Behavioral health billing is a negotiation with the plan, every session.
Session limits, authorization renewals and parity rules decide whether care continues. The clinical work is rarely the reason a claim fails.
- 97%Coding accuracy on audit
- 50+Specialties covered
- 4.9/5Average client rating
Three ways Behavioral Health 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.
- Session length does not match the code
Therapy codes are defined by time bands. A session billed to the wrong band is either underpaid or, repeated, an audit finding.
- Authorization renewals missed
Approvals cover a set number of sessions. When the renewal is late the sessions continue and the payment does not.
- Parity rules not enforced
Behavioral coverage must match medical coverage in many respects. Plans still apply stricter limits, and nobody challenges it unless somebody is watching.
What we bill for Behavioral Health practices
If something you do is not on this list, ask. We will tell you honestly whether we have the depth for it.
How Behavioral Health accounts are actually run
The worklist connects each claim to its documentation, payer requirements and next follow-up date.
- A behavioral health coder, not a general one
The coder assigned to your account works behavioral health every day. They already know which of your payers do what, and they are watching session limits, authorization renewals and time based session codes.
- Charges checked against the note
Before anything goes out, the charge is read against the documentation. A code the note does not support is a recoupment waiting to happen, and in behavioral health it is usually the highest value code on the claim.
- Eligibility and authorization ahead of the visit
Coverage is confirmed and any approval is in place before the service, not discovered afterwards when the work has already been done.
- Denials worked to cause, not just refiled
Every denial is tagged by payer and reason code. When a pattern shows up in your behavioral health claims we change the upstream step so it stops recurring.
- Reporting you can act on
Monthly numbers by procedure family and payer, with the one decision they imply, rather than an export nobody opens.
Included for Behavioral Health practices
- Coders who work behavioral health daily
- Charge review against documentation
- Eligibility and benefit verification
- Prior authorization management
- Denial management by payer and reason code
- Aged A/R worked oldest first
- Patient statements and balance follow up
- Monthly reporting by procedure family
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.
Behavioral Health billing across the country
These state guides explain local Medicaid programs and payer administration. They cover general billing requirements, rather than a separate Behavioral Health 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 Behavioral Health practices ask
Do you track session authorizations?
Yes, with the renewal started before the last approved session is used.
Can you bill telehealth?
Yes, with the modifiers and place of service each payer requires, which are not consistent between them.
Do you handle intensive outpatient programmes?
Yes. They bill per day rather than per session and need their own setup.
Will you challenge parity violations?
Where a plan is applying limits it should not, we appeal it and document the basis.
Have a behavioral health coder read your last ninety days
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.