Overview
John Hopkins Medicine states that 1 out of 4 adults suffers from mental disorders each year . Therefore, it is necessary to empower behavioral health practices with effective billing for the well-being of society . This blog highlights
What Is Behavioral Health Billing ?
Behavioral health billing is the process of submitting, processing, and managing insurance claims for mental health and substance use services. It involves several key components and processes that are crucial for successful revenue management:
What Type of Information Is Required For Behavioral Health Billing ?
For an accurate behavioral health billing , there should be precise documentation of the below factors .
- Medical history of patient
- Contact information of patient
- Contact information of provider
- Treatment plan for his behavioral health
These factors also vary across different insurances .
How Behavioral Health Billing Helps You ?
Insurance Verification and Eligibility
It verifies the insurance coverage of patients . Moreover, it ensures that services are eligible for reimbursement . Thus it lowers the probability of denials.
Claims Submission and Processing
It ensures the accurate and timely submission of claims to insurance organizations . In addition , it is an important factor when it comes to rapid reimbursement for the behavioral services provided by practitioners .
Reimbursement and Payment Management
Behavioral health billing manages reimbursement . Moreover, it ensures accurate compensation for the behavioral services to the doctors
Denial Management and Appeals
Behavioral health billing helps to handle the denials efficiently through experienced professionals . Therefore, it is responsible for decreasing delayed payments . Moreover, they play a crucial role to optimize revenue .
Patient Billing and Collections
Behavioral health billing can streamline patient billing and collection processes. Moreover, it improves the experience of patients . Thus, it reduces the financial budget of patients and providers.
What Are Potential Challenges in Behavioral Health Billing ?
Insurance Coverage Disparities
The most common challenge of behavioral health billing is the disparity in insurance coverage. Its probability is greater in the case of behavioral health services as compared to physical health services. Moreover, there are a large number of insurance plans that are offering limited coverage for treatment of mental health . Therefore, it makes it difficult for the people with mental issues or disorders to access the treatment or therapy they need.
Complex Coding System
There are specific codes to describe and signify the services provided in behavioral health billing . This coding system is complex. Moreover, the errors are expected in coding . Therefore, there are greater chances of delayed payments . Besides, it may lead towards denial of claims too.
Prior Authorization Process
Most of the time insurance companies demand prior authorization when it comes to behavioral health billing . This is an additional process. Therefore, this extra layer prolongs the waiting time to receive concerned behavioral care .
Provider Reimbursement Rates
In addition , it has been observed that behavioral health providers are less liable to receive reimbursement for the services as compared to other medical specialists . This factor makes it challenging for them to maintain the financial aspects of their medical practices. Therefore, most people hesitate to enter this medical realm .
What Should You Consider While Choosing the Behavioral Health Billing Company ?
You should be considering the following factors when selecting the right billing company.
Experience and Expertise in Behavioral Health Billing
You should consider the behavioral health billing company that has a proven record and evidence of the expertise and knowledge .
Knowledge of Payers and Insurance Companies
Behavioral health billing companies should be familiar with the requirements of the payer. Moreover, it should be capable of minimizing denials and optimize the reimbursement rates.
Compliance and Security Measures
Opt for the billing company that adheres to strict compliance .Moreover, it should have reasonable data security standards. Because it is crucial in all medical billing realms to protect the details of patients .
Technology and Reporting Capabilities
Advanced technology and reporting features can help to streamline the billing process. Moreover, this will provide insight into financial aspects of the practice .
What Is Behavioral Health Coding ?
Medical billing companies utilize the following codes while they are screening or treating one’s behavioral health.
| Code | Function/Purpose |
| 96127 | This code is used for emotional assessment . |
| 99406, 99407 | These two codes are used to code tobacco use cessation counseling visits. |
| 99484 | This code signifies general behavioral health integration care management. |
| 99406, 99407, 99408, 99409 | All these codes mark behavior change interventions |
Conclusion
Behavioral health billing is crucial to ensure that the people who are facing mental health challenges or substance abuse may have access to effective care. There are numerous challenges in behavioral health billing but addressing these challenges and making changes in the policies . Therefore, the stakeholders can provide a supportive and equitable environment for both behavioral health providers and the patients . Moreover, behavioral health medication lacks financial stability . There is longer time for reimbursement as compared to physical medication and the coding is way too complex .This further complicates the process. Thus resolving these issues will make behavioral services easily accessible . Therefore, we will be in a better position to have a healthier society .