There’s a lot at risk when deciding who to trust with your revenue cycle management. Whether you run a $20MM regional program for substance use disorders or a clinic with four providers, you need to get paid for the services you provide.

Proper revenue cycle management is a time-consuming challenge, but it is the foundation of your organization’s financial success:

• You’ll want to maximize your reimbursement rates.
• Claims need to be filed promptly.
• Problems need to be addressed quickly, before they compound after multiple rejections.

So, what’s the best way to approach mental health and substance use disorder billing? After 22 years of supporting behavioral health agencies, we’ve seen every solution.

We’ve hired and trained billers for our own behavioral health billing service, and we’ve worked closely with thousands of in-house mental health billers around the country that use ClinicTracker and BillingTracker in their offices. Here are some insights to help you make this key decision.

Hiring In-House Billers for Mental Health

As a business leader, you may not have the time or expertise to handle your billing, and you may opt to hire billers at your office. To support your billing needs in-house, we recommend staffing one full-time biller for every 3-4 mental health or substance use service providers. If you will only have one biller, you’ll want to arrange coverage for illness and vacation time.

What to Look for in an In-House Billing Candidate

Your billing staff should demonstrate a deep understanding of the nuances of behavioral health coding and the requirements of each of your payors. You will also need access to reporting that allows you to monitor open claims, denials, and aging.

When interviewing candidates for an in-house billing specialist position, make sure they have a full understanding of the entire claims process, from entering the charges to submission, handling rejections, follow up with payors, and posting payments. Your candidate should be able to correctly explain when a claim should be appealed, how to handle secondary & tertiary payors, and when a patient can be balance billed, and when they can’t. It is also helpful for a biller to have experience using your EHR.

If you can get a team of in-house billing experts that meet these requirements, hold on to them!

Outsourcing to a Billing Service for Mental Health

Don’t have the budget for salaries and benefits to hire a full-time mental health billing staff? A professional billing service will spare you the HR hassles and expenses.

ClinicTracker’s Billing Service can provide the support you need and maximize your incoming revenue stream.

If you notice accounts receivable over 45 days are growing, that’s a sign to hire a professional billing service. Do you, your staff, or your patients have a growing sense of confusion or frustration over bills? Eliminate that anxiety by hiring a professional billing service.

Things to Consider with an Outside Billing Service

Your first questions about a Billing Service should center around costs, such as termination, data conversion, and per claim fees. In addition to understanding how you will be charged, we recommend interviewing potential billing service partners just as you would an internal hire:

• Will the billing service representative be a good fit with your team?
• How will this person communicate with you, your team, and your patients?
• Are there certified coders on staff?
• What key performance indicators (KPIs) are included in their report packages?
• On average, for their existing clients, how many days are claims outstanding?
• Could you speak to one of their existing clients, one that is similar to you?

A billing service must be more than HIPAA-compliant and secure. Consider the compatibility between your EHR and the system the outside billing company uses. How will you import and export data between the systems? Do you have the time and financial resources to manage the integration?

ClinicTracker EHR and BillingTracker work seamlessly together and our billing specialists are experts in both systems, which means you don’t have to worry about integration or training billers on new tools.

Outsourcing your revenue cycle management saves time, staffing expenses, and preserves your mental health. A professional billing service will take the weight off your shoulders and allow more focus on the mental health and substance-use services you provide. Contracting a billing service gives you access to a team of subject matter experts who can easily meet your payor requirements, provides you with transparency through reporting and open dialogue, and most importantly, ensures that you get paid for your valuable work.

Looking to outsource billing activities for your behavioral health program?

Reach out to talk with us.