Medical billing is a useful way of managing all medical-related billings between patients, medical professionals, and insurance companies. An automated process where mental health and other medical professionals, without being involved directly in the billing process with the insurance company, can focus on their actual tasks. It is productive and beneficial when a hard-time facing medical professional gets free from these complexities, and a professional is hired for medical billing services. Medical billing service is a complex process, while mental health billing is more time and effort taking tasks than other tasks and billing services. This is the reason that behavioral and mental health billing providing professionals are hired who, not only, push the workload off of the medical professionals but also automate and manage this efficiently. So, why is that, the mental health billing is not so easy?
Complexities of Mental health Billing
Unlike all other healthcare units, medical billing for the mental health sector is a more complex process as it takes more time, efforts and energy, there are also few additional barriers in the mental health services, specifically, which makes it different and more complex. What does it take for a regular check-up? A normal checkup includes common analysis, like checking blood pressure, checking heartbeat, weight, height, and other things. However, the billing process is also very common among healthcare providers and health insurers. As a general perception medical billing for medical health services is quite complex as compared to other healthcare sectors because of the fact that mental health care contains scope, time and number of restraints that are compulsory for the treatment of medical health. In other sectors of health, a patient takes normal and average time which is standardized for all the patients.
Why we can’t standardized mental health billing process?
The services that are entertained for a mental health treatment are quite difficult and have multiple factors in terms of approach by a therapist, length of the session of location in which service has to be entertained. It also involves the age of the agreement/ willingness of a patient for the treatment. Numbers of other different factors are included as well. Because of which the treatment and a billing process cannot be standardized.
Another reason for this complexity is that services which have to be provided for mental health treatment carry lack of resources. It has been observed that a limited group of therapist practice these services plus some of them don’t possess any administrative support so it can say that the burden of the billing process is carried by the physician by themselves.
Let’s study some tips that can be useful for billing for services that are related to mental health treatment.
Checking of patient’s coverage and insurance:
The very initial step is to make ensure about the insurance plans of a patient and its benefit before making any visit. Apparently it seems very time taking process and it would take some time definitely but it makes you sure about patient’s coverage availability before providing them with any service and it will produce a larger return in the end. For this purpose, a process can be used which is called as verification of benefits such as VOB. This process should be conducted before starting any services or treatment to the patient.
CPT codes understanding:
CPT codes stand for common procedural technology. Insurance providers use this technology of codes to calculate and determine the amount and density of reimbursement which has to be given the patient for their healthcare facilities. It is assumed and expected by each physician and therapist to understand their services and CPT codes that are associated with these services before dealing with behavioural health billing. It’s not only associated with health billing but it can be applied for all sectors of health. As a matter of fact, it’s kinda critical for a physician to understand the services they are providing and associate them with CPT. There are some services providers which provide the same code to each patient which neither legal nor recommended.
As a matter of fact, there are two kinds of CPT codes that are used specifically for behaviour and mental health sector. These codes are of E/M codes and code of psychiatric evaluation. It has been observed that E/M code has to be used for evaluating any new medical issue plus three elements of documentation have to be provided which are off the history of a patient, examination and a medical decision making. Now if we talk about codes of psychiatric evaluation, it is used for diagnostic assessment. It is considered a session of psychotherapy can include services of E/M but this time does not toward the overall timing of therapy session.
Submission of claim properly (An understanding):
A correct billing format claim and correct code to the correct insurer has to be submitted in order to receive reimbursement. The billing format can vary from one insurance company to another so, it a fundamental step that an individual should know about insurance company’s proper filling method plus the file has to be submitted within the which is allocated by insurance plan.
Updating of patient’s data regularly:
It’s a general practice that the number of patients changes their policies of insurance and just forget to inform about it to their physician which can reject the claim filed by a physician so updating the data on regular basis can avoid this conflict and can lead to the less difficult billing process.
Educating of support staff for billing process:
It is a compulsory event to educate the staff which helps the physician to carry out about all billing processes so if support staff is awake about the codes that are conducted for medical health billing them it would be kinda less complex for the physician or a therapist to process the filling.
So it is co concluded that filling a process of billing in a right way at the right time ensures all the providers that they would get paid for all the services that they have provided plus no revenue would be lost.