A clean claim is formatted correctly, contains accurate information, and is free of mistakes or typos. If you’re new to mental health billing, you may feel overwhelmed, uncertain, or anxious about the process. Most mental health experts aren’t trained to navigate the medical billing landscape.
How Better Billing Can Improve the Entire Practice or Clinic
It’s already integrated with practically every payer that exists in the mental health billing world…so it can pull up the claim status for everything you’ve submitted through it. It is equally important to determine and document the medical necessity based on which the ICD codes are assigned. You can work hard to submit your claims, and go above and beyond for it as well. This is yet one more reason why mental health providers choose billing services like TheraThink to help. Our Beginner’s Guide to Mental Health Billing is for the brand new and having-no-clue outpatient therapist looking to learn how to bill insurance companies. You will learn what client information you need, how to verify mental health benefits, create and submit claims, and account for EOBs.
Re-File Insurance Claim As Corrected on CMS1500 Form
Refer to your NPI and tax ID in their system, then ask if claims were received and have any errors. If you don’t know which CPT codes to use for billing, refer to our popular and easy to read guide here. You are to charge them after the fact for their patient responsibility payment per session as listed on the completed EOB your receive from filing your claims.
Reimbursement Rate Negotiation Tool & Template
Providers must pay more attention to generating bills with complete and correct information. Regulations, billing codes, and insurance policies are subject to change. Staying updated on these changes is crucial for maintaining billing efficiency and compliance. Many professional associations offer resources, workshops, and seminars https://www.bookstime.com/ focused on billing and coding. Engaging with these educational opportunities can empower practitioners with the knowledge to handle billing more effectively. Clearinghouses screen for incorrect content and discrepancies before a claim ever reaches the insurance company, so your claim may be rejected by the clearinghouse first.
- Unfortunately, incorrectly chosen CPT codes can also chip away at the integrity of your practice over time.
- The representative may be able to assist you with the solution that will result in a payment.
- Some involve coverage issues, others are easy fixes, like outdated or missing information.
- If you don’t want to use one centralized EHR system, you can file claims to each insurance company’s website via the submission guidelines in Chapter 2.
- Everything transpiring between a patient and the mental healthcare provider should be in the medical record.
Record Denials and Erroneous Claims
Common Procedural Technology (CPT) codes are also necessary for billing for psychiatrists and other mental health providers who can prescribe medications and provide diagnoses. Now that you know how ICD codes are relevant to insurance billing, CPT codes have a similar role. ICD codes are used primarily for diagnosing a patient, whereas CPT codes are used to support the diagnosis with the necessary medical treatment. mental health billing for dummies As a mental healthcare provider, you can do everything right up until you submit a claim, but all of your hard work will be undone if you don’t do it properly. For instance, after you provide a service, you should expect to receive a reimbursement from a claim. 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.
- This is partly due to the stigmatization that still exists around mental health.
- Once you’re familiar with the ICD-10, CPT, E/M and psychiatric evaluation codes relevant to your services, you can formally begin the billing process.
- The same goes for specialists who perform very targeted diagnostic tests related to one body system or illness on all patients.
- The provider can research to gain knowledge about most insurance companies’ repeated use of claim forms.
- Refer to your NPI and tax ID in their system, then ask if claims were received and have any errors.
Always Double-Check Each Patient’s Insurance
- Use digital claims processing when possible for better tracking of your claims and data and faster claims submission.
- You are to charge them after the fact for their patient responsibility payment per session as listed on the completed EOB your receive from filing your claims.
- In short, you’ll receive more money and avoid unpleasant surprises by getting the copay out of the way up front.
- Pre-authorization requirements also create hurdles for mental health billing.
- 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.
- This may take some additional time on your part, but it will be worthwhile when you can avoid common mistakes.
Following these best practices for your mental health billing will make the tedious process more bearable. When it comes to medical billing collections, it’s crucial to create a standardized and measurable billing process and properly train your staff. Refer to the table below to find the correct license level modifier to use when coding modifiers for your behavioral health insurance claims. Connecting with insurance services for mandatory information and verification is also easy. If your questions are not resolved with the above techniques, you can pull the required insurance data from EHR (Electronic Health Record). VOB helps avoid unnecessary claim voids and increases reimbursement rates.
