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medical billing for mental health providers
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Challenges and Solutions in Medical Billing for Mental Health Providers

In the complex world of mental health, the medical billing services play an important part in ensuring a smoother and more efficient revenue cycle. However, medical billing for mental health providers does not come without its challenges.

Medical Billing for Mental Health Provider

Mental health providers, in addition to medical billing companies, face complex and rather unique challenges. Combined, this can negatively impact a practice’s financial outcomes or even patient care. Let’s dive into some of the most recurring challenges in mental health medical billing services and explore some viable solutions.

Top Challenges Mental Health Medical Billing Services

Healthcare providers must avoid these top mistakes to ensure a steady flow of revenue from reimbursements; these challenges include the following:

1. Incorrect CPT Codes

Maintaining the specification with the procedural codes for mental health billing is forever helpful. What’s more, maintaining the specifics of procedural codes is further beneficial while recording the times spent for each session.

In medical billing for mental health providers, it is highly probable to overbill for a shorter session or underbill for various services. Furthermore, adding a new service can also be time-consuming as you will have to review the code descriptions for every service.

In an instance when you do not know the CPT codes, then two things may happen. First, you might need to receive payments for your services. Second, you might end up overcharging – which shall prompt an investigation by the concerned authorities.

2. Constant Use of ICD-10 Code

Medical billing for mental health providers can often turn sour – as providers fall into the trap of repeatedly using the same ICD-10 codes. Doing so can and does lead to billing errors. To avoid the risks of an audit. It is vital to come up with variety in healthcare billing. For instance, billing a similar diagnosis code for every patient, like anxiety disorders, is a huge red flag.

3. Subjective Error-Indicating Codes

Another challenge in billing for mental health providers is that billing can be problematic – or more so when specific codes in mental health billing are used. Billing many of the codes that are specific to mental health services can undoubtedly create issues for your practice. Ideally, there are three codes to beware of, and these include:

  • Billing Code 90837 (For Individual Psychotherapy)
  • Billing Code 99215 (For Established Patient Visits)
  • Billing Code 90853 (For Group Psychotherapy)

4. Use of Outdated Codes

Medical billing for mental health providers poses another challenge if the providers do not stay current with the latest ICD or CPT codes. These codes are rapidly and consistently evolving; thus, staying updated on these changes and updates is essential. The good news is that there are grace periods when the code sets are changed.
Ideally, payers expect billers to be using the latest codes for submissions. It is also important to note that your claims will be denied or rejected altogether if you do not change codes after the grace period ends. Thus, mental health providers need to use the latest codes to submit claims.

5. Unbundling of Codes

The unbundling of codes is a practice in mental health billing where multiple codes are utilized for increasing payments. Healthcare billing for mental health providers should be vigilant of unbundling, as it is another red flag in the eyes of the audit teams. 

Unbundling is associated loosely with fraudulent or abusive practices in mental health billing services. What’s more, knowing and understanding the code description is essential.

Get Help in Medical Billing for Mental Health Providers

Consider taking help in your mental health billing to make your workflow even more manageable.
Billing processes for mental health services differ from billing for other medical services. Taking on healthcare billing can be overwhelming for your staff and counselors, and it can even adversely affect patient care and services.
For this, only consider outsourcing your medical billing services.

Final Words:

Most healthcare providers often need more expertise and time to handle billing operations. Additionally, only a few businesses or people have the resources necessary to establish an internal billing department. All of these scenarios perfectly align with medical billing for mental health providers. 
Outsourcing healthcare billing in your practice can benefit you in multiple ways, including outsourcing tasks like statement preparations, filing, data entry, and even follow-ups with zero probability of errors.

Frequently Asked Questions

Medical billing for mental health encapsulates varying types of billing for mental health services – that too until complete recovery.

The primary difference between medical and mental health billing is the limitations and restrictions that insurance companies enforce for behavioral health claims.

Professional billing and institutional billing are two major kinds of medical billing in the healthcare industry.

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