Elements of Behavioral Health Revenue Cycle Management

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behavioral health revenue cycle management

Behavioral Health Billing Software is a powerful tool providers need to optimize their revenue cycle. From the time your patient schedules a visit to the time their bill is paid in full, there are steps providers must take to make sure they get paid. From checking a patient’s coverage to filing a claim and collecting payment, there are so many details that go into the revenue cycle process. Choosing billing software can be tough when there are so many on the market and all of them are making different promises for how they can help. So what features should your behavioral health billing software have? 

Must-Have Behavioral Health Billing Software Features: 

Claim Scrubbing

The number one cause for a denied claim is that there was an error somewhere on the claim. This could mean that there was an incorrect billing code applied to the claim, the patient information was incorrect or even one digit was off from their birthday. Whatever it is, payers will always find a cause to deny a claim where they can. For this reason, providers need to make sure they are only submitting clean claims. A clean claim is one that is free of errors and is primed for payer approval. 

A quality behavioral health billing software will help providers assess each claim pre-submission and scrub it clean of errors. This minimizes any opportunity a payer might find to deny the claim and delay your payment. 

Remittance Reporting 

Remittance Advice is the information that a payer sends attached to your payment/reimbursement This information is a breakdown of what was billed, what was paid, what was not paid, and any other financial information related to your claim. Quality behavioral health billing software should come with remittance reporting tools that help you better understand all of this information in easy-to-view reports. This data is useful when filing future claims so that you have a better idea of what to expect from that payer as well as give you routes to improve your reimbursements. 

Electronic Eligibility Verification 

If a patient is not eligible to receive certain services, then their insurance will not pay for them. Making sure a patient is eligible and covered by their insurance is a key component to making sure you get paid. Quality behavioral health billing software comes with automated electronic eligibility verification. This enables you to check on a patient’s coverage in an instant rather than have to chase that information down over the phone or make assumptions about their eligibility. 

Billing Reports 

A better understanding of your billing will help you optimize it in the future. The behavioral health billing software that your organization chooses should have robust reporting tools that give you a clear picture of your revenue cycle. With this data, you can pinpoint weak points in your billing process and take steps to strengthen them moving forward. 

For example, if your organization keeps getting claims denied from a certain payer or for a certain service, there has to be a reason why. That information can be hard to calculate and pinpoint on your own, especially when you need to focus on the care you are giving your clients/patients. 

Billing software with reporting features can help you find the cause of your denied claims more easily. You can review these reports to find if you are coding the same kind of claim wrong over and over again or if there is a frequently made error in your billing process, allowing you to course-correct and get those claims approved in the future. 

Clean Claims

As was mentioned earlier, clean claims are a path to on-time payments. If providers can increase their clean claims as much as possible, then there will be fewer delays in their revenue cycle and they can strengthen their bottom line. Quality behavioral health billing software is designed with your specific revenue cycle in mind. It can help you increase your clean claims to a number that you never thought possible, bringing in timely payments and optimizing your billing process. 

Denial Management 

When denial does occur, then providers need to act fast. There is only so much time that is available for a provider to correct that claim and resubmit it. Billing software can help you track these time windows/payer requirements so that you never miss a deadline and can still get reimbursed for that claim.  Providers that can implement quality billing software will see a drastic improvement in their revenue cycle.

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