourcing your practice’s medical coding is an effective option for optimizing processes and alleviating administrative burden. You can learn more about medical coding outsourcing in our blog, Five Reasons to Outsource Your Medical Coding Services.
2. Document thoroughly and legibly
Comprehensive and legible documentation is vital for successful mental health billing. According to the American Psychological Association (APA), records benefit the client and the provider by documenting treatment plans, services provided, and client progress.
Record keeping also enables providers to plan, implement, and monitor an appropriate course of treatment. Clear and detailed records of each session, including treatment plans, progress notes, and outcomes, support insurance claims and ensure care continuity.
Finally, providers should maintain a standardized documentation process that adheres to industry regulations and insurance requirements. Doing so strengthens the provider’s case for reimbursement and facilitates effective communication with insurers and other healthcare professionals involved in the patient’s care.
3. Verify mental health insurance coverage before the appointment
Before scheduling an appointment, mental health providers should verify the patient’s insurance coverage and benefits. Understanding the patient’s plan details and limitations enables providers to set clear expectations regarding potential out-of-pocket costs, co-pays, and deductibles.
Leveraging electronic verification tools or partnering with a top revenue cycle or medical billing company can streamline this process, saving time and reducing administrative burdens for mental health practices.
4. Timely submission of claims
Submitting claims promptly is essential for timely reimbursements. Mental health providers should establish clear internal procedures for claim submission within a reasonable timeframe following each patient’s appointment.
Using electronic claim submission methods can accelerate the process and reduce the risk of missing deadlines. In addition, automated claim tracking systems help promptly identify and address any potential claim issues.
To ensure timely submission, providers should maintain an organized billing schedule and closely monitor deadlines. A routine check-in process for pending claims can also help detect delays early and facilitate quick resolution.
Efficient claim submission practices enhance cash flow and minimize administrative burdens, allowing mental health professionals to focus more on patient care.
5. Appeal denied claims
Claim denials can occur for various reasons. According to the American Academy of Profesional Coders (AAPC), common reasons for rejected or denied claims include:
- Coding errors
- Duplicate claims
- Lack of medical necessity
- Patient eligibility issues
- Insufficient documentation
When a claim is denied, mental health providers should proactively identify the reason and promptly appeal when appropriate.
Engaging with a medical billing company, with an expertise in behavioral health, can be advantageous during the appeals process. Their expertise in navigating claim denials can increase the likelihood of successful resubmission and reimbursement.
At Health Prime, we can help!
Trusting your medical billing to an expert partner is also a good strategy if you are a mental health professional or facility interested in reducing your administrative burden while enhancing your reimbursements.
Delegating administrative tasks can free mental health practitioners to focus on patient care. By entrusting billing complexities to specialists, practices can enhance efficiency, ensuring timely claims processing. This efficiency reduces administrative burdens and creates room for additional patient visits, ultimately enabling providers to expand their capacity without compromising care quality.
At Health Prime, we specialize in providing comprehensive medical billing services tailored to mental health providers. We understand the complexities of mental health billing and can help you maximize reimbursements while ensuring compliance with all relevant regulations. Contact us at [email protected].
