Mental Health CPT Codes: The Definitive Guide 2024

mental health billing for dummies

You use this tool every day, so why not make it a habit to check the “claim status” section that’s included with and provided by your clearinghouse? It’s already integrated with practically every payer that exists in the mental health billing world…so it can pull up the claim status for everything you’ve submitted through it. Learn how to offload your mental health insurance billing to professionals, so you can do what you do best.

Every mental health insurance claim will require a large amount of information, but that information needn’t be overly complicated. Since a clearinghouse acts as a middleman between you and insurance organizations, they’re an essential piece of the mental health billing puzzle. Before you “officially” send your claims to your client’s payers your clearinghouse should help you out via scrubbing and rejections.

Understand CPT Codes

Traverse the dynamic interplay between insurance coverage and mental health billing on this pathway. For example, you can choose a billing software that allows you to use your current billing system or perform an integration as needed to suit the needs of your practice. Alternatively, you can customize your billing process by outsourcing to a third-party partner to optimize your workflow and enhance your revenue cycle management (RCM) processes. If your practice has an online providers portal, you can also check there to discover and verify a patient’s benefits and eligibility for your services.

mental health billing for dummies

Some providers will even try to do the billing themselves but eventually this will become overwhelming and create time management problems, not to mention lost income. Common Procedural Technology (CPT) codes are also necessary for billing for psychiatrists and other mental health providers who can prescribe medications and provide diagnoses. Now that you know how ICD codes are relevant to insurance billing, CPT codes have a similar role.

Urgent Care Billing Mistakes and How to Avoid Them

Call up the phone number on the back of their insurance card and begin the process of verifying eligibility and benefits. Now it’s time to verify their insurance coverage and your network status in their plan, then their benefits based on all of that, via a phone call. The past and present status of that client’s insurance policy through a particular insurance company’s coverage. mental health billing for dummies In the new codes, greater distinctions are made between whether the assessment is being given by a mental health professional, such as a psychologist or neurologist, or a technician. In general, you’re responsible for using the most accurate and appropriate CPT billing code when billing for services that you provide, regardless of who does the actual billing on your behalf.

However, if you think that the claim is correct as it is, you can write a letter or fill out a specific payer form. Whether you send this to the payer by mail or upload it to their portal, this process of disputing a denial is called an appeal. Although troubling, receiving a denial from a payer for a claim you submitted isn’t the end of the world. Anyway, this section lists the industry terms used within mental health billing.