In the complex landscape of healthcare, behavioral health billing comes with various challenges. Healthcare providers constantly struggle to maintain a balance between medical billing and patient care.
As the number of patients increases, devoting time to behavioral health billing becomes difficult. Healthcare providers also need to deal with intricate billing processes, including verification, coding, claim management, and processing.
However, even with complexities, handling medical billing efficiently is essential to maintaining the financial stability of the practice. With the assistance of behavioral billing services, healthcare providers can improve operational flow while boosting the bottom line.
The possibilities are endless, that is why exploring major concerns and finding solutions is crucial. In this blog, we will learn the main medical billing issues in behavioral healthcare practice and figure out the best course of action.
Medical Billing Challenges Intervening Your RCM Growth
Inefficient behavioral health billing is stressful for healthcare providers and impacts the financial health of the practice. There can be various reasons behind improper administrative flow. Usually, a healthcare practice can face errors while documentation and coding, leading to denials and rejections.
Denials can be harmful for revenue cycle management as they slow down the cash flow. Around 5%–10% of claims get denied on average, and this is not a positive indication.
Let’s go through behavioral billing challenges one by one for better understanding:
Manual Medical Billing Process
Before the advent of technological tools, it was logical to perform medical billing manually. However, in today’s time, it can be time-consuming, causing significant errors throughout the process.
For behavioral health billing as well, the manual process can slow down revenue growth. Prevailing errors can disrupt positive cash flow and prevent the healthcare practice from achieving profits. Where behavioral billing services can solve this issue.
Different Coding Requirements
Behavioral medical coding is different from other medical specialties. CPT codes for mental health billing can be complex due to the challenging nature of the practice.
Without proper skill and knowledge, it is easy to confuse specific codes and make coding mistakes. This has a direct impact on the revenue cycle management, with a greater chance of losing significant collections.
Maintaining a clean claim rate is all about knowing coding requirements and staying current with coding standards. For coding expertise, behavioral health services can also help healthcare providers.
Frequently Changing Billing Guidelines
Behavioral medical billing is a process with ever-changing billing guidelines. Not staying aware of the altering billing regulations can put healthcare providers behind in achieving growth.
If medical claims are not prepared in terms of new rules and policies, healthcare providers are sure to lose revenue. This is essential to avoid coding mistakes and maintaining the safety of sensitive patient information.
The need to stay current adds another task to the check list of healthcare providers. However, if they want to shift their burden, they can opt for behavioral billing services.
Errors and Missing Details
Errors and missing details are a prime reason behind increasing denials in a practice. Such inaccuracies can occur at any step in the medical billing process. Usually, errors at the time of documentation result in coding errors at the time of claim filing.
A minor mistake in the beginning can lead to greater disadvantage later. Accuracy is also the reason behind improved efficiency. So, healthcare providers need to take measures and upgrade the behavioral health billing process.
Behavioral health services can do an even better job at streamlining the billing process and avoiding inaccuracies.
Submission and Follow-up Delays
Just like claim filing, submissions need perfection as well. Generally, negligence towards submitting claims keeps healthcare providers away from maximizing revenue. If any claim is filed after the due date, it is likely to result in a denial. To prevent this, healthcare providers must ensure timely submissions.
Behavioral billing services perfectly handle such situations by showing precision in all medical billing steps. Their system is designed to be on time in terms of claim submissions and their follow-up.
Limited Use of Technology
It is high time healthcare providers incorporated technology in the medical billing process. Advanced technological tools can do what humans can’t. They ensure accuracy and efficiency in all the steps. They also reduce the chance of manual errors and limit the use of paper.
Technology takes away work pressure on individuals, leading to a well-organized medical billing process. Relying on innovative ideas is currently trending, and making use of it can help achieve a boosted bottom line.
It is normal for healthcare providers to feel unsure about this, as this is not their area of expertise. That is why they can depend on health services for behavioral health billing.
Trying to Handle RCM Alone
Performing medical billing is a team task, and an individual cannot handle everything alone. Healthcare providers can underestimate the hassle behind behavioral health billing and lead to insufficient revenue.
Rather than thinking this, it is a better idea to delegate the task to professionals. Experts understand challenges, target the areas of improvement, and help healthcare practices receive adequate revenue.
Behavioral billing services are well-versed in meeting all requirements and ensuring timely filing. Also, healthcare providers get more time to enhance the quality of patient care, leading to more patient satisfaction.
Reasons to Outsource Behavioral Health Billing
Behavioral health services can effectively solve medical billing complexities and help healthcare providers achieve adequate reimbursement. Outsourcing has various reasons, and they are:
Functional Claim Management
With behavioral billing services, healthcare providers don’t need to worry about common challenges such as inaccurate documentation, errors in coding, or delays in claim submission.
Outsourcing partners work with a team of qualified coders and billers who ensure smooth flow in the medical billing process. As a result, healthcare providers maintain accuracy and achieve efficiency seamlessly.
Upgraded Productivity
Working with professionals has many benefits, and one of those is increased productivity in all medical billing steps. This is possible because billers and coders target every medical billing step with precision while matching the timeline of the complete billing process.
While behavioral health services focus on the administrative process, healthcare providers can work on patients without any distractions. Health services also improve the operational flow, reducing confusion and delays.
Behavioral Billing Expertise
Behavioral health billing is different from other specialties with unique billing and coding challenges. Moreover, every healthcare practice is different with complex requirements.
Expertise gained over the years helps professional health services navigate through a healthcare practice’s distinctive challenges. This way, healthcare practices are able to achieve a higher clean claims rate and overall efficiency. A specialization in a preferred specialty solves half the problem.
Reduction in Expenses
Partnering with behavioral health billing is considered a cost-efficient option. It allows healthcare providers to avoid hefty investments to maintain an in-house medical billing staff. Healthcare providers no longer need to spend on hiring and training in-house staff.
As all the administrative burden is shifted to experts, healthcare providers can monitor their operational expenses and stay within their budget. Along with this, there is no hassle for healthcare providers to make important financial decisions.
Adherence with Regulatory Standards
In the healthcare billing landscape, meeting regulatory standards is crucial for healthcare providers to avoid legal consequences. Behavioral billing services are well aware of this fact, and they ensure complete compliance with necessary standards.
Specially, they make sure to adhere to HIPAA compliance to protect sensitive patient information from misuse. Following such rules and policies helps healthcare providers and practices in building patient trust. Moreover, healthcare providers become safe from reputational damage and legal action.
Access to Technological Solutions
Behavioral billing services incorporate the latest technological solutions to improve medical billing processes and generate desirable results. They enhance the quality of verification, documentation, coding, and submission with the help of tools.
With this, healthcare providers get a streamlined behavioral health billing process and meet desired revenue goals. Utilizing technology also helps in ensuring data security and protecting sensitive patient information.
Bottom Line
Behavioral health billing is complex and demands expert assistance to achieve adequate revenue. Healthcare providers can improve their financial performance if they outsource behavioral billing services. Professionals handle intricate tasks seamlessly by reducing errors and denials.
If you are a behavioral healthcare provider contemplating partnering with health services, Eminence RCM can help you.
Eminence RCM proficiently manages behavioral health billing and assists healthcare providers in dealing with complexities. Our team understands your unique medical billing requirements and offers personalized billing solutions. We significantly reduce manual errors, coding complications, and streamline submissions. Our team also ensures complete HIPAA compliance and stays current with changing policies. We make sure all denials go through a robust denial management process for maximum revenue recovery. Moreover, we hold a specialization in behavioral health billing.
At Eminence RCM, we prioritize your requirements and work our best to improve your financial posture.