Mental health clinicians may have to deal with issues in the billing department that can make their jobs more difficult and stressful. Relative to other professionals in the healthcare industry, they can be disadvantaged because of what services they are offering. If your practice has trouble having claims get approved, you aren’t the only one. These are a couple problems that staff in mental health billing could be facing.
They See Patients Too Frequently
While it might not sound bad to see patients so often, it can often be more of an issue than you may think. You should see patients every 5-7 days normally. If you see them more than twice per week, that may be too much. Patients that require treatments multiple times each week need to seek higher-level care.
By trying to see patients so many times in a week, it results in you having too many patients to serve and bill. It becomes unrealistic to try and serve that many patients every day. As an example, insurance companies could raise an eyebrow if they notice that you see and bill a high number of patients each day with the exact same code.
Clients Who See Multiple Therapists
One of the other pitfalls to mental health billing comes from clients who see multiple therapists. This is most likely to occur whenever clients must see their therapists at the same location where they visit their doctors, but they also have private therapists who they visit for other reasons. Payer sources do not like paying for multiple therapists for one client.
Using the Exact Same ICD-10 Code Too Much
In the world of mental health billing, it is a problem if the ICD-10 code is used too frequently. You need to have variance in your billing. Otherwise, you could end up facing audit risks. It is a problem if you bill identical diagnosis codes for every patient you have.
While insurance companies have been more accepting of having the same codes used for many patients while the COVID-19 pandemic has been happening, it is not something we recommend, and it’s not a legal practice.
Treatment Plans
One other pitfall in the world of mental health billing is the treatment plans that patients get. If you don’t finish up a patient’s treatment plan, you’re sure to not get payment, and you might also have to send money back to a payer source once the audit is finished.
There are certain agencies that will require that treatment plans get signed by patients. Funds will need to be relinquished if these plans are not signed.
Also, with regards to finishing treatment plans, professionals in mental health billing try billing either 90836 or 90833, so they can get additional time. But, the extra time is considered part of therapy, meaning you will need a treatment plan.
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