We recognize the unique struggles your specialty faces, let us help manage your business.
Behavioral Health is often riddled with complications when billing out charges for various encounter types.
The ongoing changes in the healthcare environment have necessitated that a billing team have dedicated and prompt follow through on denials and no claim responses. The range of patient care issues provided by Behavioral Health practitioners is wide and varied. Even though our focus is on medical billing and accounts receivable management, our broad experience across the entire Revenue Cycle Management process in Behavioral Health is why we can give you an advantage compared to in-house billing.
Our team at Etransmedia has the knowledge and skills necessary to successfully work denials and provide our Behavioral Health clients with valuable feedback to assist in managing and decreasing the most frequently seen denial types, while streamlining revenue and increasing your practice’s collection rates. Getting you paid fast!
What we know…
How reimbursement is based on what was done and why, and the financial risks involved.
New terminology concepts that are supported by ICD-10
Drug “use” vs “dependence” vs “abuse”
Recurrent depressive disorder
Mood disorder related to physiologic condition
Adjustment reaction with withdrawal
Distinguishes between current episode and most recent episode for bipolar disorders
New Codes for Mental Health & Psychiatry
There are two new add-on prolonged service codes: +99415 and +99416. They are used to document prolonged face-to-face clinical staff service with physician, NP or PA supervision. The same rules apply as above.
Since these codes are used for clinical services under supervision of a prescriber, they will obviously apply more to a psychiatry or intensive outpatient (IOP) setting.
*Note: the above guidelines apply to outpatient services only. Document the services provided and the length of time they took. If you are reporting additional procedures, document the time and note that they are excluded so no payer suspects you of double-dipping for reimbursement.
Any CPT code with a “+” prefix must be reported with a primary code. These are add-on codes and should never appear alone on a claim.
On October 1, 2016 the Centers for Medicare and Medicaid Services (CMS) will no longer accept unspecified codes in most cases.
Starting in October, CMS requires greater specificity for claims filed in ICD-10-CM/PCS. The 12-month grace period originally introduced in 2015 said they would not deny claims for lack of ICD-10 specificity. That all changes on October 1, 2016. Payors will most likely follow suit if they haven't already.
First Pass Clean Claim Rate
Boost in Revenue*
Reduction in Cost*
We’re always on top of all the latest coding and billing updates for Behavioral Health practices. Additionally, to make sure all claims are reimbursed on the first claim submission, our system is able to pre-edit claims prior to the initial submission for possible billing/coding errors. Our detailed end of month reports keep our clients up-to-date on what is happening in their practice so any issues can be addressed quickly. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.
Although the new industry standards can be confusing and difficult to navigate, our dedicated team here at Etransmedia can assist in guiding you and helping to make your practice grow successfully.
*Please Note: Results are not guaranteed, implicitly or explicitly, and will vary based on several factors such as individual practice demographics, specialty, payer mix, operations, and management among others
Service and Technology Packages
Our customizable revenue cycle management service and technology solution packages allow you to outsource based on the specific needs of your practice
Silver RCM Service
This package has the core service and technology needed for revenue management allowing you maintain the responsibility of patient billing.
Gold RCM Service
This package includes the core RCM services with added denials, A/R management services, and full service patient billing
Ancillary RCM Services & Technology
Available to enhance any package