Only 85% of claims for behavioral healthcare treatments receive approval.
When it comes down to it, behavioral health is a whole other medical billing beast that professionals battle. Simply put, counselors and psychiatrists provide services in a very different way and format than medical doctors. These professionals don’t perform x-rays or take temperatures – most of their time is spent talking, working through issues, and finding ways to manage emotions. From here, insurance companies dictate how much time can be spent in sessions and how many can take place on a given day. This is where things get dicey – behavioral health professionals walk a fine line to find an adequate balance between a successful treatment and billing plan.
15% of claims for treatments sit on the table awaiting collections. How can we fix that? Let’s find out.
Recheck Insurance Cards
We know – you complete this task yearly when insurance plans get renewed. We urge you to check these cards before every visit to your office. Insurance plans change. Coverage lapses. Sometimes our clients lose their jobs. All of these reasons are why it’s so important to check at every visit. This ensures you won’t receive an outright denied claim after submission.
Rechecking insurance cards also helps your practice to ensure that no manual errors have been made. Another great way to bypass any entry errors is to implement an automated process like Medicscan. It extracts information on medical insurance cards and populates your practice management system to save you time and eliminate the possibility of errors.
Preferred Filing Methods
Each insurance company has a preferred filing method – stay up to date on these parameters. It is likely that if you submit a paper claim to an insurance company that prefers electronically filed claims, yours will be rejected. Remain aware of filing parameters and in turn you will avoid rejected claims.
Remember the following when filing claims…
- Follow the required billing format
- Specific to the patient’s insurance provider
- File within the allotted time frame
- Different window for claim submission for every company
- Apply the code that corresponds with the care delivered
- Only charge the fee allowed by the insurance policy
- Include the appropriate policy number
- Receive pre-approval for claims if they are required
- Submit claims to the appropriate address
All of the above information not only aids in helping your claim to be approved, but it also helps your claim be approved faster.
Sliding Scales and Deferred Payments
If your behavioral health clinic chooses to only accept cash payments, it would not be the only one. Many choose to bypass insurance all together to avoid the possibility of denied claims and the headaches those provide. If this is the route you decide to go, be sure to encourage easy ways for your clients to pay their bills. Sliding-scales or deferred payment schedules can make all of the difference in you receiving payments in a timely manner.
As you can see, behavioral health specialists jump through mounds of red tape when it comes to submitting claims, too. There are many facets that must be accounted for to increase the likelihood that your claim will be accepted and you will receive payment.