Mental health billing treatments and services can be complicated for billing because they have different rules. Let’s compare them to regular checkups at a healthcare clinic. When you go for a physical checkup, the doctor usually does similar things like checking your blood pressure, height, weight, and more.
Billing these services to health insurance is usually easy because they all come under one charge. However mental health services are not the same. They can vary a lot. The session’s length, where it happens, the way it’s done, the patient’s age, and how much they get involved can all affect how it’s coded and billed.
Simple Tips for Mental Health Billing
When you’re learning how to bill for therapy services, you can always get better and be more efficient. There are things you can do to make insurance billing faster and have fewer mistakes. For accurate billing, you can also get reliable medical billing services. This helps both mental health providers and patients. Apart from this, Following are some tips for mental health billing that can make the process easier:
Check Beforehand
Some health plans need approval before you can bill for therapy, especially if it’s not the usual kind. Always see if you need this approval when you’re working with a new client.
Keep Records Updated
Make sure the information about your patients is correct and up to date. This includes their insurance and personal details. Check this at least once a year, and more if needed.
Submit Claims on Time
Some clients have rules about when you need to send in your bill. If you miss the deadline, you won’t get paid. Make a schedule to send claims regularly, like once a month.
Fix Mistakes
If your claims have been rejected before, it’s frustrating. Find out why it happened and fix the problem. This way, you can send a correct claim. Looking at past rejected claims helps you see if there’s a pattern to fix. Make sure to send the corrected claim within the insurance company’s deadline.
Always Check Patients’ Insurance
In the mental and behavioral health field, it’s a good idea to double-check things. If you’ve had trouble with wrong information causing problems with insurance claims before, it’s smart to double-check. Make sure you know your patient’s insurance before you see them, whether they’re new or returning.
Knowing what their insurance covers before you give treatment will make billing easier and reduce frustration. It might take a little more time, but it’s worth it to avoid mistakes. You can do a benefits check to find out about your patient’s insurance and plan treatment accordingly.
Check the patient’s insurance
To make mental health billing easier, you must verify the benefits (VOB). This confirms if the patient’s insurance covers the treatment they want.
It’s crucial because even if patients have insurance, it might not pay for your services.
Always ensure that your patient’s insurance covers the mental health services they require.
Verifying benefits helps you know how much the insurance company will pay for their treatment.
You can call the insurance company with the patient’s account number to get this information.
Check Insurance Coverage
To make mental health billing simpler, it’s crucial to verify a patient’s insurance benefits (VOB). This means confirming if their insurance covers the services they want. Besides what’s on the insurance card, you might need to dig deeper into their policy.
Even if a patient has insurance, it might not include mental health services. So, always make sure their specific needs are covered. Doing a VOB can also help figure out how much the insurance company will pay for these services. You can call the insurance company using the patient’s account number to get these details.
Submit Claims Correctly
If you work in mental healthcare, everything you do is great until you send your claim. But if you mess up there, all your hard work goes to waste. For example, when you give a service, you expect to get money back from a claim. However, if you put in the wrong code or send it to the wrong insurance company, they might say no or have other money problems.
When you send a claim, you need to do it in the right way for the insurance company you’re sending it to. To make this easy, find out how that insurance company likes claims sent and when they want them. You should send your claim in that time frame, or it could take a long time to get your money. To be safe, you can ask the insurance company how they want claims sent when you do the VOB process.”
Learn about CPT Codes
CPT codes are the way to bill healthcare services, there are specific codes for each specialty. For instance, CPT codes for primary care clinics are different compared to mental health services.
CPT codes help therapists and mental health providers with mental health billing. Just like ICD codes are important for insurance billing, CPT codes play a similar role. ICD codes diagnose patients, while CPT codes support the diagnosis by specifying the medical treatment needed.
CPT codes are crucial for mental health billing because they ensure you get paid correctly and avoid insurance checks. These codes also record the exact service your patient gets, which determines your payment. It’s vital to know the services your practice provides and the associated codes. Like ICD codes, mental and behavioral health providers use some common CPT codes.
CPT codes often indicate the session’s duration and whether the patient or their family was present, like:
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90832: 30-minute psychotherapy with the patient
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90847: Family or couples psychotherapy with the patient present
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90853: Group Psychotherapy (excluding family groups)
Key Takeaways
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Mental health billing differs from routine checkups due to various factors.
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Always double-check patient insurance to avoid common mistakes.
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Verification of Benefits (VOB) is essential for understanding patient coverage.
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Properly submit claims in the correct format and within the insurer’s timeframe.
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CPT codes are crucial for accurate billing and avoiding audits.
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Understand common CPT codes used in mental health services.
