Guidelines for Accurate Behavioral and Mental Health Medical Billing

Guidelines for Accurate Behavioral and Mental Health Medical Billing

Medical billing for mental and behavioral health presents a set of unique and complex challenges. Behavioral health patients may require additional services such as support programs, literacy training, rehabilitation, and other specific services for comprehensive care. When billing for these services, discrepancies often occur between the standard timing of treatment accepted by insurance providers and the actual time a treatment takes, which can potentially lead to billing issues. Additional challenges faced by mental and behavioral health practices include spending more resources and time on coordinating patient care instead of attending to their patients’ needs, and not receiving care from specialty programs.

In order to combat the already tedious and complex nature of medical billing, below are some quick mental and behavioral health billing guidelines to ensure profitable billing operations:

  1. More information is better

Collect as much information from the patient as possible, including alternate phone numbers, addresses, insurance type, social security number, etc. This may help resolve billing errors related to demographic information prior to contacting the insurance company.

  1. Understand CPT codes

Common procedural technology (CPT) are codes used by insurance providers to calculate the reimbursement to healthcare practitioners for services provided. It is crucial to understand the services your practice offers and the respective CPT codes associated with those services for maximum reimbursement.

Related Article: Four Revenue Cycle Management Myths Impacting Rural Healthcare Providers

There are two types of CPT codes available for behavioral and mental health practitioners: Evaluation and Management (E/M) Codes and Psychiatric Evaluation Codes. E/M Codes are used to evaluate new medical issues and must include three documentation elements:

  • History
  • Medical Examination
  • Medical Decision Making

Psychiatric Evaluation Codes are used for diagnostic assessment. It can include E/M services, but it lacks the time associated with E/M services.

  1. Properly submit claims

For quickest reimbursement, ensure the correct code is submitted in the correct billing format. Additionally, it is essential to keep track of submitted claims to resolve any denials without exceeding the time limit for timely filing.

We understand the complexities around mental and behavioral health billing. iPatientCare’s platform is designed to support precise behavioral health billing and aims to simplify and streamline medical billing, allowing practitioners to focus on providing the best care to their patients.

Is outsourcing medical billing the right choice for your practice?

It is imperative to bill accurately and submit clean claims for services provided to operate a profitable practice. Outsourcing your billing process will relieve staff of tedious work and save a large amount of revenue lost to billing and claim submission errors.

In addition to our software platform, iPatientCare offers a complete, turnkey revenue cycle management service. At iPatientCare, we partner with mental health practitioners to offer enhanced medical billing services, and to assist with appeals for any denied insurance claims. Our behavioral health billing specialists make your billing process easier than ever.

For example, medical billing providers, such as iPatientCare, provide dashboards that alert users to billing issues and patient accounts. Practices can easily check and maintain patient volumes, procedure mixes, collections, days in accounts receivable, and major denials. Comprehensive performance reports, are automatically generated, helping providers gain a better understanding of the financial health of their practices.

Guidelines for Accurate Behavioral and Mental Health Medical Billing

iPatientCare’s revenue cycle management services bring you best-in-class billing and coding services for your behavior and mental health facility. Please contact us for more information and we will be in touch shortly.


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