Even if you’re an expert at running a behavioral health or addiction treatment facility, you may not be as much of an expert in healthcare billing. It may sound simple: Send out an invoice after a patient has left the program and receive payment. Unfortunately, getting the money that you are owed is a lot more complicated. Behavioral health billing is a complex process, and even if you don’t actually handle sending out the bills yourself, you should have a decent understanding of the process to ensure that your revenue cycle is healthy. Here’s a beginner’s guide to behavioral healthcare billing:
Verification of Benefits
Understanding your revenue cycle is imperative to minimizing errors that could lead to you losing money you deserve. The revenue cycle includes every aspect of the billing process from start to finish and when that process is healthy, your facility will be able to maximize your revenue.
The first step in the revenue cycle is verifying a patient’s insurance benefits. The verification of benefits has evolved well beyond deductibles and co-pays and it’s no longer a simple eligibility check. To check a patient’s benefits prior to admittance, follow these steps:
- Gather the patient’s required information and get a picture of the front and back of their insurance card to ensure you’ll have all the necessary information you need to verify with the insurance provider.
- Call the customer service number on the patient’s insurance card.
- Give them your facility’s NPI and tax ID number and ask them to check if your facility is in-network.
- Provide the patient’s name, birth date, and subscriber ID as listed on the insurance card.
- Ask for the patient’s co-pay, co-insurance, and deductible.
Waiting on the phone all day to verify incoming patients’ insurance could become a full-time job in itself. At Billing Solutions, we provide you with your own authorization experts to save you time and standardize your admissions process to improve patient flow.
When submitting claims to the insurance provider, it’s important that the clinicians submitting the forms know exactly which codes to use, otherwise it could cause the claim to be denied and payments to be delayed. At Billing Solutions, we handle your claims processing electronically to simplify the revenue cycle. We’re able to direct your claims to multiple payers and make sure your billing is correct the first time.
Manage Rejections, Denials, and Reimbursements
If you’re new to medical billing, you’re probably wondering why claims get denied and how often that happens. Unfortunately, it can happen a lot more frequently than you might think if you’re not prepared. The most common reasons claims may get denied are:
- Insufficient information to process your claim
- Human error, such as putting the wrong code for the service on your claim
- Services received are not covered under the patient’s plan
- The lifetime maximum limit with the patient’s insurance provider is reached
Handling your medical billing in-house often increases your chances for errors and claim denials. This then takes even more time for your clinicians to call the insurance provider again and submit an appeal. At Billing Solutions, our specialists work diligently to obtain your reimbursement by managing claims and efficiently navigating reimbursement negotiations with the insurance company. This leaves more time for you and your clinicians to focus on your core competency: behavioral healthcare.
Simplifying Your Behavioral Health Facility’s Billing Process
Don’t lose your time or money attempting to manage your billing in house. Utilizing a third-party healthcare billing company ensures your facility is receiving all the hard-earned money you deserve, which you can then put towards expanding your company to help more people. Give Billing Solutions a call today and take the headaches out of dealing with insurance and collections, so you can finally put your focus fully into your behavioral health facility’s treatment program. Receive your free account analysis and we’ll also give you a demo for our healthcare billing software, Nectar.