As the technology becomes more advanced and we stay more connected digitally, the larger the gap of social isolation becomes. Staying connected digitally does have benefits, but the lack of genuineness and real emotional connection has given rise to serious mental health issues.
The greater mental health issues mean a bigger need for quality mental health services. While most mental health providers are dedicated to providing crucial care, the increasing demand for such services necessitates the use of efficient tools like behavioral health software to manage the influx of demand.
As a behavioral health provider, one of the most frustrating parts of your job isn’t the work you do for the clients; it is the endless back-and-forth with insurance companies for reimbursements. From effectively filing the claims and making sure all the codes are accurate to diligently following up on payments and denials, the administrative work can indeed be overwhelming. That is why investing in smart and automated behavioral health software is a must nowadays. With the increasing demand for behavioral health services and the complexity of medical insurance compliance, having automated systems is indispensable.
Furthermore, the delay in payments from the insurers not only harms the financial health of your business but can also impact your client satisfaction when they’re stuck in the annoying billing errors. Therefore, in this guide, we’ll discuss common pitfalls that cause most insurance claims to be delayed.
Streamlining Submissions for Swifter Reimbursements
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Verify Benefits and Authorizations Before Treatment Begins
Most mental health insurers prefer to pre-approve their customers’ treatment plans to ensure the services provided are medically necessary and covered in their insurance plans. For mental health providers like you, getting your customers’ claims pre-approved can help you ensure timely payouts and ensure your practice remains financially sound.
Whether it is group therapy activities for adults, psychiatric evaluations, or medication management, following pre-authorization protocols all each of these can increase your chances of securing claims swiftly.
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Confirm Provider Credentials and Network Status Are Current
Most mental health patients prefer working with practitioners who are in the network with their insurance provider. The simple reason for this is that it helps them avoid paying for the services they’re availing upfront and settle claims by themselves later. Therefore, before serving patients, make sure from your end whether your NPI, tax ID, and credentialing information are up to date or not. Even if you were in-network last year, it doesn’t mean your status wouldn’t change. Confirming such crucial things that involve both capital and the reputation of your mental health business in advance can help you avoid delays and drama in receiving the claim.
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Get the Coding Right, Every Time
One of the biggest reasons insurance claims are denied is incorrect coding. That’s why you must make sure your staff or billing team is using the correct CPT codes for the services provided and ICD-10 codes for diagnosis. Doing something as simple as this can also help you significantly reduce the number of denials. Besides, you must invest in behavioral health software to automate and accurately manage your insurance claims and the scaling demand for your services. It’ll immensely help you in reducing your administrative workload and minimizing errors.
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Submit Claims Quickly—and Electronically When Possible
The sooner you submit claims, the sooner you get reimbursed. Many insurers have claim-filing deadlines that usually range from 90 to 180 days from the date of service.
Therefore, it is wise to make sure in advance when this deadline starts for each of your patients to avoid any hurdles in the insurance claims. Further, submitting claims electronically through a clearinghouse can speed up the process even more.
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Create a System to Track and Follow Up on Claims
Most mental health providers wait till the end of the month to check the status of the insurance reimbursements—whether accepted or denied. This leads to delays from their own end and further decelerates the claims process. If you’re one of the mental health providers who manually keep tabs on such things, you’re unknowingly creating bottlenecks in your revenue cycle. Therefore, consider setting up an automated tracking system that flags pending claims and aging balances. Besides, with this information in your hands, you can easily do follow-ups and resolve denied claims.
Final Thoughts
After spending your whole day in mental health patient care, addressing insurance denials and following up on reimbursements is the last thing you’d want to do. While filing insurance claims is a part of your job, if it’s burning you or your team out, it’s a sign to invest in an automated system that takes all the headache of filing, accuracy, and following up away and allows you to reallocate your time and energy to patient care.
