Billing in behavioral health is different from other medical billing. There are special rules, unique codes, and important requirements that must be followed. If mistakes happen, it can lead to claim denials, delayed payments, or even legal issues.
Knowing what to watch for can help your practice stay organized, get paid faster, and reduce stress. Here are some common billing mistakes and how to avoid them.
1. Using Incorrect or Outdated Codes
Insurance companies need the right codes to process your claims. If the codes are old or not specific enough, your claim may be denied.
How to avoid it:
- Stay updated with current CPT and ICD-10 codes.
- Double-check that each service is coded accurately.
- Use code modifiers when needed to show the full details of the service.
2. Missing or Incomplete Documentation
Claims need proper notes to back up the services provided. If the therapist’s documentation is missing key information, the insurance company may not pay.
How to avoid it:
- Make sure every session has a clear, complete note.
- Include time spent, service type, and clinical details.
- Match documentation with the codes used on the claim.
3. Failing to Verify Insurance Benefits
Assuming a patient’s insurance will cover everything can lead to problems. Coverage for behavioral health can vary widely between plans.
How to avoid it:
- Verify insurance before the first visit.
- Confirm co-pays, deductibles, and coverage limits.
- Check for authorization requirements in advance.
4. Not Tracking Claim Status
Submitting a claim is only the first step. If you don’t follow up, you may not know if it was accepted, denied, or under review.
How to avoid it:
- Set up a system to track claims from start to finish.
- Follow up on unpaid claims regularly.
- Respond quickly to requests for more information.
5. Ignoring Denials or Delays
If a claim is denied, ignoring it doesn’t make it go away. Many claims are denied for fixable reasons.
How to avoid it:
- Review the denial reason code to understand what went wrong.
- Correct and resubmit the claim when possible.
- Appeal denials when necessary with proper documentation.
6. Not Staying Compliant with Changing Rules
Billing rules change often, especially in behavioral and mental health. Failing to keep up can lead to audits or fines.
How to avoid it:
- Stay informed on Medicare, Medicaid, and private insurer updates.
- Train your staff regularly on the latest billing changes.
- Work with a billing company that specializes in behavioral health, like Aspen Ridge Billing.
How Aspen Ridge Billing Can Help
Billing mistakes don’t just cost you money—they cost you time, energy, and focus. We specialize in behavioral health billing, so you don’t have to stress about codes, compliance, or insurance rules. We handle:
- Accurate coding and claim submission
- Documentation reviews
- Denial management and appeals
- Ongoing support for your staff
When you work with us, you can focus on what matters most—caring for your clients.
H2: Clean Up Your Billing Process
Avoiding common billing mistakes starts with the right knowledge and the right support.
Whether you’re a solo therapist or run a group practice, clean billing processes help you get paid faster and stay compliant.
Need help cleaning up your billing process?
Let Aspen Ridge Billing take the guesswork out of your billing, so your practice runs smoothly and efficiently. Get in touch with us today.
