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Behavioral Health Revenue Cycle Management
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Behavioral Health RCM Services We Offer
Quality patient care and financial stability must go hand in hand if you want your behavioral health facility to stay on top of its game! We formulated our behavioral healthcare RCM services to empower facilities and help them effectively navigate the medical billing intricacies and compliance complexities since behavioral health requires a nuanced approach
When you outsource behavioral health revenue cycle management to us, we strive to boost your practice's financial performance by implementing robust strategies. These include patient eligibility verification, prior authorization, charge entry, payment posting, denial management, A/R follow-up, performance analytics, and reporting. Our effective RCM solutions will help you receive your rightful reimbursement on time while supporting your ongoing operations.
Common Behavioral Health RCM Challenges
Behavior health practices often struggle with a healthier revenue cycle as the specialty demands ongoing authorizations for extended treatment plans. If somehow they meet the authorization requirements, understanding the complex coding systems themselves becomes a hurdle in clean claim submission, while hiring certified coders in-house is too expensive. As a result, errors in coding (such as wrong modifier usage, diagnosis, and procedural code mismatch) and missing or inadequate documentation all lead to an increase in the denial rate.
Ensuring adherence to industry regulations and federal/state laws while maintaining an efficient behavioral health RCM demands robust monitoring systems and continuous staff training, which many facilities find challenging to invest in. All these factors make it difficult for behavioral health practices to stay profitable!
Lack of Prior Authorization
Most behavioral health conditions demand extended treatment plans, necessitating ongoing authorization management to ensure timely reimbursement. However, it is a labor-intensive and time-consuming process as approval criteria for various care services may vary for different insurance companies. Delays in getting the required authorization may impact the behavioral health RCM.
Complex Coding Systems
Medical coding is an intricate process and not a one-time thing. HCPCS, ICD, and CPT coding systems often undergo updates. Choosing an outdated or deleted code can delay reimbursements, derailing your overall behavioral health RCM performance. Therefore, practices must ensure coding accuracy while reporting group counseling or therapy sessions.
High Claim Denial Rate
Increased claim denials are the main culprit disrupting the behavioral health RCM. Denials often occur due to coding inaccuracies, inappropriate or missing modifiers, inadequate documentation, lack of medical necessity, or lack of prior authorization. Behavioral healthcare practices that experience frequent denials may have an inconsistent billing workflow.
Compliance Related Issues
Practices must stay compliant with a complex web of regulations, including state-specific mental health laws, substance abuse confidentiality regulations, and HIPAA privacy rules while ensuring an efficient behavioral health RCM. Non-adherence to these regulatory standards can lead to audits, heavy financial penalties, lawsuits, and practice bans.
Benefits of Outsourcing Behavioral Health RCM
Do you wish to supercharge your collections, minimize the risk of claim denials, streamline your medical billing workflow, ensure adherence to the complex regulatory landscape, and navigate the coding systems without investing in an in-house behavioral health revenue cycle management team? If your answer is affirmative to any or all of these statements, our behavioral health RCM solutions are what you deserve to experience peace of mind!
We spent a decent amount of time researching the unique revenue cycle challenges behavioral health facilities encounter across the USA! Based on the insights, we crafted our services and trained our RCM team to serve as the ultimate solution to all the revenue cycle challenges that behavioral health practices face without breaking the bank.
Say goodbye to the high-maintenance in-house medical billing and coding team, expensive equipment and software, and unnecessary overhead costs by outsourcing behavioral health RCM services to MediBillMD. We handle your monthly revenue cycle management needs without the worry of hiring/retaining the right talent or investing in their ongoing training.
We have an experienced team of behavioral health RCM specialists ready to steer your practice toward the financial success it deserves. Our team strives to meet your revenue cycle KPIs, such as net collection ratios, account receivables, bad debt, and denial rate, so your practice can thrive in the competitive landscape.
We have tailored our behavioral health RCM solutions to tick all the checkboxes related to the varying state laws and HIPAA privacy rules, so you can continue providing quality care services to patients with mental health, substance abuse, and other behavioral concerns without worrying about non-compliance with the industry regulations.
A steady cash flow is integral to ensuring your practice functions smoothly. Our behavioral health RCM services are designed to help you achieve a high claim first-pass rate, reduced denial rate, and low A/R days. As a result, you experience faster reimbursements, ultimately leading to a healthy revenue cycle.
Our behavioral health RCM specialists work tirelessly to keep your denial rate and account receivables to a minimum by following industry best practices. However, in case of denials or payment delays, we work towards their successful resolution and follow up with the payer for payment recovery to avoid revenue leakage.
Behavioral health has more regulatory challenges than other specialties. Different states have different standards to adhere to. As a result, facilities face another hardship in pursuit of outsourcing behavioral health RCM services as they try to figure out whether an RCM firm will be able to follow state-specific policies! It's time to dump all these worries because we are empowering behavioral health providers across all 50 states of the USA.
Overcome Behavioral Health RCM Challenges with MediBillMD
Yes, you read it right! You can overcome behavioral health RCM challenges by partnering with our expert RCM team at MediBillMD. Whether complex billing codes are the culprit behind the high denial rate or varying payer guidelines and lack of authorization are the factors keeping you away from your rightful reimbursements, our team knows how to turn the tables for you, leading to higher profitability!
| Behavioral Health RCM Challenges | MediBillMD Solution | |
|---|---|---|
| Complex Billing Codes | Our behavioral health RCM team is well-versed in diagnosis and procedural codes and stays current on ICD, CPT, and HCPCS updates to ensure error-free coding and clean claim submissions. | |
| High Denial Rate | Our behavioral health RCM solutions are designed to keep the claim denial rate to a minimum. We ensure accurate coding, follow specific payer guidelines, and provide comprehensive supporting documentation. | |
| Prior Authorization Issues | Our team proactively receives prior authorizations for ongoing long-term behavioral health treatments to mitigate the risk of non-payment and reimbursement delays, which are often the result of a lack of authorization. | |
| Varied Payer Mix | Adherence to different insurance payers' reimbursement guidelines and billing requirements is another key element of our behavioral health RCM solutions. It ensures you receive timely payment for your rendered care services. | |
Lowest Prices Guaranteed
Are you looking for a reputable RCM company to offload the behavioral health revenue cycle management challenges from your shoulders? Get our RCM services at a mere percentage of your monthly collections!
Get in Touch with a
Behavioral Health RCM Expert
Still unsure whether or not outsourcing your behavioral health RCM to a third party, like MediBillMD, is a wise choice? Schedule a call with our revenue cycle management expert for better clarity!
