Mental health has now emerged as a global issue especially after covid. We all understand how hard it can be for people dealing with mental health issues. Even after the increased need for care, claim denial can be a huge hurdle standing between patients and their treatments.
These denials can not only affect the patient’s care journey but also impact the revenue of healthcare organization. Psychiatry billing codes are on a whole different level of complexity. However, in this blog we will learn some strategies that can be used to minimize the number of claim denials hence making the process easier for providers as well as patients.
Understanding Psychiatry Billing
Psychiatry medical billing is the process of filing claims for the treatments and procedures rendered to the patients by psychologists, therapists, and psychologists. There are a lot of discrepancies when compared with conventional medical billing.
This may include the coding of psychotherapy sessions depending on the time spent in the session. Eligibility verifications and changes in guidelines are also checked to ensure adherence with policies.
Ways to Minimize Claim Denials in Psychiatric Billing
Let's dive into some of the most effective strategies to minimize claim denials which will help your psychiatric practice’s financial health.
Confirm Insurance Eligibility & Verification of Benefits
Psychiatry medical billing services are provided by out-of-network professionals unlike other healthcare services. This makes it important to double check the details of the patient’s insurance prior to the treatment. This can avoid confusion and ensures a hassle-free billing process.
This has two major steps,
- Verifying the authenticity and current validity of the insurance policy stated
- Verifying the details of benefits offered in the plan
Some other things that must be considered are the annual visit caps, pre-authorization requirements and out-of-pocket expenses. This is a proper way of creating a devised payment structure so that there are no misunderstandings and financial pressure on the providers as well as patients.
Understand the Different Billing Process for Medicare, Medicaid, and Commercial Insurance plans
Psychiatry medical billing services works in a variety of layers of rules and guidelines because of the different payment processes for private and government insurance providers. Both these payers have a different set of codes, legal standards, and ways of submitting claims for billing.
The complexity is further increased by the fact that some codes are used differently depending on the payer types. There are some codes within different payer types that may need different modifiers. This takes the complexity to a whole different level.
This will lead to claim denials which is time-consuming and expensive. If you want to get maximum reimbursements for your psychiatric billing, you must have the knowledge of the rules set by every payer and provider.
Determine Telemedicine Guidelines & Billing
Telemedicine is rapidly increasing in the healthcare scenario. Especially in the psychiatric health sector with a global market size of around $324 billion by 2030. The credit of growth can be connected directly to the rise in psychiatric billing services and the comfort provided by telemedicine.
However, the rules for insurance telemedicine services change quite frequently. This makes it important for providers to stay updated with these changes, especially while avoiding claim denial and getting proper reimbursement.
That is why it is important for providers to make sure that they follow the changing policies if they want to have a good cash flow while being able to deliver care through telemedicine.
Patient Balance Follow-up and Payment
Psychiatry medical billing services are provided by out-of-network providers. This means that the patients are left to pay the high costs of treatment. While handling this delicate situation, providers must be very careful and understand the patient’s needs primarily.
It is important that practices tailor their communication with patients to understand their primary concern. Plentiful payment methods also work quite well for patient satisfaction.
Moreover, payment plans determined during the registration process based on the benefit levels can be very useful for patients to pay the out-of-pocket costs.
Integrate Advanced Technology
Integration of technology is one of the most important elements if you want to have successful psychiatric practice. Technolgy can really improve your operations and help in reducing errors in Psychiatry billing codes.
Choose an EHR that can easily be integrated with your billing process for fast and efficient delivery. This helps in fast coding within the EHR with a low possibility of mistakes.
For example, adopt electronic billing that accelerates the claims and avoids loss of paper-type claims. It is important to negotiate with a clearinghouse service to perform certain functions automatically. Clearinghouses can process the claims, check eligibility and manage denials to save the much-needed time for other processes.
Educate Your Staff About Psychiatric Medical Billing & Denial Management
Make sure that your staff understands the challenges of psychiatric billing and denial management to prevent any denials. The training should be targeted towards the needs of psychiatric medical insurers that may include information about the use of ICD-10 and CPT codes in psychiatric health settings.
The staff should have all the knowledge about the medical necessity related to behavioral health interventions. They must be familiar with all the documentation that would support the treatment plans and patient outcomes.
This will keep your team up to date with all the changes in the legal framework and industry standards. It will reduce the chances of denial due to improper coding and lack of documentation.
Outsource Medical Billing
Psychiatric medical billing is a hectic task which takes up a lot of time of the practitioners. This is why outsourcing it to billing professionals is a great way to manage the billing process.
Unify healthcare services offers world class psychiatry medical billing services. We have a team of trained professionals who are well versed in all the elements of medical billing. Our trained professionals are always up to date with the latest coding and billing guidelines.
Unify healthcare services can easily handle your psychiatric medical billing requirements. We ensure that all the codes are accurate and signify the treatment rendered according to the insurance payers. Eligibility verification is done prior to the treatment avoiding any chances of over billing.
It is a complex process that faces changes in laws and rules that can strain your internal finances. While we take care of all the billing and coding related concerns for you, you can focus solely on providing the best patient care. This improves patient satisfaction which ultimately leads to increased footfall.
Combined with world class psychiatry medical billing services, your practice will become unstoppable in terms of revenue.
Unify healthcare services envisions making billing easy for every practitioner so healthcare providers have less things to worry about and they can focus completely on their expertise.
We don’t just offer services; we offer peace of mind!
