Optimization of your billing process is an opportunity to make behavioral health practice more manageable. It’s not a secret now that the less time you spend on managing your medical billing, the more time you can focus on your clients to give them proper treatment for their issues. Any practice will get benefitted from streamlined medical billing processes, like fast reimbursement, increment in cash flow.
Although, billing can be overwhelming to know what process developments will have the main impact on your practice.
Medical billing basic is to start with patient eligibility verification, it’s good to validate patient’s insurance and coverage well before the Date of Service time so that your practice will be well informed. Though it can be time-consuming to validate a patient’s coverage since you can make sure that the client has coverage for the services and better identify what insurance is going to pay you.
Some insurance companies offer this service online that makes it easy to verify coverage, while others require you to call them to get information. But verifying coverage before each patient’s visit is not always practical to your staff. At a minimum, you need to sure to know benefits before the first session and re-validate at the start of the year when most coverage renews. We at Medical Billers and Coders has a streamlined process to know patient’s insurance verification process that enables our clients to know whether they will get payment from payers or patients.
It's good practice to ask for a patient’s insurance card and government-issued ID card e.g. driving license. This will enable your practice to capture all required details about patients e.g. correct name (no spell mistakes), address, and contact number, date of birth, marital status, SSN, employer details, and more important insurance information. In addition to this, while collecting personal information, you should document the type of therapy involved in treatment. The patient’s diagnosis, progress, therapy goals, and the duration of the session need to note.
Every behavioral practice ensures that they are providing correct information on claims to save efforts, money, and a lot of hassle to avoid denials. CPT (Common Procedural Terminology) codes are used by payers to identify if they will pay off a claim. It is mandatory to use the correct CPT codes for the services you provided and keep up-to-date on changes to the codes.
Payers normally do not require pre-authorization for first visits or basic behavioral health sessions. But in certain cases (for example, sessions that are over 45 minutes or multiple sessions for one client in one day), various payers have their own rules. It’s a good practice to check if pre-authorization is necessary before any non-standard session or for that matter when you begin working with a new client.
Many payers have submission requirements such as they require claims must be submitted within a certain period of time – like from 30 days to 365 days from the date of service. But it’s good to file the claim on time to get paid faster. If you fail to file a claim within the time frame, claims will get denied and your practice will not get reimbursed from the services you provided to the patient. Having a fixed billing schedule for your practice will ensure timely claim filing.
We at Medical Billers and Coders take claim filing as a priority task and we submit all claims as soon as we validate all the required information.
Creating a proper process to keep on top of the administrative requirements for error-free medical billing will help any practice to achieve success. Correct and well-organized billing has the additional help of boost your time so you can focus on client treatment.