Behavioral Health Billing: All Your Questions Answered

If you’re considering outsourcing your billing to a behavioral health billing company, you probably have a lot of questions. The idea of giving up control of your billing to an outside provider can be nerve-wracking, and as a premier behavioral health billing company, we want to make sure you understand everything about the process before moving forward. Mental health practitioners can face some unique challenges when it comes to billing and you no doubt want to be sure your behavioral health billing provider understands them and knows how to help.

Here are some of the most common questions about behavioral health billing along with some helpful answers.

Q: How does behavioral health billing differ from other medical billing?

Behavioral services tend to be structured very differently than other medical billing. Traditional medical billing is highly-structured, with a fee charged for a specific test or procedure that is easily coded and understood. Behavioral practitioners typically bill for behavioral therapy or psychological testing, which can be very nuanced types of treatment that are not as easily understood by insurance companies. As such, insurance companies tend to be much more stringent about what they will cover with behavioral billing, possibly limiting the number, type or duration of treatments they will cover. Sorting all of this out can be challenging for the typical practitioner.

Q: What are the advantages of outsourcing your billing vs. doing it in-house?

There are multiple advantages of outsourcing your billing vs. doing it in-house. First, it will probably save you money. Hiring full-time billing staff and buying state-of-the-art billing software can be expensive, and if you don’t do this, your existing staff could quickly become overwhelmed by billing issues.

Outsourcing your billing can also save you a tremendous amount of headaches, as you no longer have to worry about whether or not you have filled out forms correctly and you will no longer have to spend hours on the phone dealing with insurance companies in order to get paid on claims.

The right third-party billing service can help you get paid for more of your claims faster, letting you focus on maintaining or growing your behavioral health business.

Q: How long can I expect to wait for insurance reimbursement?

Usually, you can expect to wait about 30 days between the insurer receiving the claim and your practice receiving payment. Because you send your billing claims directly to your billing provider, who may be processing claims daily, you will get paid as soon as possible. If you are responsible for your own billing, claims may build up before you have time to submit them and it can take longer to get paid. A good third-party biller will often not take payment until you start receiving reimbursements.

Q: Can I bill my client for the balance after I receive insurance reimbursement?

Unfortunately, if you are in an insurance provider’s network, you agree to accept what the insurance company determines as the rate, so once you receive your reimbursement, billing for that session is closed. You can write off any remaining balance, if you are not in the provider’s network, except the insurance reimbursement and client payment. A behavioral health billing company is not the same thing as a collection agency, so do not expect your billing services provider to go after clients who you feel owe you cash.

Q: What happens if a client changes insurance plans without telling me?

If your client changes plans, it is often the case that you do not find out until after a claim has been rejected, and you will probably not be able to get paid on that claim unless your client can transfer it to the new insurer. However, if you have a quality third-party billing company that you outsource to, they will probably discover the problem much faster so you can get it straightened out before too much damage is done.

Q: What happens if sessions require pre-authorization and the client doesn’t get it?

If you perform therapeutic services that were not pre-authorized and the insurance company requires pre-authorization, they will probably not honor that claim. Another benefit of a good behavioral health billing company is that they will verify new patients, so you will know up-front what the insurance provider covers and whether or not authorization is required before you begin providing services.

Q: How long do I have to file a claim?

This will depend on the insurer, but private insurers typically require a claim to be filed within 90 days. Medicare providers allow 12-18 months to file. This is another advantage to outsourcing, as you are able to process and file claims more quickly.

Q: Can a behavioral health billing company help me get reimbursed for providing remote therapy?

Your behavioral health billing provider can only get you reimbursed for teletherapy if the insurance company already approves it. This can happen, but is not always easy. For Medicare reimbursement, a patient must live in a designated Health Professional Shortage Area for reimbursement. You must be licensed in the same state and use a HIPAA-compliant video conferencing method at a legitimate, authorized medical office. If you are planning on offering remote therapy, your behavioral health billing provider can find out if it is covered by insurance for this particular patient before you begin.

Q: Is testing covered in billing processing services?

Testing is a crucial part of the behavioral therapy process, but it can sometimes be costly. It’s only natural to wonder if third-party billing services can represent you for testing billing. The good news is that most quality third-party billing companies will handle your patient neurological and psychological testing claims just as they would other behavioral services.

Q: What should I look for in a billing services provider?

There are several things you will want to look for in a billing services provider. You will want to make sure you are working with a behavioral health billing provider that has the capacity to handle both small and large practices. This way, your service can scale as your business scales and you don’t have to worry about outgrowing your provider.

You want to make sure your behavioral health billing company is HIPAA-compliant and is well-versed in current ICD-10 codes. The company should understand behavioral health claims for the specialties that are covered in your practice and have experience handling billing with a wide variety of claims and insurance companies.

You also want to look for a company that provides a high level of transparency, so you have access to all the information you need about what is happening with your billing when you need it, and a company that offers a high level of support in case you have questions along the way.

Contact BPS Billing for Behavioral Billing Services Today

Now that you understand a little more about what behavioral health billing can do for you and your practice, we’d like to give you the opportunity to try it out with BPS Billing. Having been in the billing processing business for over two decades, BPS Billing has the knowledge and staff to handle the medical billing of behavioral health practices of all sizes. We offer an at-a-glance dashboard so you can see exactly what is happening with your claims and assign you an individual account manager who is available to answer any questions you may have.

We are competitively priced, verify benefits for you for new patients, process claims daily, and we don’t get paid until you get paid. We can offer you a high level of peace of mind by dealing with insurance companies and billing forms so you don’t have to. For a free demonstration of our services, please get in touch with us online today.