Mental and behavioural health medical billing involves the invoicing process for individuals with enduring conditions like depression, anxiety, bipolar disorder, substance use disorders, or schizophrenia. The focus of mental health billing revolves around regulations imposed on both facilities and patients, including limitations on visit frequency and duration. Pre-authorization may be required in some cases.
Insurance plans may not cover mental health services, and certain providers may be out of a patient's network. As a result, mental health providers must be prepared to accommodate patients who pay out of pocket.
Effective medical billing for mental and behavioural health services requires a comprehensive understanding of insurance plans, CPT codes, and strategies to minimize claim denials. Verifying benefits and the need for pre-authorization is crucial. During visits, specific CPT codes, such as evaluation and management (E&M) codes, are used. Differentiating standard E&M codes from psychiatric evaluation codes is essential.
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Attention must be given to time allocation, as E&M code time cannot be attributed to psychotherapy services. A solid grasp of CPT codes ensures accurate coding and reduces claim rejections. This leads to higher reimbursement rates and shorter accounts receivable periods.
To alleviate the burden of mental health billing, it is important to have dedicated employees who understand the process. Unfortunately, many mental health providers spend excessive time on administrative tasks, which hinders patient care. Acrev Solutions provides a solution by addressing the challenges associated with mental health billing, allowing facilities to optimize their financial gains from the services they provide.