In the field of medical billing, there are many different types of billing, and each will have slight differences from the others. Mental health billing, as an example, must cater specifically to patients who are seeking mental health treatment. As such, there are certain steps you’ll want to follow if you want to perform mental health billing effectively. That’s why, today, we’ll be offering a guide to help your medical practice with mental health billing.
Know the Distinctions Between CPT and ICD-10 Codes
ICD-10 codes and CPT codes are required both in medical billing and mental health billing. Of the two types of codes, CPT codes are more important because they focus on how you’ll be treating a patient’s diagnosis, as opposed to ICD-10 codes, which serve to determine a patient’s diagnosis. A diagnosis isn’t something that can be billed, but you are able to bill patients when you’re providing treatments for them. If you want to make billing as easy as possible, you’ll want to remember that the duration of a patient visit influences which CPT code you’ll use.
Get Yourself Familiar With Psychiatric Evaluation and E/M Codes
All of the CPT codes that you’ll want to know will be in one of two main categories. The first category is E/M codes. These codes are used when your patients have brand new issues that you need to evaluate. There are three documentation components that every E/M code needs to have:
- History: includes patient’s diagnosis, social and family histories, and system review
- Examination: has a history of the patient, their current problem, and which exams you have done
- Medical choice-making: review the number of diagnoses a patient had, as well as the number of treatments they received. You’ll also include a list of complications if they arise, and go over the complexity within your patient’s data.
Get Your Patient’s Insurance Benefits Verified
Once you understand all the different codes with which you’ll be working, then you can proceed to get the billing process underway. To start, you’ll want a VOB (verification of benefits) for all the patients you have prior to their first visit to your facility. To get a VOB, a copy of your patient’s insurance card will be needed. Once you’ve done that, you’ll want to get logged into the portal of your insurance provider and figure out if your patient’s insurance will cover all the services you provide. Contact the insurer if there isn’t a portal to access.
Know When It’s Best to Use Different Billing Forms
There are two main kinds of billing forms you will likely find in mental health billing. Those are CMS-1500 and UB-04. No matter which forms you’re using, you want to have tax identification numbers and National Provider Identifiers on hand. You will also want to know what kinds of information will be needed for the different parts of each form. This is because you might need different kinds of information, depending on the payers you have.
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