Let’s face it, the healthcare industry is vast and complex, even more so for mental health providers. This is especially true when it comes to the billing process.
The variety in the types of services, the time, scope and restraints put on mental health treatments make the billing process quite demanding. If a patient visits his or her medical doctor, the doctor will likely perform standard tests and services, such as measuring a patient’s height and weight, checking blood pressure and perhaps drawing blood. Such tests tend to be standardized across patients, differing only slightly among patients and all taking nearly the equivalent amount of time. As a result, billing is also repetitive and standardized.
With mental health providers, however, services vary way more extensively. The length of the session, the approach to therapy and the willingness of the patient to partake make it far more difficult to standardize treatment and billing. Moreover, the manner in which insurance companies look at mental health is noticeably unlike the way they look at more traditional medical practices. For example, insurance companies can determine how long treatments are allowed to take and how many sessions can take place each day, making it challenging for mental health clinicians to balance effective billing with adequate patient treatment. Additionally, the requirement of pre-authorization has resulted in more difficulty and complexity for mental health billing.
The differences between medical billing and mental health billing are also magnified by office budgets. A large group practice might hire dedicated employees to focus wholly on medical health billing, but with mental health, it’s more commonplace to have small group or solo practices with limited administrative support for billing and other office duties. Some providers will even try to do the billing themselves but sooner or later, this will become overwhelming and produce time management problems, not to mention lost income.
All this makes the billing process quite demanding for mental health professionals. They need to make sure that they can keep income levels high while also assuring that each and every patient gets the utmost quality care.
Truth is, no one gets into the mental health field because they enjoy wading through insurance industry bureaucracy. People become mental health professionals because they want to help others. However, providers cannot help others unless they collect sufficient funds to run their practices and pay themselves.
It’s rather predictable, without a dedicated staff member to keep up-to-date on healthcare billing codes, changing regulations and the billing practices of each insurance company, rejection rates will climb.
Put simply, there are fewer pitfalls involved in medical billing versus mental health billing because medical health billing is more straightforward.
As a mental health clinician, being paid for the services you provide to patients is paramount. Unfortunately, due to the frequency of insurance claim denials today, payment is not always assured for your services. Payer sources use denials and rejections as tools to force clinicians to hand over hard-earned dollars.
Let’s briefly look at some of the more common billing pitfalls.
Documentation and billing errors can also occur when a claim is missing progress notes and does not include a plan for the patient’s long-term care.
The bottom line is that billing issues for mental health professionals can lead to reduced revenue, unproductive time and further stress.
Okay, it’s been demonstrated that billing for mental health differs greatly from billing for medical services. We’ve also determined that mental health professionals often operate on a smaller budget than medical facilities and many offices employ a small staff.
As a result, taking on the billing needs of patients can stretch counselors and staff members thin, which can ultimately impact client service.
Reducing the time for billing and coding procedures can, however, be harmful to offices focusing on mental health services as insurance companies will quickly deny a claim that is not filed or coded accurately.
Such is the dilemma faced by mental health professionals today!
Most healthcare providers don’t possess the time or know-how to manage the billing process. Plus, very few have the means to take on an in-house billing team. This especially holds true for the mental health provider.
By outsourcing such things as your statement preparation, data entry, filing and follow-ups to a third party, your practice benefits in the following ways.
Or, putting it another way, the real cost of billing is not the payroll expense. It’s really all the charges that were not billed in the first place or were not followed up after billing.
An expert billing service would pay for itself.
Conclusion: Outsourcing mental health billing can allow offices to focus on patient services while realizing higher returns for services provide.
It pays to take your time and be discerning when assessing possible providers for your outsourced mental health billing. Before you make your decision, make sure to find out if the provider has the following capabilities and the wherewithal to do the job.
Another crucial issue is that the company provides suitable staff training. Inadequate training leads to added mistakes, further slowing the revenue flow to your organization.
Finally, and perhaps most important, you need an assurance the provider will keep the lines of communication open. You can expect them to contact you straight away in case of a problem, and they also need to respond promptly to any inquiries you have concerning bills and provider reimbursements.
In the long run, outsourcing provides so many benefits, you can visualize expanding your practice more rapidly than your business plans called for at the outset, since a third-party billing expert will be taking care of your revenue cycle management while you focus on patient care.
As you can guess from this blog, medical billing for mental health is not a walk in the park. A lot of blood and sweat and effort goes into the process. It can be time-consuming and quite wearisome for mental health practitioners who just want to look after their clients’ needs.
At EHS, we partner with mental health providers in order to offer pre-authorization, third party billing, claims follow-up and to assist with appeals for any denied insurance claims. EHS helps smooth out your cash flow, enhances your practice’s dealings with insurers and manage disputes, all while maximizing your firm’s revenue. Contact us today!