Medical Billing and Coding f or Mental Health
Addressing the Challenges of Me dical Billing and Coding for Menta l Health Practices
• Accurate medical coding is necessary for claim reimbursement and plays a critical role throughout the whole claim cycle. Inaccurate coding can have a negative impact on the practice in a number of ways, including by causing missing income opportunities, potential overpayments, and charges of abusing reimbursement guidelines. Incorrect coding can also cause personnel issues due to the increased quantity of follow-up required for claim denials. The most difficult task is knowing the various codes from the many code sets that are updated on regular basis.
Top Challenges in medical billing and coding for mental health practices:
• The pain of takebacks
• Incorrect application.
• Operating in a state of denials.
• Revenue integrity can close the gaps.
• Patients with mental health issues receive invoices from insurers for services like counselling, psychological evaluations, and medical management. The largest problem with mental health billing is that it frequently happens that a patient’s requirements are greater than what the insurer would pay for in terms of services.
Financial & Clerical Challenges:
• Many organizations that outsource medical billing encounter administrative and financial difficulties. Several regulatory initiatives address the current need for cost reduction and quicker medical billing services.
They are:
• Data Collection: Patient registration & Claim preparation.
• Claims Transmission: Coding edits & Diagnosis Entry.
• Claims Management: ERA Download & Payment posting (electronic/paper)
• A/R Follow-up: Secondary Claims, denial management & appeals.
Documentation Challenge:
• Describe the need for treatment and provide a clinical justification.
• Incomplete, non-concise, inaccurate data, including the face-to-face consultation.
• Missing legible, dated and signed document.
• Improper maintained and unavailable data for review.
• Inappropriate medical coding for billing purpose.
