Addiction medicine billing with clear service boundaries.
Addiction medicine can involve medical visits, counseling, medication-related care and services delivered through different programs. We help practices distinguish those billing arrangements, review supporting records and follow claims without assuming that one office-based workflow fits every treatment setting.
- ClaimsDocumentation review
- A/RPayer follow-up
- ReportsClear next actions
Three ways Addiction Medicine claims quietly lose value
Review these issues against the documentation, remittance and policy that applied on the date of service. They can appear as denials or underpayments.
- The treatment setting is billed under the wrong model
Office-based services and program-specific billing can follow different rules. We confirm the provider type and arrangement before submitting claims.
- Separate services overlap in the account
Medical, counseling and other charges need support in the record and review for overlap. We do not add services simply because they occurred during the same episode.
- Testing responsibility is unclear
Ordering a test does not mean the practice can bill it. We review who furnished the service and the applicable arrangement.
What we bill for addiction medicine teams
If something you do is not on this list, ask. We will tell you honestly whether we have the depth for it.
How Addiction Medicine accounts are actually run
The worklist connects each claim to its documentation, payer requirements and next follow-up date.
- Confirm the provider and program model
We define the practice’s services, enrollment and billing responsibilities before work begins.
- Separate the documented service components
Medical visits, counseling and outside services are reviewed on their own terms.
- Review exceptions and payer questions
Documentation and arrangement issues are resolved with the appropriate team.
- Report claims by workflow
The practice can distinguish payer delays from missing records and scope questions.
Included for addiction medicine teams
- Charge review against the clinical record
- Eligibility and benefit checks within the agreed scope
- Submission and rejection follow-up
- Payer denial review and supported appeals
- Payment posting and balance reconciliation
- Aged receivable review
- Specific documentation queries for your team
- Reporting on outstanding work and next actions
These describe how we run the service. They are commitments about our process, not a guaranteed outcome on any individual claim.
We work inside the system you already use
We agree user permissions, claim queues, reporting access and escalation contacts in your current system before work begins.
Addiction Medicine billing across the country
These state guides explain local Medicaid programs and payer administration. They cover general billing requirements, rather than a separate Addiction Medicine service in each state.
Arizona payer guideAHCCCS and 7+ plans
Washington payer guideApple Health and 7+ plans
Texas payer guideTexas Medicaid and 8+ plans
New York payer guideNY Medicaid and 8+ plans
California payer guideMedi-Cal and 8+ plans
Ohio payer guideOhio Medicaid and 8+ plans
Florida payer guideFlorida Medicaid and 8+ plansWhat addiction medicine teams ask
Does this automatically include opioid treatment program billing?
No. Program-specific billing must be scoped separately from office-based professional services.
Can you bill tests performed by an outside laboratory?
Not automatically. The provider arrangement and applicable requirements determine who may bill the service.
Should patient treatment details go in the website form?
No. Send business contact information only. Any necessary records must use the agreed secure process.
Let’s review your addiction medicine billing
Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.