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behavioural health billing services

A Comprehensive Guideline Of Behavioral Health Billing Services

Behavioural health billing services are a necessity for every mental health program. With the cost of these services rising and insurance companies not reimbursing fully, providers should be able to bill for their services by knowing how to get paid for them. This blog aims to help you understand how behavioural health billing services work and why it’s essential for your organization.

What Is Behavioral Health?

Behavioural health is the science of treating mental and behavioural disorders. It includes diagnosis, treatment, and prevention of conditions such as anxiety, depression, eating disorders, and substance abuse. Behavioural health professionals are specialists in the field who work with individuals with emotional problems or chemical dependency daily. They can help patients manage their illnesses through therapies or medication management programs and support those who live with them in their homes or work settings (such as hospitals).

How Does Behavioral Health Billing Work?

Behavioural health billing is the process of submitting a claim to an insurance company for payment. The behavioural health professional (BHP) submits the claim, which the billing service provider processes. This can be done electronically or manually. The BHP then collects money from the insurance company after they approve or deny your claim based on information provided during their initial assessment, diagnosis, treatment plan, or therapy session(s). Many different behavioural health services fall under this category, including counselling/psychotherapy; group therapy; drug addiction rehabilitation programs; outpatient mental health treatment centers, etc.

A strong awareness of the numerous codes that mental health treatments include is essential to bill the claims correctly. If the billing software does not account for psychotherapy or psychology, the practice may encounter difficulties during the procedure. Practices must hire dependable and knowledgeable vendors to handle their billing and solve problems associated with non-traditional healthcare services and other particular demands and processes. The program should be able to simply discover and enter codes based on the requirements and concerns of the patients being treated.

Behavioural health practices typically function under specific conditions. It exhibits disabling severe behavioural issues that may necessitate additional services such as support programs, rehabilitation programs, and other specialized services. Another problem that behavioural health practices confront is that they must devote more resources and time to organizing patient care rather than catering to their patient’s needs. Second, most mental health treatments are offered to patients in primary care settings, preventing them from receiving treatment through specialty programs, which are more helpful to the patients.

Why Is Mental Health Billing Difficult?

Several mental health treatments and services are available, each with its own constraints that can make medical billing problematic. Let’s compare it to regular exams of the doctor for your physical wellness. Most exams in this situation are standard and similar. The doctor will perform the same examinations and tests on multiple people, such as monitoring blood pressure, height, and weight, listening to your heart, and taking blood samples.

When these procedures are billed to health insurance, it is typically easy because routine examinations are frequently grouped under one general price. This is not usually the case for mental and behavioural health care. A variety of variables contribute to the discrepancies in these services. The session duration, location of services, therapeutic method, patient’s age, and desire to engage can all impact coding and billing. This is one of the reasons why mental health billing gets challenging for physicians, as it is challenging to give standardized therapy to all patients, making billing just as tricky. Insurance companies have worked to standardize billing for mental and behavioural health services to reduce payment in terms of treatment length, treatment number, and the maximum number of insured treatments. Pre-authorization is also required by many health insurance policies, which implies that patients must obtain permission before getting coverage for some mental health therapies. This procedure can cause insurance billing to be delayed and prevent a patient from getting the necessary treatment. Due to a shortage of resources, mental healthcare professionals may sometimes grow upset with medical billing. Many small private practices have little administrative support to assist with medical billing, which can result in unintentional errors and exhausted physicians and therapists.

Types of Mental Health Services Covered

It’s critical to understand the types of mental health services that are covered for your patients, who may have different insurance or medical coverage. Some insurance policies, for example, will only cover mental health care provided by certain professionals, such as physicians, psychiatrists, clinical psychologists, and clinical social workers. Furthermore, because insurance does not fund the treatment, some independent mental healthcare professionals can only diagnose the patient with a mental illness. If you work in private practice, the diagnosis and treatment of mental illness by physicians and psychiatrists will most probably be covered by insurance. These services frequently cover some counselling, such as a general form of:

Family medical psychotherapy

If a family member has a specific ailment, diagnosis, or other mental health difficulties, direct family members or caregivers to attend therapy sessions to understand their condition and how to care for them. This service can occur with or without the patient and is sometimes reimbursed.

Group psychotherapy

A group of patients is chosen to be treated actively to help change behaviour patterns. If their diagnoses are curable, medical insurance should cover them.

Psychiatric therapeutic services

Individual therapy with a patient who can interact and comprehend interactive questioning and treatment from a provider is referred to as psychiatric therapeutic services. This therapy may include the treatment of behavioural patterns, emotional disorders, and assessments.

Psychiatric diagnostic review

This mental health service collects a patient’s medical and mental health history. A physician will also conduct a mental health status assessment on the patient to assess their willingness and capacity to respond to treatment.

What Makes Behavioral Health Different From Medical Billing?

One of the essential things about behavioural health billing is that it’s more complex than medical billing. While there are similarities, they’re not identical. Many physicians are not familiar with behavioural health procedures and their associated codes because they aren’t included in the standard medical coding system used by most insurance companies and large hospitals.  

The main difference between behavioural health billing and medical billing is that the former involves more complex coding requirements, which makes it harder for providers to complete their work accurately. This means that if you’re trying to get reimbursed by insurers or patients’ insurance companies, they may only be able to repay part of what they owe because some codes don’t apply precisely enough or haven’t been appropriately entered into the system yet. This can lead companies into trouble when trying to accurately resolve discrepancies between what was billed and what was paid out by insurance companies. No one knew how much each code should cost until all other expenses were taken care of first. In addition, make sure your doctor knows what services are available and how much they cost. If possible, ask them if he knows anyone who specializes in working with people experiencing mental disorders/illnesses such as depression or anxiety disorder so that both parties can communicate better during treatment sessions via phone calls rather than face-to-face meetings where misunderstandings could arise due to lack of communication between both parties involved (i.e., doctor vs. patient).

In-House Vs. Outsourced Behavioral Health Billing – Which Is Better?

When you’re looking for behavioural health billing services, in-house and outsourced options are both available. The benefit of outsourcing your behavioural health billing is that it can be more cost-effective and efficient than if done internally. For example, suppose a provider has an office full of staff members who require training on how to bill for their services (or with whom they need access). In that case, this could potentially add up over time—if not immediately after hiring someone new into their team.

Why Should You Outsource Behavioral Health Billing Services?

Suppose you’re looking for a way to focus your time, energy, and resources on other aspects of your business or life. In that case, outsourcing behavioural health billing services may be the answer. Whether it is due to a lack of expertise in this area or need more time to manage it yourself, there are many reasons why you should consider outsourcing behavioural health billing services. You can focus on the patient and improve your service. When you have more time to focus on this crucial aspect of your business, you’re more likely to be able to provide better care for patients in need. By outsourcing this function, you will also be able to dedicate more time and attention to improving other areas of your organization—such as marketing or hiring new employees—which could ultimately lead to increased profitability for all involved.

You can increase efficiency by eliminating employees who aren’t needed anymore (or weren’t needed at all). This means that you don’t need as much staff or money invested in people who aren’t doing anything productive with their lives because they’re too busy working long hours at an office cubicle somewhere else instead. To begin with, most people don’t have enough knowledge about what goes into running an effective behavioural health practice. This means they will likely make errors when entering data into their system or submitting claims against patients needing coverage under their policy. Mistakes could lead directly or indirectly (through higher premiums) toward more costly treatment options, such as chemotherapy drugs used during cancer treatment plans; these costs can sometimes exceed $100K per year.

Let our experts handle your behavioural health billing services.

As a behavioural health practitioner, you know that billing is essential to manage your practice. It’s also one of the most challenging services to operate independently. Our team has years of experience working with other professionals in this field, and we have developed a proven track record for success. We can help you get organized so you can stay organized too.


It is important to note that behavioural health billing is a complex process. However, our experts can help you navigate this process with ease. They understand the importance of working within your budget, which makes them perfect for behavioural health billing services.

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