Maximized Control Over Your Finances
Feeling overwhelmed by the complexities of insurance billing and the reimbursement processes? If so, then look no further! Therapy and behavioral health billing is a complex and time-consuming process, with many nuances.
Bristol Healthcare provides effective full-service medical billing services that are tailored to address your unique needs and requirements. Our team’s extensive experience and knowledge in this field, and we stay up-to-date on the latest regulations and guidelines to ensure that you receive the highest level of service. We help streamline your billing process, reduce administrative overhead, and ensure timely and accurate reimbursement.
Through the years of collaborating with psychiatrists, psychologists, and social workers we have been able to develop a deep understanding of the unique nuances that come with this specialty, including:
- Medical codes and modifiers
- Treatment plans
- Place of service codes
- Coordination of benefits
- Medicaid and Medicare billing
- Claim submission and follow-up
- Accounts receivable management
- Old A/R clean-up and recovery
Our team is dedicated to providing exceptional service and support and continuously strives to build strong and lasting relationships with each of our clients. By partnering with us, you can truly focus on what you do best – providing compassionate care to patients.
-
Certified Resources
Our specialists are AAPC & AHIMA certified.
-
HIPAA Compliant
All patient-related data is handled only by authorized personnel.
Our behavioral and mental health billing and coding services are designed to set you up for success from the get-go.
- Expertise in end-to-end revenue cycle management.
- Streamlined billing processes and reduced administrative burden
- Accurate and timely claims submission
- Thorough verification of insurance benefits and coverage
- Proactive denial management and appeals
- Improved revenue and cash flow
- Strict compliance with regulations
- Personalized reports for active process improvement
Schedule a Free Consultation
Partnering with us means you can have peace of mind knowing that your mental health and behavioral health billing needs are in capable hands. Contact us today to learn more about how we can help you streamline your billing processes and improve your revenue cycle management.
Schedule ConsultationOur mental health and behavioral health billing process involves several steps, from verifying insurance coverage to submitting claims for reimbursement. It includes:
- Insurance coverage verification: It is important to verify the patient’s insurance coverage to determine if the services will be covered by the patient's insurance plan. This involves checking the patient's insurance ID card, calling the insurance company, or using an online portal to verify coverage
- Determine pre-authorization requirements: Some insurance plans require pre-authorization for services. We contact the insurance company or use an online portal to determine if pre-authorization is required.
- Choose the correct billing codes: Mental health and behavioral health services are typically billed using Current Procedural Terminology (CPT) codes. The specific code used will depend on the type of service provided and the length of the session. For example, individual psychotherapy is typically billed using code 90834 for sessions lasting 45-50 minutes, while family psychotherapy is billed using code 90847.
- Documentation: It's important to document the services provided in the patient's medical record, including the date of service, the type of service provided, and the length of the session. This documentation may be required by the insurance company for reimbursement purposes.
- Claim Submission: Once the services have been provided and documented, we submit a claim to the patient's insurance company for reimbursement. The claim is then reviewed to ensure the inclusion of appropriate billing codes and any other required information, such as the patient's diagnosis and treatment plan. We submit the claims electronically or by mail, depending on the insurance company’s requirements.
- Claim Follow-up: After the claim has been submitted, we periodically follow up with the insurance company to ensure that the claim is being processed and that payment will be received promptly. This may involve providing additional information or appealing the claim if it is denied.
- Patient Payments: Once the claim has been processed and approved, the physician will receive payment from the insurance company. The payment will be sent electronically or by mail, depending on the insurance company’s requirements. We then apply the payment to the patient's account and provide the patient with an explanation of benefits (EOB) statement.
Overall, our specialists ensure all claims are submitted accurately and efficiently, and that physicians receive the maximum reimbursement for their services.
The mental health billing process can be complicated and challenging due to several issues that arise during the process. Some of the common issues faced by our clients during this process includes:
- Insurance verification and pre-authorization requirements: Verifying a patient's insurance coverage and determining if pre-authorization is required for services can be time-consuming and complicated. Insurance companies have different requirements for verifying coverage, and pre-authorization requirements can vary depending on the type of service provided and the insurance plan.
- Choosing the appropriate billing codes: Mental health and behavioral health services are typically billed using Current Procedural Terminology (CPT) codes, and choosing the correct code for each service can be challenging. There are several different codes for different types of services and different lengths of sessions, and it's important to use the correct code to ensure accurate billing and reimbursement.
- Documentation Issues: Insurance companies often require detailed documentation of the services provided, including the date of service, the type of service provided, and the length of the session. This documentation can be time-consuming and requires a keen eye for detail.
- Claim denials and appeals: Insurance companies may deny claims for a variety of reasons, including missing information or incorrect coding. Appealing denied claims can be time-consuming and may require additional documentation and information.
- Payment delays: Insurance companies may take several weeks or months to process and pay claims, which can cause cash flow issues for mental health and behavioral health providers.
- Regulatory compliance: Mental health and behavioral health billing must comply with a range of regulations and laws, including HIPAA, Medicaid, and Medicare. Failing to comply with these regulations can result in penalties and fines.
The mental health and behavioral health billing process requires careful attention to detail and a thorough understanding of the unique nuances of this specialty. Below are a few examples.
- Diagnostic codes: Mental health and behavioral health services require a diagnosis code to be included in the claim. These codes are used to indicate the patient's diagnosis and the medical necessity for the services provided. Diagnosis codes for mental health and behavioral health services are typically found in the International Classification of Diseases, 10th Revision (ICD-10).
- Treatment plans: Insurance companies may require a treatment plan to be included with the claim for mental health and behavioral health services. The treatment plan outlines the goals of the treatment and the methods that will be used to achieve those goals.
- Place of service codes: The place of service code is used to indicate where the services were provided. For mental health and behavioral health services, the place of service code is typically 11, which indicates that the services were provided in an office setting.
- Length of session: Mental health and behavioral health services are typically billed based on the length of the session, with different codes used for different lengths of time. It's important to accurately document the length of the session to ensure accurate billing.
- Coordination of benefits: Coordination of benefits refers to the process of determining which insurance plan is primary and which is secondary when a patient has multiple insurance plans. This can be complicated in mental health and behavioral health billing when the services are provided by a specialist who is not the patient's primary care provider.
- Medicaid and Medicare billing: Medicaid and Medicare have specific requirements for mental health and behavioral health billing, including documentation requirements and billing codes. It's important to be familiar with these requirements to ensure accurate and timely reimbursement.
Partnering with us helps ensure that claims are submitted accurately and efficiently and that you receive the maximum reimbursement for services provided.
The most common HCPCS, ICD, and CPT medical codes used in mental health and behavioral health include:
- 90791: Psychiatric diagnostic evaluation.
- 90832: Psychotherapy, 30 minutes with patient.
- 90834: Psychotherapy, 45 minutes with patient.
- 90837: Psychotherapy, 60 minutes with patient.
- 90846: Family psychotherapy (without patient present), 50 minutes.
- 90847: Family psychotherapy (with patient present), 50 minutes.
- 96116: Neurobehavioral status exam.
- 96150: Health and behavior assessment.
- 96151: Health and behavior intervention, individual.
- 96152: Health and behavior intervention, group.
- F10: Alcohol-related disorders.
- F11: Opioid-related disorders.
- F14: Cocaine-related disorders.
- F15: Other stimulant-related disorders.
- F16: Hallucinogen-related disorders.
- F18: Inhalant-related disorders.
- F19: Other psychoactive substance-related disorders.
- F31: Bipolar disorder.
- F32: Major depressive disorder.
- F33: Major depressive disorder, recurrent.
- F41: Other anxiety disorders.
- F42: Obsessive-compulsive disorder.
- F43: Reaction to severe stress, and adjustment disorders.
- F44: Dissociative and conversion disorders.
- F50: Eating disorders.
- F60: Personality disorders.
- F90: Attention-deficit hyperactivity disorder.
- H0001: Alcohol and/or drug assessment.
- H0020: Alcohol and/or drug services; methadone administration and/or service.
- H0031: Mental health assessment, by non-physician.
- H0034: Medication training and support.
- H0038: Behavioral health counseling and therapy, per 15 minutes.
- H0043: Intensive outpatient psychiatric services, per diem.
- H0050: Group counseling, per 15 minutes.
- H2011: Crisis intervention, per hour.
It's important to note that these codes are subject to continuous updates, and the specific codes used may vary depending on the patient's condition, the type of service provided, and the insurance plan. We always use the most up-to-date codes and verify with the insurance company that the codes being used are acceptable for reimbursement.
What Our Clients Say
Together with our clients, BHS experts partner to achieve desired outcomes
and push the boundaries of what's possible.
“Partnering with Bristol Healthcare Services was one of the best decisions we’ve made for our practice. Their team of experts has a deep understanding of anesthesia billing and coding, and they’ve significantly improved our revenue cycle efficiency. The results speak for themselves – our denial rates have dropped, our revenue has increased, and we now have the transparency and control we need to make informed business decisions. Bristol’s commitment to excellence has made them an invaluable partner to our practice. We highly recommend their services.”
“I wholeheartedly recommend Bristol Healthcare to any organization seeking to optimize its revenue cycle and achieve lasting financial stability. Their expertise, professionalism, and personalized approach have been instrumental to our practice's growth and success.”
“Bristol has completely transformed our cardiology practice’s billing and coding processes. Their expert team quickly identified our coding issues, provided customized training, and implemented clear protocols that led to a drastic drop in claim denials and a notable revenue increase. We’re now more efficient and can focus more on patient care. Their professionalism, attention to detail, and real-time support have been outstanding. Highly recommend them to any practice looking to improve their revenue cycle!”
“Bristol Healthcare Services transformed our practice’s coding and documentation. We saw a remarkable increase in revenue, reduced coding complications by 28%, and boosted productivity by 20% in just one year. Their tailored approach and expertise were game-changing for our practice!”
“Jay – Great. I really appreciate your in-depth analysis on our outstanding. Your AR recovery process has been excellent.”
“We greatly appreciate the conscientious nature of your team. Their concern for quality is clear in the work that they perform.”
“Your attention to detail is excellent. Thanks for catching my staff’s error. I just love talking to Ray about process improvements.”
“Jay! Thanks to you and your team for formulating a winning team! I am proud to be aligned with you guys!”
“Our partnership with Bristol proved to be a game-changer. Their expertise in revenue cycle management and their commitment to delivering excellent service has truly transformed our practice's financial outlook.”
“If it wasn’t for your verification team, I would’ve never known I needed authorization for this surgical procedure. They have consistently sent verified reports on time, every day.”
“I highly recommend Bristol to any healthcare provider seeking a reliable and efficient medical billing partner. Their commitment to excellence, attention to detail, and dedication to maximizing revenue has been instrumental in helping our practice thrive financially.”
“Do you guys ever sleep? Thank you for answering all my questions immediately. I can’t imagine what I will do without your team.”
“I thank your coders for clearing our four months backlog within two weeks. I appreciate all your recommendations, it surely helps to improve our documentation.”
“Partnering with Bristol has been one of the best decisions I've made for my clinic, and I am grateful for their invaluable support."
“You have consistently provided accurate billing entries for us. I thank the entire team for a job well done."
“Your follow-up methodology seems to be working. Our collections have been increasing month on month. Great job! Stay on it.”
“I wanted to pass on our appreciation for the work the Bristol team is doing on the new BristolByte™ Quick Save feature. I am quite impressed by the speed with which the team is making design changes and implementing a process that will surely save us time. We appreciate it!”
“Their team took the time to understand our practice’s unique needs and workflows to implement a personalized billing process that ensured improved reimbursement rates. We’ve now eliminated duplicate data entry, minimized errors, and saved our staff valuable time.“
“With their expertise in managing our billing processes, we have been able to focus on what truly matters – delivering outstanding orthopedic care to our patients.”
