In this guide by TheraThink, you'll learn the five mental health insurance billing best practices that will help you prevent denials, stay organized, and maximize your reimbursements.
Insurance billing is dreadful, let’s be honest. With many colleagues dropping out of taking insurance from patients, and the reimbursement rates often saying static, there is growing pressure for all therapists to quit taking insurance and focus on just private pay.
Just as unfortunately, doing so is far easier said than done.
Hopefully this guide will lighten the burden on you folks who do continue to work with insurance panels. (And if you do, perhaps you should try to negotiate a raise!)
Follow these five rules for billing and watch all the headache melt away! Or at least a fair amount of it!!
Rule #1: Always Pre Verify
Pre-verifying the eligibility of benefits for your new patients using mental health insurance is absolutely critical. You’ll learn if you’re in network, where to send claims, if you need to request an authorization, how much to ask for their copayment, and if they have an outstanding deductible.
Always! Yes, always call to check eligibility and benefits for your new clients. This 15 minute call will save you hours of pain in the long run! Do it!
No really, this is HUGE! Always.
Rule #2: Always PhotoCopy All Information
Having a backup is important for HIPAA and it’s important for your own records. Never trust a form filed out by a human being, always trust the photocopy of an insurance card!! We are all prone to errors so make sure snap or scan a copy of all their information when you first see a new patient — take out your smart phone and get a-photoing!
You will also reference the back of the insurance card and use that number and that number only to call to verify eligibility and benefits for that new patient. That phone number will always get you to the right office, even if the patient’s mental health coverage is subcontracted and wildly confusing. This will save you time and energy so always use the phone number for providers on the back of their card!
Rule #3: Always Collect Maximal Information
Make sure to write down their favorite color, while you’re at it. But really, always get far more information than you need to file claims. Include the address and date of birth of the “Insured Party” (e.g. a spouse or parent) and their social security number. Make sure to get a work phone number and any address that the person has had within the last two years (often times their insurance policy is registered under an old address that you will need to bill to).
Make sure that your medical intake and insurance documents for new patients are exhaustive. Really go above and beyond in asking for their information. This saves you valuable time when on the phone with an insurance company, instead of waiting for 15 minutes only to realize you don’t have the right address!
Rule #4: Always Record Insurance Phone Calls
Not with an extra microphone but by asking for a reference ID for every call you make. At the end of each call simply ask for the operators name and a “reference ID” for the call. We also suggest you jot down some short notes about the call.
Record the date, the insurance company, the number you called, the operators name, and the reference ID in a spreadsheet for your records. IF there is any mistake, again human error happens to any humans including those working at insurance companies, you can reference your call and reference ID to make sure the issue is resolved correctly.
Take the time do to this as it can save you hundreds of dollars per year.
Rule #5: Always Bill Clients and Insurance Co’s ASAP
Don’t wait around to file your claims! We strongly recommend filing at least once every two weeks at bare minimum.
Make sure you confirm that claims for new patients are being filed correctly after waiting three weeks post-filing (for electronic claims) or four weeks (for paper claims). If they aren’t being filed correctly, ask how to resolve the issue and get them in the mail!
Don’t be lazy about billing insurance companies! Make sure to file right away for timely payment and to prevent any issues down the road. Most insurance companies will cut off claims after 90 days for breaching their “timely filing” agreements. Don’t lose your money over something so simple as submitting your claims!
If you need help, TheraThink runs a billing service that takes care of all of this and far more.
Hopefully, though, we’ve given you enough insight and know-how to tackle the basics of mental health insurance on your own!