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Common mistakes that cause claims denial in behavioral health billing

The study of thoughts, hormones, emotions, and mentality that influence a person’s behavior and how it impacts their day-to-day lifestyle is known as behavioral health. Therefore, someone who deals with patients’ mental health can be considered a psychiatrist or therapist. Nowadays, billing for behavioral and mental health services is becoming tough due to the complicated procedures involved in it. The recent opioid abuse epidemic, which includes both prescription painkillers and heroin, has had a big impact on the health care system in the US. Therefore, now it is not easy to handle all your all medical billing on your own. So, if you want to make more money from your practice, you need to use the best behavioral health billing services.

Various techniques used in behavioral health care clinics

Psychologists and therapists use a variety of techniques to help their patients, including counseling, medication, and even meditation. These treatments take different lengths of time depending on the patient and their condition. A patient with immobilizing behavioral problems needs further rehabilitation, literacy instruction, etc. However, the time allotted by insurance companies for each treatment approach is longer than it actually takes, which results in errors when services are billed. Therefore, it is important to evaluate the causes of denied claims and delayed reimbursements. 

Some of the more prevalent reasons why claims are rejected

When a patient’s insurance claim is rejected, it can harm not just your cash flow but also your relationship with the client. Some claim denials can be challenging, but even if they’re successful, they might leave claim status in ambiguity, which your clinic and patient want to avoid. Therefore, understanding the common causes of claim denials is essential for their prevention. Thus, professional behavioral health billing services may provide software solutions to prevent claim rejections and denials.

Not obtaining Pre-certification or authorization 

Pre-certification or pre-authorization is important to get to protect your practice and patients from financial loss and to increase patient satisfaction. Pre-authorization is vital in determining which insurance companies demand it and for what purposes.

In some cases, your medical billing operating system might help you figure out what to do by pointing out specific treatments and health coverage. Furthermore, it is preferable to obtain pre-permission for a procedure to avoid any inconvenience in the future.

Submission of false and inconsistent data

When you put erroneous data on claims, then there are more chances of claim rejection or denials. Data and information contradictions may occur for several reasons, including incorrect data input or inaccuracy in the documentation of gender-specific conditions. When a mistake or discrepancy is detected, it is recommended that practices should implement alert mechanisms. So, doctors can save time and money by sending their claim submissions to a professional medical billing company. These companies know more about medical billing and coding, so they can do a better job.

Claims are not submitted on time

Every claim has a deadline within which it must be submitted and evaluated for payment. When a healthcare practice fails to file a claim by the due date, then they have to pay the price. Healthcare professionals commonly fail to file claims on time because of incomplete or incorrect superbills, also known as charge tickets. Therefore, they may ask specialized behavioral health billing services for timely submissions of claims to insurance companies to get the maximum reimbursement. You can also reduce these claim denials by proper use of diagnosis coding.

Use of diagnosis coding properly for filing of clean claims

Diagnoses Coding enables mental health providers to recognize the various treatments, diagnoses, and activities provided to a patient. The purpose of diagnosis coding is to make it simpler to classify various mental illnesses or diagnostic tests used during therapy. These codes are necessary for the insurance billing procedure. Some typical diagnostic codes for mental health therapies, such as psychotherapy, include:

  • F32.1 Major depressive disorder, moderate, single episode
  • F32.1 Panic disorder with agoraphobia
  • F32.1 Major depressive disorder, mild, single episode
  • F41.1 Anxiety disorder in general
  • F32.1 Major depressive disorder, mild, single episode
  • Obsessive-compulsive disorder (F42)

Bottom Line

If it’s tough for you to increase the productivity of your mental health clinic, don’t worry. To maximize the revenue from your claims and denials, you could partner with an outsourced medical billing company. For this, you may rely on Medcare MSO to provide you with the most effective billing services for mental health. We handle all of your Electronic Medical Claims (EMC), which includes a daily review of any EMC rejections, which we then correct and re-bill as necessary. 

Therefore, spend some time looking over our comprehensive services page or give us a call right now to get our highly dependable medical billing services.

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