DENmaar: Streamlining Clinical, Administrative, and Billing Operations for

Behavioral medical billing is one thing that mental health practitioners simply wish to do away with. It is a special kind of frustration that is conjured when you try to file insurance claims for mental and behavioral health benefits.

Due to the types of services offered, or the pre-authorization needed, the challenges that mental health practitioners face are unlike any their contemporaries have to deal with.

What Makes Mental Health Billing so Complicated?

Lack of a standardized process as compared to other practices would be a simple answer to this question. In a Behavioral health practice, there are a number of variants when it comes to types of services offered. Major time in behavioral healthcare is spent on therapy sessions. Insurance companies take note of how long the duration of these treatments can go for, as well as how many of these sessions can take place in a day. Both counselors and psychiatrists simply have a very different way of dispensing their services.

These make it very difficult for them to balance their treatments with an adequate billing system. Another area that clearly distinguishes mental health billing from other conventional billing plans is the fact that the problems with behavioral medical billing are only amplified by office budgets.

Counselors will often try to process their own bills, to cut down on operation costs for their private practices. The lack of dedicated staff to update billing codes for behavioral health, changing regulations, and billing practices for each of the respective insurance companies, will result in rejection rates skyrocketing.

If you want to process your claims quicker, then the following can help:

File within the time allotted by the insurance company
Use only the billing format required by your client’s insurance company
Use the appropriate code for the delivered treatment
Limit the bill’s total to the fee allowed by your client’s insurance policy
Use the appropriate policy number for the bill claim
Submit the claim to the right address
Receive pre-approval for treatment as needed by the insurance plan

On average, only 85 percent of claims for behavioral healthcare is approved. Improving these approval rates is the biggest challenge facing behavioral healthcare providers today.

Make it a habit to double-check your client’s insurance plan before each and every visit. Sudden policy changes and lapses in coverage are common in the world of health insurance. Try to stay ahead of the game for your own benefit.

Be up-to-date on each of your client’s insurance company filing methods. Paper and fax have become a thing of the past, and are now being replaced by email, and online filing services. Stay in touch with the insurance companies, as you don’t know when they will change their billing method.

DENmaar’s Behavioral Health Medical Billing Services.

As you can guess from the article, medical billing for mental health is not a walk in the park. A lot of effort, blood, and sweat goes into the entire process. It can be time-consuming and really frustrating for mental health practitioners who just want to tend to their client’s needs.

Here at DENmaar, we partner with concerned practitioners to offer pre-authorization, third party billing, claims follow-up, and to assist with appeals for any denied insurance claims. With DENmaar, you get the assistance of our behavioral medical billing consultants to make your billing process easier than ever.

Medical billing on its own is a seriously complicated process. However, medical billing for mental health is a whole new level of the headache-inducing choir. It comes with its own set of unique and complex challenges. When you take into consideration the size and time availability of office staff, unbundling concerns, pre-authorization, etc., behavioral health practitioners are always at a disadvantage compared to their contemporaries in other fields

Understanding the process of behavioral health medical billing is the only way for mental health practitioners to achieve salvation. As then and only then can practitioners spend more time and money on something that matters to them beyond everything else – their patients.

Having emphasized the importance of comprehending the process, we at DENmaar have designed an intricate and precise behavioral health billing software that aims to lift the unnecessary weight of medical billing off your shoulders, thus allowing you to focus on what you are good at, which is tending to your patients.

What Makes Medical Billing for Mental Health So Difficult

The variety in the types of services, the time, scope, and restraints put on mental health treatments, all of them work in conjunction to make the medical billing very difficult. For practices other than mental health, the process is easily standardized; hence the medical billing process remains fairly easier to understand and implement.

However, the very volatile and diverse nature of behavioral health treatment doesn’t allow the luxury of convenient medical billing to those who practice it. Behavioral health treatment differs vastly. The session length, the therapeutic approach, the location in which services are rendered – all contribute to the complex nature of behavioral health medical billing.

Behavioral Health Billing Guidelines

So how can you, as a Mental and behavioral health practitioner, combat the tedious nature of medical billing? Read on for the answer.

     1. Double Check Each Patient’s Insurance and Coverage

The very first thing you need to do as a responsible mental health practitioner is to learn about each of your patient’s insurance plans and coverages before each visit. Although this may sound like a time-consuming choir, knowing each and every patient’s insurance plan will reap greater returns in the end.

You can check all of your prospective client’s coverages by conducting verification of benefits for each of your patients before you begin treatment or serving the client in any manner.

Verification of benefits allows providers to unearth important information that is not available in the patient’s insurance card. By checking the VOB, you can rest assured knowing that they are insured for the services they are getting from you and will know how much the insurance company is willing to pay for the services of a client.

Many insurance companies provide online provider portals that can be used to perform verification of benefits by the provider. If a portal is not available, then you can directly call the insurance company to gather the needed information.

To conclude, it is very important to know the coverage and insurance plan of all of your patients, so you don’t end up with rejected claims and unpaid bills.

     2. Understand CPT Codes

CPT or ‘common procedural technology’ are codes used by insurance providers to determine the amount of reimbursement to be delivered to healthcare facilities. When dealing with billing, it is imperative to know the associated behavioral health codes for billing. It is extremely crucial to understand the services your facility offers and its respective CPT codes.

Some mental health practitioners use the same CPT codes for all their services. This is illegal, and we recommend our clients never to do such a thing. There are two types of CPT codes available for behavioral health practitioners – E/M Codes and Psychiatric Evaluation Codes

E/M Codes are used to evaluate new medical issues and must have three documentation elements provided. They are:

• History
• Medical Examination
• Medical Decision Making

On the other hand, Psychiatric Evaluation Codes are used for diagnostic assessment. It can include E/M services, but the time associated with E/M services is not counted.

     3. Submit Claims Properly

For you to get reimbursed for a claim without a hassle, not only do you need to file the correct code in reference to the correct insurer, but also submit the claim in the correct billing format. Make sure that you are well aware of the insurance companies filing method, and that you do file within the time allotted to you by the insurance company.

Learn More: How to Handle Claim Denials & Maximize Reimbursements

DENmaar’s Mental Health Medical Billing Service

As you can guess from the article, medical billing for mental health is not a walk in the park. A lot of effort, blood, and sweat goes into the entire process. It can be time-consuming and really frustrating for mental health practitioners who just want to tend to their client’s needs.

Here at DENmaar, we partner with concerned practitioners to offer pre-authorization, third party billing, claims follow-up, and to assist with appeals for any denied insurance claims. With DENmaar, you get the assistance of our medicare behavioral health billing specialists to make your billing process easier than ever. Call us on 844-727-3627 to get started!

We at Denmaar have always strived to bring our clients a reliable and powerful feature that helps in the faster creation of treatment plans. Well, what seemed like a vision for the future is now possible because of our new Partner Wiley and their robust invention in Wiley Treatment Planner.

An Insight on Wiley Treatment Planners

Wiley treatment planners are now an integral part of Denmaar’s Treatment Planners. Treatment planners, in general, helps mental health practitioners to not only define the problems they face on a daily basis but also helps provide them with goals, interventions, and objectives to create a fully executable, customizable treatment plan.

Here is How Wiley Treatment Planners Can Help You:

• Saves Time that would have been wasted in Paperwork.
• Offers Practitioners the freedom to develop a customized treatment plan.
• Includes Over 1000 Clear Statement describing in detail the behavioral representation of each relational problem.
• It includes long term goals, short term objectives, and clinically tested treatment options.
• Deploys an easy to use format that helps locate treatment plan components by behavioral problems.

Apart from creating evidence-based options and best practices for your clients, treatment plans can also be useful when it comes to treatment review.

Build an Effective Treatment Plan with Wiley

1. Problem Selection
Treatment planners allow you to sort and apply to present issues relevant to your client. Choose the problem that effectively represents the problem of your client.

Example: Anxiety

2. Defining the Problem
The treatment planner has the ability to clearly describe the behavioral definitions of the problem represented in the client. The symptom pattern should be associated with codes found in DSM 5 or ICD-10-CM codes.

Example: Motor Tension
                 Hypervigilance

3. Goal Development
The planners provide a variety of other goal statements for each problem identified, so it is easier for you to set a broad set of goals for the resolution of the problem faced by the client.

Example: Reduce overall frequency, intensity, and duration of the anxiety.

4. Objective Construction
A treatment plan includes objectives written in the behaviorally measured language. This makes it more clear to review agencies, health maintenance organizations, and managed care organizations. The objectives mentioned in treatment planners are defined to meet the demand in accountability.

5. Intervention Creation
Interventions are the actions that are designed for the completion of your objectives. You will find at least one intervention for one objective.

6. Diagnosis Determination
The determination of a clear diagnosis is based on your client’s complete clinical presentation. You must compare behavioral, emotional, cognitive and interpersonal symptoms with the criterion for diagnosis on the basis of the DSM-5 code. Remember it is ultimately your knowledge of the DSM-5 and client assessment data that will give you a valid diagnosis.

Treatment Planner with Denmaar

Our new feature now allows you to create treatment plans with unprecedented ease, NO TYPING REQUIRED!

It is well integrated into our platform to minimize both time and effort. The process is as direct as assigning a diagnosis to your client.

Wiley Treatment Planner is a gift we have been planning to deliver to our customers for a long time. Some of our community members have already tested the planner, and the response has been overwhelmingly positive.

Treatment Planners are just another convenient way to empower healthcare professionals to run their businesses more efficiently.

If you are already a Denmaar Customer, then you can use Wiley Treatment Planners for free now.