Managing your bottom line might not be why you got into behavioral healthcare, but it’s one of the most important things to consider when running your business. Following the best practices for billing in behavioral health can allow you to serve more patients than before since you’ll be more compliant and profitable.
When you have a software platform like Sunwave Health, running your numbers becomes easier. Our platform includes tailored elements, like financial management software for behavioral health providers like yourself. Every element of the patient journey—from admissions to alumni management—is seamlessly integrated to provide a better experience for everyone. Call 561.576.6037 to schedule a demo.
Behavioral Health Treatment Is Nuanced
One of the main differentiators in how mental health treatment is delivered compared to medical care is the level of complexity. Often, patients receiving behavioral health services require ongoing care and support, which can make coding, billing, and invoicing challenging.
Ongoing behavioral health treatment might involve multiple levels of care and different providers. Since many insurance payors are now incentivizing the value-based care model, it’s particularly important to have a strong billing system in place. This allows for accurate tracking of services, outcomes, and reimbursement rates.
Best Practices for Providers
Documentation and Coding
Accurate documentation and coding are crucial for proper billing in behavioral health. This includes documenting the services provided, the level of care, and any changes in treatment plans. ICD-10 and CPT codes should be used correctly and consistently. Any discrepancies or errors can result in claim denials or delayed payments, ultimately impacting the bottom line of your practice.
Timeliness
Documentation should start the moment a patient walks through the door, and codes should be entered within 24-48 hours of services being rendered. This ensures that billing is done in a timely manner, reducing the risk of missing out on reimbursement due to expired filing deadlines.
Verification of Benefits
It’s crucial to verify insurance benefits before providing treatment to ensure coverage and proper billing procedures are followed. This step can prevent costly claim rejections or denials down the line.
Compliance
Compliance with state and federal regulations is essential for behavioral health providers. This includes following HIPAA guidelines, ensuring proper authorization for treatment, and accurately documenting any usage of telehealth services. Non-compliance can result in penalties or even the loss of a provider’s license to practice.
How Software Can Help
Implementing a software platform like Sunwave Health can greatly improve billing practices for behavioral health providers because it provides an integrated look at patient data.
- General ledger segmentation – Each general ledger in the platform is customizable to track financial data related to claims, adjustments, payments, or even a set of segments to keep you organized.
- Automated adjustments – Our software can handle the most complex payment arrangements and billing agreements with automated adjustments, including reimbursements based on the historical percentages received by particular payers.
- Journal run and period closed – Review and verify your transactions to tie out the system and journal. This ensures that your data is accurate and up-to-date for reporting.
- Customized reports – With Sunwave Health, you can run and save specific reports that give insight into your practice’s financial health.
Plus, since Sunwave is an all-in-one platform, your revenue cycle management (RCM) is easily processed through our software. This means tracking and managing claims, payments, and denials can be done all in one place.
Schedule a Sunwave Health Demo Today
With Sunwave Health, managing your bottom line becomes more efficient and effective. Our tailored financial management elements for behavioral health providers streamline your processes so you can focus on delivering quality care to your patients. Schedule a demo today by calling 561.576.6037, and see how our platform can benefit your billing practices.
