Hello fellow psychiatrists! Is the world of mental health billing making you overwhelmed? Well, it’s normal if you are new to the practice or even an old provider in this field.
As a mental health service provider, you won’t be familiar with these complex mental health billing CPT codes, modifiers, and rules set by payers.
As a result, these tasks like medical billing & coding become daunting for you because they will likely be performed by medical coding and billing experts.
However, they say there is a solution to every problem, that’s right!
I’m here to guide you with everything you must know to make your mental health practice successful. So, keep reading this blog!
An Introduction to the Medical Billing Landscape
Let’s take it this way, when you run a restaurant or some other business, you instantly get paid by the consumer.
Right? But the same does not happen for hospitals or any other healthcare facilities.
In the healthcare industry, payments are not received immediately in the provider’s (doctors) accounts. To get paid for their rendered services, they need to follow some complex procedures of medical billing services.
Now you must think medical billing is all about sending invoices to patients or payers (insurance companies).
However, it’s more than that! When sending claims, you must check the patient information, codes, regulations, etc. Otherwise, there is a chance that you won’t get paid for your provided services.
In mental health billing services, if you make the simplest mistake while coding. Your payments are POOF! Bid farewell to all your thousand dollars in a simple one mistake!
What Makes Mental Health Billing Complicated?
The healthcare industry is complex and more so for mental health providers, but the question here is why?
Let’s start from the beginning!
When a patient comes, you have to follow some treatment procedures…
These treatments involve checking blood pressure, tests, height & weight etc. In other words, mental health treatments are more personalized and vary from patient to patient. It means there will be different billing standards for each patient.
You will generate more demand and less billing reputation than other medical services.
Moreover, when discussing personalized treatments, we mean the length of the patient therapy session and other aspects of diagnosis.
These different parts of processes make billing challenging for this industry. And the “one billing model” suggested by payers can’t be applied to all patients.
What’s the Solution?
Different modifier codes are used to tell the extra information to payers about the patients’ treatment. If you use the wrong modifiers, your claims will be rejected.
Another possibility is that your client might be seeing other therapists and the payer won’t pay for two therapists for a single client.
Gather Right Patient Information
In order to get paid for your rendered services, you need to file your claims with the proper documentation and without any coding errors.
First, you must gather customer information to make your medical bills accurate and reimbursable to the payers.
Medical billing services start right after the patient makes the first appointment with your clinic, and you begin to enter the patient’s information.
This step is important because if you make the slightest typo mistake in a patient’s name, insurance ID number, DOB, etc, your claim will be directly sent to the denial.
The next important step is to confirm the patient’s insurance plan. You need to know the benefits and limitations of a patient’s plan. This way, you and your patients have fewer chances of confusion.
Understand and Cleanly Submit Your Claims
Understanding the medical billing codes is essential and can’t be neglected because your payments depend highly on them. Send your claims to the payers using the proper documentation formats.
Each insurance company has its preferred filing methods. So, sending them claims using their preferred methods increases the possibility of getting paid.
Moreover, you need to take care of overbilling or underbilling your claims. For instance, the patient had a 30-minute session with you. But you are using the code (90837) for a 60-minute session.
You are simply upcoding, and this will make your claim go into rejection. Moreover, these errors can also put you in difficult situations like penalties.
Outsource Your Services to a Medical Billing Company
Have you heard people saying always let the experts do their work? When you outsource your medical billing services to experts, there is a high chance for you to thrive in your practice.
First, it frees up your time and lets you focus more on your mental health practice rather than keep spending time understanding complex mental health codes, rules, and regulations.
When you outsource your services to a medical billing company, they will send claims accurately to the payers and reimburse your payments.
Moreover, when you work with experts, there are fewer chances of errors because experts know how to deal with these insurance companies.
Conclusion
In this blog, we have discussed the world of medical billing. We discussed solutions to meet the challenges providers face in this practice. Billing services for psychiatry are more complex than other medical specialties.
When you send claims to payers, you need to properly monitor patient information, codes, regulations, and other critical details.
Otherwise, a simple mistake in the mental health billing process can result in significant financial loss. You need to regularly check compliance and coding changes to make your claims accurate.
Generally, we can say that the rules set by payers for psychiatry services are more strict, making medical billing difficult for doctors in this field.
James Bourke has a passion for writing about health and wellness topics. When not writing, he enjoys spending time with his friends and loved ones.