Behavioral and mental health facilities are unique in the support they provide patients. But like other businesses, they can only sustain their operations and keep their doors open when revenue comes in.
Billing for behavioral health practices is unavoidable and a critical part of a practice’s success. Staff must carefully manage the revenue cycle to ensure that care providers and facilities are consistently compensated for services in a timely manner — all while navigating changes in treatment codes and varying payer requirements.
In many cases, the staff that handles behavioral and mental health billing services is at the facility. But these tasks don’t have to fall on the shoulders of internal staff. There is the option to outsource your behavioral health medical billing to a third party instead.
Wondering if it makes sense to outsource your behavioral health clinic accounting functions? We’ll run through some of the tell-tale signs it’s time to turn over the reins.
Administrative staff at behavioral and mental health facilities juggle a busy to-do list. When this list includes chasing down insurers and overseeing the revenue cycle management (RCM) process, it introduces more complexities that add stress to administrators' plates.
While medical billing comes with challenges, mental health billing is inherently more complex since it’s less standardized than treatments for typical physical illnesses or injuries. With greater variability in treatment standards, staff is more prone to choose incorrect CPT codes — and if these honest mistakes continue to happen over time, facilities can be flagged for fraudulent practices. While worrying about these factors, administrators also feel the pressure of having to stay up-to-date with billing protocols that are subject to continuous change and can alter CPT codes.
The combination of these stressors, alongside the fact that billing operations take away from patient-facing interactions, can lead to staff dissatisfaction and loss of employees.
The accounts receivable cycle for mental health practices starts when the facility first bills a patient or an insurance company for the rendered services. The longer that these unpaid invoices remain in accounts receivable, the less likely facilities are to receive full or even partial payment.
One of the biggest culprits for accounts receivable delays past that 45-day mark is the initial denial of insurance claims. In many cases, these denials can be rooted in use of the wrong billing code in paperwork or the need for clarity around the medical necessity of the services. While these fixes are relatively simple to address, many practices don’t appeal these claims due to time and bandwidth reasons, turning potential profits into written off expenses.
Another issue is these same practices can often lack visibility into overdue invoices. A lot of staff find themselves combing through siloed documentation to track patient collections. When inefficient, this manual step in the billing process makes it challenging to stay on top of patient payments as well as project the organization’s cash flow.
When administrative staff is caught up in dealing with insurance claim denials and late payments, they have less time to dedicate to other facets of patient care. For patients, this lack of service can become a source of frustration and lead them to look elsewhere for healthcare services.
Administrative staff are often the first touchpoint a patient has with a behavioral health facility. It's important that these patients are just as enthusiastic about those interactions as they are about ones with mental health providers. Being bogged down by billing operations can not only lead to communication gaps elsewhere in the patient experience, but it’s more likely for billing issues to occur as internal staff tries to juggle numerous responsibilities.
When a patient has to call an office to fight an insurance claim denial or have a charge removed from their bill — with potentially multiple calls made to reach a resolution — they can feel frustrated by the extra work on their part and be less likely to recommend a facility’s mental health services because of those reasons.
Improving your facility’s behavioral and mental health billing services doesn’t mean you have to budget for the salaries and benefits of full-time staff members. You have a more cost-effective option: outsource your mental health billing services to ClinicTracker.
Our HIPAA-compliant Billing Service solution accounts for every stage of your revenue cycle management, from patient account billing and claim submission to claim tracking and billing compliance. While our team of experts in mental health and substance abuse billing help simplify and shorten your revenue cycle, you’ll get paid faster and have time to focus on what matters most to mental health professionals: your patients.
Learn more about why ClinicTracker is the ideal solution when you want to outsource your mental health billing. Download a free copy of our buyer’s guide.