Transitioning to In-House Billing for Mental Health Services

If you are struggling to find out the place of service code or modifier to use for your insurance claims, this is something we provide as part of our billing service free of charge. The majority of group practices and almost all successful individual private practices utilize outside billing mental health billing for dummies services in one capacity or another. This is the standardized form that insurance companies accept (although now less than before) for your claims submission. Normally all of this information gets submitted digitally, rendering this form useless, unless you know exactly how to fill it out.

• It is also essential to ensure that staff members are not caught in a cycle of overusing specific codes.
• You can run a verification of benefits (VOB) to see if your patient is covered.
• Every mental health insurance claim will require a large amount of information, but that information needn’t be overly complicated.
• If the insurance company has a preferred filing method, make sure you comply with it and the time frame set forth by the insurer.

When you start working for a new client, always check if preauthorization is required before providing any non-standard session. The first tip is to know your patient’s insurance plans and benefits before each visit. However, making sure you understand the coverage available for each patient before receiving any services will lead to a larger return. Following these best practices for your mental health billing will make the tedious process more bearable.

Get Your Call Routed to the Right Eligibility and Benefits Line

It could be a good idea to break down the process into steps for new and established patients. As mentioned above, submitting the form is painful enough the first time; there’s no point in doing your job twice as hard and having to submit a second, third, or even fourth corrected claim. Insurance and mental health billing are closely intertwined, playing a crucial role in ensuring individuals have access to essential psychological services. Mental health insurance billing involves understanding coverage, accurate documentation, and precise coding. Clinicians can also outsource mental health billing services as part of an existing EHR or practice management system.

Learn the benefits of developing a private practice business plan and download a free template. When payers speak with you, they’ll give every conversation a reference ID and indicate the representative with whom you’ve spoken. You should do the same ― ask your contact for the reference ID and their name. This way, if you have to contact the payer again (and you almost certainly will), you’ll have a traceable record of all billing steps you’ve taken to date. In either case, you should have your National Provider Identifier and tax identification number readily available.

Ask About Eligibility

If you aren’t sure how to submit the claim accurately, consider asking a colleague or hiring an expert. IF YOU MUST bill claims via paper, ask about their claims address as well. Ask the representative about your network status with this client’s plan. Inquire about the type of plan and if you are in-network or out-of-network with their plan.

• Here are 10 of the most commonly used ICD-10 Codes for Speech Therapy, so you can ensure your practice maintains its compliance and delivers accurate care services to patients in need.
• Although this isn’t a requirement, it’s not out of the ordinary and a best practice to photocopy the insurance cards of your clients and store them in a safe place.
• However, if you file an incorrect code or accidentally file it to the wrong insurer, you can be denied or run into other billing issues.
• The image above is a screenshot of Health First Colorado’s claim submission web portal.
• This service may be provided with or without the patient’s presence and is occasionally reimbursed.
• Having the customer service phone number isn’t essential for submitting claims, but is necessary to gather eligibility and benefits information and to verify claim status and payment amounts.

To input the data and create the forms, you can try using a pure software solution, such as an EHR (electronic health record). EHRs come with calendaring, appointment reminders, simplified documentation, internal messaging, a patient portal, and credit card processing. However, there are often issues with mental health billing that can hinder the treatment process, such as inaccurate documentation or preauthorization. Mental and behavioral health providers may stumble upon one or more of these problems – and many others – which make it hard to run their practice effectively.

How standardization (or lack thereof) affects mental health billing

Use the allotted information to get a quote for “outpatient mental health office visit services”. Now it’s time to verify their insurance coverage and your network status in their plan, then their benefits based on all of that, via a phone call. In addition, integrating billing functions with existing IT infrastructure can pose hurdles. Even if a practice chooses a tailored EHR, customizations and data migrations can take time.

• Learning more about the mental health billing process can make it easier for you to spend more time and energy on your patients and less on inconvenient discrepancies.
• You may need to prompt a clearinghouse or payer to identify why it’s stalled and how soon it can be resolved.
• It’s likely that the bulk of the solution provider’s clients are doctor’s offices.
• The process of submitting your client claims to your clearinghouse and/or insurance payer.
• To help illustrate that point, I’ll give you another example of what this industry is like within the state of Ohio.
• You can ensure your claim is not denied at the clearinghouse by calling the insurance company and asking if they have the claim on file.