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Clinical documentation and financial performance may seem like two separate worlds, with one belonging to clinicians and the other to the billing team. In reality,
The behavioral health sector has seen a significant wave of investment activity in recent years. Private equity firms, health systems, and strategic acquirers have taken
If you run a behavioral health or substance use treatment program, you’re already familiar with the ASAM criteria—the American Society of Addiction Medicine’s framework for
When a behavioral health claim comes back denied, the reason code on the explanation of benefits may seem like it should tell you exactly what
One of the most challenging experiences in behavioral health billing is receiving a claim denial on a service that was fully authorized. You dotted your
Claim denials are one of the most frustrating parts of running a behavioral health practice. You’ve done everything right—delivered the care, documented the session, and
Growth is often a good thing, but it can also create stress, especially for a behavioral health facility that’s scaling. From the outside, growth looks
If you’ve recently outsourced your behavioral health billing, or you’re considering it, one of the first questions on your mind is probably: how long before
In behavioral health billing, most people focus on the back-end of the revenue cycle, which includes claim submission, denial management, appeals, and collections. It’s understandable
Most mental health practice owners understand their revenue cycle in broad strokes. Patients come in, claims go out, and payments arrive. Pretty straightforward, right? Not
Most behavioral health practice owners have a solid understanding of the big-picture revenue cycle: claims go out, payments come in, and denials get worked. But
Mental health practices are in the business of healing, but they still need to operate like a business to keep their doors open. That depends
In behavioral health billing, 99214 is arguably the most widely submitted established patient E/M code—and also one of the most challenged. Many providers are sure
Few billing and coding decisions carry the same impact as whether to assign 99213 or 99214 for an established patient behavioral health visit. Code too
Not every patient who needs care will have an insurance plan that fits neatly into your existing contracts. A prospective client may have out-of-network benefits,
Every behavioral health practice generates data. Patient visits, claims submitted, payments posted, authorizations requested, denials received — the numbers are always there. But data without
If you’ve spent time in healthcare billing, you’ve likely seen the terms preauthorization and precertification used in similar ways. Some payers use them interchangeably, while
Ask most behavioral health providers what they got into the field for and you’ll hear a version of the same answer: they wanted to help
