How to Effectively Manage Your Practice’s Billing: Tips for Mental Health Clinicians

 How to Effectively Manage Your Practice’s Billing: Tips for Mental Health Clinicians

Written by Kelsey Someliana-Lauer, Therapy Practice Solutions Virtual Assistant

Managing billing is one of the most crucial yet challenging aspects of running a successful mental health practice. Billing errors, delayed payments, and insurance denials can not only cause financial strain but also take time away from providing quality care to clients. Implementing effective billing strategies can streamline the financial operations of your practice, reduce stress, and ensure you get paid for the valuable services you provide.

In this blog post, we’ll explore practical tips to help you manage your practice’s billing more efficiently. From verifying benefits to handling denied claims, these strategies are designed to improve the financial health of your practice and free up more time for client care.

Tio #1: Verify Benefits Prior to a Client’s First Session

Verifying a client’s insurance benefits before their first session is essential for avoiding unexpected billing issues and ensuring that both you and the client understand their coverage. Try the following to ensure benefits are verified: 

• Contact the insurance provider: Reach out to the client’s insurance company to verify their mental health benefits and coverage details. If you don’t have time for the insurance phone call, you can often utilize an online insurance portal (such as Availity) to verify benefits.
  
  

• Check for pre-authorization requirements: Some insurance plans require pre-authorization for therapy sessions. Confirm if this is necessary to avoid claim denials.
  
  

• Clarify co-pays and deductibles: Understand the client’s co-pay amount and deductible status to provide accurate information about what they will owe. It’s easier to collect per session than to chase a client after a handful of sessions go by!
  
  

• Document benefit details: Keep a record of the benefits verification, including the date and the representative you spoke with, for future reference. Always ask for a reference number!
  
  

• Communicate clearly with clients: Inform clients of their benefits, co-pays, and any potential out-of-pocket costs before their first appointment to manage expectations. Email clients their anticipated benefits with a disclaimer*, letting them know your best estimate.

*We strongly recommend including a disclaimer to let clients know you are providing an estimate of benefits and final payment decisions are made by the insurance company at the time the claim processes. 

Tip #2: Check Claims for Common Errors Prior to Submission

Errors in insurance claims can lead to denials, delays, and frustration. Taking the time to review claims for common errors before submission can greatly improve your chances of getting paid promptly. Here are some easy details to double-check:

• Verify client information: Double-check that all client details, such as name, date of birth, and insurance ID number, are accurate and match the information on file with the insurance company. This is a common mistake we see!
  
  

• Use correct billing codes: Ensure that the appropriate CPT codes and diagnostic codes are used and that they align with the services provided.
  
  

• Confirm provider credentials: Verify that the clinician’s National Provider Identifier (NPI) and other credentials are correctly listed on the claim.
  
  

• Check for authorization requirements: Make sure pre-authorizations or referrals required by the insurance plan have been obtained and are noted on the claim.
  
  

• Review submission deadlines: Be aware of each insurance company’s filing deadlines to avoid late submissions, which can result in claim denials.

Tip#3: Handle Denied Insurance Claims Efficiently

Denied claims can disrupt cash flow and require additional time and effort to resolve. Developing a systematic approach to handling denials can help reduce their occurrence and speed up resolution. Here are some ways to handle denied claims:

• Review denials promptly: Address denied claims as soon as they come in to avoid backlogs and cash flow issues. You don’t want a claim sitting under a “denied” status for months on end!
  
  

• Understand common denial reasons: Keep a record of common reasons for denials to identify patterns and address issues proactively.
  
  

• Communicate with insurance companies: Build relationships with insurance providers and stay updated on their requirements to minimize denials.
  
  

• Appeal denied claims: Don't hesitate to appeal denied claims if you believe they were rejected in error. Provide thorough documentation to support your case.
  
  

• Educate clients on insurance: Inform clients about their insurance benefits and limitations to manage their expectations and reduce misunderstandings.

We hope this post gave you some practical tips for insurance billing in your mental health private practice! At Therapy Practice Solutions, we know how important it is for you to use your time and energy in ensuring high quality care for your clients. If you’d like to offload tasks to make time for providing great care to your clients, reach out to us today. The pros at Therapy Practice Solutions would love to help you help others. We look forward to hearing from you!