How to Choose a Mental Health Billing Company
Choosing a medical billing company is an important decision for a mental health practice.
The billing company may be responsible for a significant part of the practice's revenue cycle, so the decision should involve more than comparing percentage rates.
A good evaluation should consider specialization, scope, processes, communication, reporting and accountability.
1. Look for Mental Health Experience
Medical billing is not identical across specialties.
A billing company that works primarily with unrelated specialties may not understand the specific workflows used by behavioral health practices.
Ask:
> How much of your business involves mental and behavioral health?
Also ask which provider types they support.
2. Understand the Full Scope of Services
"Medical billing" can mean very different things.
One company may only submit claims.
Another may handle the entire revenue cycle.
Ask whether the service includes:
- Eligibility verification
- Claims
- Rejections
- Denials
- Payment posting
- A/R
- Appeals
- Credentialing
- Authorizations
- Reporting
Get the answer in writing.
3. Ask About Denial Management
A claim denial is not the end of the process.
Ask:
> Who works denied claims? > > How quickly are denials reviewed? > > What happens when a claim requires correction? > > Who handles appeals?
A billing company should be able to explain its process clearly.
4. Ask About A/R
Accounts receivable is one of the most important areas to understand.
Ask for examples of the reports you will receive.
A useful A/R report may allow you to see:
- Patient
- Payer
- Date of service
- Claim status
- Amount billed
- Amount paid
- Outstanding balance
- Age of balance
- Follow-up activity
5. Ask How They Communicate
Billing problems often require communication between the provider and billing team.
Ask:
- Who is my point of contact?
- How often will we communicate?
- How are urgent issues handled?
- How are missing documents requested?
- How are problems escalated?
6. Ask About Your EHR
Tell the billing company which EHR or practice-management platform you use.
Examples include:
- SimplePractice
- AdvancedMD
- eClinicalWorks
- Valant
- Tebra/Kareo
- Other systems
The important issue isn't whether a company has a logo on its website.
Ask:
> How will you actually work inside our system?
7. Understand the Pricing Model
Ask exactly how fees are calculated.
For percentage-based billing:
- What counts as collections?
- Are patient payments included?
- Is there a minimum?
- Are credentialing fees separate?
- Are there additional charges?
- Are setup fees charged?
8. Ask for Reporting
You should be able to understand the performance of your billing operation.
Useful reporting may include:
- Charges
- Payments
- Adjustments
- Denials
- Aging
- Outstanding claims
- Collection trends
9. Ask About Credentialing
If the company offers credentialing, ask:
- Which payers?
- Which states?
- Individual or group enrollment?
- CAQH support?
- Recredentialing?
- Payer follow-up?
- Status reporting?
10. Look Beyond the Percentage
A billing company charging 4% and another charging 6% cannot be compared solely by percentage.
The real question is:
> What does the practice receive for the fee?
Compare the complete scope.
Questions You Should Ask Before Signing
Ask the billing company to explain:
Who submits my claims?
Who works my denials?
Who follows up on aging A/R?
Who posts payments?
Who verifies eligibility?
Who handles credentialing?
How often will I receive reports?
How quickly will my questions be answered?
What happens if I want to terminate the relationship?
The clearer the answers, the easier it is to evaluate the relationship.
How Mental Health Medical Billers Approaches Billing
At Mental Health Medical Billers, our focus is specifically on mental and behavioral health providers.
We support the revenue cycle across areas such as claims, payment posting, denials, A/R, eligibility and credentialing.
If you're considering changing billing companies, we can review your current setup and discuss your options.
[Get a Free Billing Assessment]