Our Blog

Substance use treatment is life-changing, but behind the scenes, billing for these services is anything but simple. Navigating the complexities of insurance claims, pre-authorizations, and compliance requirements can feel overwhelming, especially when providers should be focused on patient care. So who exactly handles the billing for substance use treatment? And how do you ensure it’s done accurately, efficiently, and in compliance with ever-changing regulations?

The landscape of behavioral health and substance use treatment is changing rapidly, and so are the billing requirements that support it. Providers are facing a growing number of regulatory changes, coding updates, and documentation requirements. Staying on top of these developments is essential, not just for compliance, but also for securing timely reimbursements and delivering uninterrupted care.

Do you sometimes feel like navigating insurance claims is more stressful than providing actual patient care? Well, you’re certainly not alone. Payor issues are one of the biggest pain points for behavioral health and addiction treatment facilities. Between delayed reimbursements, denied claims, and confusing coverage policies, these “payor headaches” can quickly derail your cash flow.

Accurate billing isn’t just about submitting claims. It starts long before services are ever provided. One of the most crucial steps in the revenue cycle is Verification of Benefits (VOB). Unfortunately, it’s also one of the most overlooked. Skipping or rushing through this step can lead to denied claims, unexpected patient bills, and major revenue setbacks.

As a mental health provider, your priority is helping people heal. This requires a great deal of time, focus, and compassion, things that are hard to give when you’re busy chasing reimbursements, dealing with denials, or navigating changing payer requirements. The good news is that you don’t have to let the business side of your care pull you away from your purpose. With the right revenue cycle management (RCM) company, you can improve your practice and your patients’ access to care.

Claim denials can be incredibly frustrating and costly for providers, especially those who work tirelessly to support individuals with mental health and substance use disorders. Unfortunately, behavioral health billing is one of the most complex areas of healthcare revenue cycle management (RCM), and claim denials are all too common. In 2020, approximately 20% of the 765,000 behavioral health claims deemed medically necessary were denied by insurers.