The 2021 Guide to Behavioral Health Insurance Billing

Providers need to pay special attention to behavioral health insurance billing in 2021. The COVID-19 pandemic swept our nation at the beginning of 2020. Since its start, the need for quality mental health services has increased across the country. A higher number of individuals are suffering from mental and behavioral health-related issues due to the Coronavirus. Increased isolation, financial hardship, fear, and much more have prompted a jump in the delivery of services to clients and patients everywhere. Many providers have viewed this as an opportunity to begin offering behavioral health services to clients in need. For providers introducing BH services, special attention must be paid to behavioral health insurance billing. 

The Complexities of Mental/Behavioral Health Billing: 

While providers might be familiar with medical billing, behavioral health insurance billing is much different. With behavioral health comes a host of different rules, regulations, codes, and procedures. Until recently, many insurance providers did not cover the cost of mental health services. Over the last decade, work had been done to decrease mental health stigma as well as stress the importance of mental health services. As of 2021, more insurance companies than ever before are offering coverage to clients who need mental and behavioral health services. 

Tips to Improve Behavioral Health Insurance Billing:  

Verify Coverage 

If you are a provider looking to improve behavioral health insurance billing at their practice, verifying coverage is an essential part of the process. By verifying coverage prior to the rendering of services, providers can protect their reimbursement from the payer. When coverage is not verified, and providers deliver services to clients without insurance or with a lapse in their coverage, the payment responsibility changes. Providers then have to depend on the client to pay for the services they received. Behavioral health insurance billing is much simpler for providers who verify coverage prior to a visit. 

Understand CPT Codes 

The number one reason a provider’s behavioral health insurance billing claim gets denied is due to an error in billing codes. Providers that wish to optimize their reimbursements need to perfect their understanding of CPT codes. CPT codes are keys that are tied to a specific type of visit or service that providers offer. An insurance company either does or does not cover the cost of that service under the client’s plan. For providers looking to maximize payer reimbursements for their behavioral health insurance billing process, accurate CPT codes are a must. 

Submit A Clean Claim 

A clean claim is a behavioral health insurance billing claim that was approved and reimbursed after its first submission. Clean claims are important for avoiding denials and maximizing your bottom line. The higher number of clean claims a provider can submit, the faster their payments will roll in. In order to achieve a high percentage of clean claims, your organization might need help. 

Outsource Your Billing to a Third Party  

Outsourcing your billing services to a third party might be exactly what your practice needs to optimize its behavioral health insurance billing. An experienced vendor offers services like claim validation, denial management, and more to increase clean claims and streamline your organization’s revenue. 

They help to accurately code claims and submit them to prevent any possibility of denial. Claim validation ensures your claims are free of simple errors that lead to denials. Should a denial take place, they are ready to immediately correct any errors and resubmit it, so your practice never sees a delay in payment. They work diligently to pinpoint where mistakes are being made and make corrections accordingly. For client responsibility balances, your vendor will post payments directly to the client’s account. 

With a dedicated billing specialist at your side, your practice can perfect its behavioral health insurance billing.

learn more about TheraNest’s Managed Billing