Insurance reimbursement rates are on the decline, getting lower with each passing day. On the other hand, costs of operations are getting higher. This can make mental health practice management incredibly stressful. Mental health billing can be especially stressful because you have to handle everything perfectly. Otherwise, payer scrutiny could occur, and your practice could miss out on much-needed revenue. Here are some tips we have for mental health billing for insurance reimbursement.
Have Detailed Documentation On Hand
Just like with the personal information of your patients, you should have detailed records of other pieces of crucial data. Such data to keep on hand includes what goals therapy hopes to achieve, how long the therapy sessions are, how a patient is progressing through therapy, the type of therapy offered, and what diagnosis the patient has.
File Insurance Claims Punctually
You need to be sure that your claims get submitted on time. If you don’t, they will certainly get denied. To get information on acceptable time frames for submissions, you should get in touch with your individual insurance companies. They will tell you how much time you have to submit claims. Typically, the acceptable wait time can be anywhere between 90 days and 1.5 years, so clarity with your insurance companies is crucial.
You can even go an additional step further and make a fixed billing schedule, which will make it even easier to get medical claims submitted at the proper time.
Track Your Medical Claims
In the world of mental health billing, tracking your medical claims is needed. Checking on your claims regularly allows you to detect problems with them before you exceed the time limit you have to submit them.
Determine When You Need Pre-Authorization
Typically, insurance companies won’t require pre-authorization if it would be for something like first-time therapy visits. This can change, however, if you have more than one therapy session per day or if you exceed 45 minutes during a therapy session. Every insurance company has different rules that they follow, and it’s always crucial that you touch base with these companies just to be sure of whether you need pre-authorization or not.
Inform Your Support Staff
If there are any support staff around your practice who help you when carrying out mental health billing, you’ll want to teach them which medical codes are the correct ones to use for each service provided. When your support staff is kept up-to-date on what codes to use, the chances of up-coding and under-coding go down significantly. Also, whatever service code you use will always match whatever pre-authorization has been given.
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