FAQ: What Should You Look for When Choosing Behavioral Health Billing Companies?

Behavioral health billing companies specialize in managing the unique billing and revenue cycle needs of mental health and substance abuse treatment providers. Outsourcing to a reputable billing company can improve practice efficiency, increase revenue, and ensure compliance. However, not all billing companies are created equal. Here’s what to look for when choosing a behavioral health billing company:

1. Expertise in Behavioral Health Coding

  1. Behavioral health billing involves specific ICD-10 and CPT codes, such as:

  1. 90837 for 60-minute psychotherapy sessions.

  2. F32.9 for major depressive disorder.

  3. H0031 for mental health assessments.
    Ensure the billing company has certified coders with experience in behavioral health to avoid errors and maximize reimbursements.

2. Comprehensive Revenue Cycle Management

  1. A good billing company should handle all aspects of the revenue cycle, including:

  1. Patient registration and insurance verification.

  2. Claims submission and follow-up.

  3. Payment posting and denial management.

  4. Financial reporting and analytics.
    This end-to-end approach ensures smooth operations and improved cash flow.

3. Denial Management and Appeals

  1. Behavioral health claims are often denied due to coding errors, missing information, or lack of medical necessity. Look for a billing company with a strong denial management process that includes:
  2. Identifying and resolving denial trends.
  3. Appealing denied claims promptly.
  4. Implementing corrective actions to prevent future denials.

4. Compliance with Regulations

Behavioral health billing must comply with federal and state regulations, such as HIPAA and the Mental Health Parity and Addiction Equity Act (MHPAEA). Ensure the billing company stays updated on regulatory changes and conducts regular compliance audits.

5. Technology and Software

The billing company should use advanced practice management and billing software to streamline processes. Key features to look for include:

  • Electronic claims submission.

  • Real-time eligibility verification.

  • Secure patient data management.

  • Customizable reporting tools.

6. Transparent Pricing

Behavioral health billing companies typically charge:

  • A percentage of collections (usually 4-10%).

  • A flat monthly fee (ranging from 500to3,000+).

  • A hybrid model combining both.
    Choose a company with transparent pricing and no hidden fees. Ensure their pricing aligns with your practice’s budget and needs.

7. Experience with Your Practice Size and Specialty

Whether you’re a small private practice or a large treatment facility, the billing company should have experience working with practices of your size and specialty. For example, if you offer telehealth services, ensure they are familiar with telehealth billing codes like 90837-95.

8. Strong Customer Support

Reliable customer support is crucial for addressing issues quickly. Look for a billing company that offers:

  • Dedicated account managers.

  • 24/7 support availability.

  • Clear communication channels.

9. References and Reviews

Ask for references from other behavioral health practices and read online reviews. This will give you insight into the company’s reliability, quality of service, and customer satisfaction.

10. Customizable Services

Every practice has unique needs. Choose a billing company that offers customizable services, such as:

  • Prior authorization assistance.

  • Patient billing and collections.

  • Credentialing and contracting support.

Why Partner with a Behavioral Health Billing Company?

Outsourcing to a behavioral health billing company can:

  • Increase revenue by reducing claim denials and errors.

  • Free up staff time to focus on patient care.

  • Ensure compliance with regulations.

  • Provide detailed financial insights to help grow your practice.

By carefully evaluating these factors, you can choose a behavioral health billing company that meets your practice’s needs and helps you achieve financial success

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