In the mental healthcare landscape, billers and providers face challenges related to workloads and regulations. When their processes aren’t aligned, these challenges can become worse. Optimizing billing and provider satisfaction in behavioral health should be a priority for every practice.
Between complex regulations, a high patient load, documentation demands, and the sheer volume of patient data that must be entered and maintained, it can feel extremely difficult for clinicians to do their best work. And it can be extremely difficult for billers to confidently manage their claims process. Luckily, when these two workflows are aligned, they allow the practice to flourish.
Here’s how to make both billers and providers happy at your practice.
Challenges in Behavioral Health Treatment and Billing
A behavioral health biller and a behavioral health provider each face a unique set of challenges. Many of these are interrelated. Billers often struggle with things like:
- Complex billing codes. Behavioral health billing codes are affected by so many aspects of the treatment session, such as the length and location of the session, the treatment method used, and even details as simple as the patient’s age.
- Insurance claim rejections. Rejections happen for many reasons, and must be monitored and addressed in a timely fashion. Multi-provider practices have large numbers of claims to manage.
- Compliance issues. Laws at the state and federal levels guide billing procedures, and billers must know and comply with the rules.
Providers, on the other hand, tend to grapple with:
- Paperwork burden. Today’s providers face full client rosters. Providing the thorough documentation of every session that billers need in order to send the claims is time-consuming.
- Delays in reimbursement. If a practice’s revenue cycle isn’t managed well, there may be delays in paying providers. The burden of documentation contributes to this problem, since that must be finished before bills can even be submitted.
- Impact on patient care. Overwhelming documentation demands and billing cycle management can take energy and focus away from patients.
Because documentation, billing, and the revenue cycle are so intertwined, effective collaboration between providers and billers will solve both sets of problems. But how can practices encourage these professionals to bridge the gap?
Leveraging Technology to Bridge the Gap: Optimizing Billing and Provider Satisfaction in Behavioral Health
Mutual understanding and cooperation can solve billing issues and result in better treatment for patients. Technological solutions, such as Electronic Health Records (EHR) and billing software, streamline the billing process and support better communication.
Keep in mind that for this to work, billers and providers will need to be trained in using the technology. You’ll need to provide training either through an EHR provider or on your own to make sure that everyone uses the functions of the tech as intended.
Coding and Documentation
Accurate coding and thorough documentation are important for billing success. This reduces the number of rejected claims and helps providers get the full amount of reimbursement they deserve for their services.
EHRs help ensure better documentation when they provide templates to capture all of the information needed for billing. This speeds the documentation process and makes it less likely that a provider will make a mistake or leave out required info.
Filling out documentation as quickly as possible after a session is another way of increasing the chances that you’ve captured all of the important details. Here again, an EHR can help, because electronic templates—especially those that utilize efficient tools like check boxes, auto-narrative generation, and carrying data forward from previous documents—make the process faster, and thus more likely to be completed promptly rather than left for later.
Some behavioral health EHRs make it easier to find all the appropriate codes that you might use in mental health. Given how complex coding can be, it’s good to have a tech solution that is designed with that complexity in mind.
Completed documentation documentation and correct billing will reduce the number of rejected claims, which will save billers time and promote a healthy revenue cycle.
Compliance and Regulation
Templates are useful in maintaining compliance because they nudge behavioral health providers to capture all the necessary data. This make it easier for billers to send claims that adhere to all regulations. Some EHRs, such as Valant software, automate as many billing steps as possible, such as auto-generating a billing component for every treatment session and screening bills for mistakes before submission.
Compliance also covers the security of patient data. EHRs that are designed for behavioral health are likely to have appropriate protections in place for client and billing information, making them HIPAA-complaint.
Balancing Patient Care and Billing
When technology makes the above tasks faster and easier, providers can shift more of their focus to patients and spend less time on documentation and claims management. Optimizing billing and provider satisfaction in behavioral health has a direct line to improved outcomes and patient satisfaction.
Case Studies
Many behavioral health practices have reaped the benefits of improving both biller and provider satisfaction.
- InterCare Psychiatric Services experienced how billing tech can ease friction and make a huge impact on staff well-being. Chief operating officer Kristin Seitanakis said, “We are billing everything that we’re doing, nothing is getting lost, and about 92 percent of our insurance claims are less than 30 days old. Work stress has seen a noticeable decline. Billing staff used to worry about tasks they needed to manage. Now everything appears on the dashboard.”
- Jacob Hamm saw the necessity of practitioner/biller collaboration as both a manager of a behavioral health practice and, later, the owner of a practice management consulting firm. He found that good software could ease friction between the workflows of clinicians, billers, insurance companies, and clearinghouses.
- Catalyst Counseling LLC struggled with completing and submitting claims on time, often losing bills in the system. Fixing their billing process worked wonders for their productivity. Sarah Kugel, chief administrative officer, feels more confidence in their overall processes since employing a behavioral health specific EHR. “I know I’m not billing things without documentation, and I know that as long as therapists are recording their appointments, we’re billing everything they’ve done.” That’s good news for providers waiting to get paid, and billers who don’t want to spend time tracking down lost bills.
Conclusion
It is possible to achieve a balanced workflow that makes mental health providers and billers happy. Technology can enable this process by helping both sets of professionals do their work faster and more thoroughly. When documentation, coding, and the revenue cycle are closely managed, everyone wins.
As challenges in the mental health landscape continue to shift, the healthcare industry will continue to adapt. EHRs will stay at the forefront of responding to these changes and making the job of the mental health provider easier.
