The medical coding and Mental health billing are regarded as the complicated process. There are countless complications, included in the medical coding system. Hence, there are risks that mistakes can be created. Minute errors in mental health might result in claiming denials, which will lead to delay in the payments. At times, experienced and trained mental health teams might end up in making payment loss, extreme claim denials, and federal penalties. In addition, frequent coding errors in mental health might impact the relation with the patients, which can result in creating a negative effect.
As the insurance companies avoid claims with the specific coding errors, there are risks that you are going to lose the repayment revenue, till you will resubmit the claim. It is the right time that you should start the elimination of the coding errors, reject claims, lower the details, and boost the reimbursements. In this article, we will speak about the 5 common errors, with the mental health billing:
Wrong use of CPT code
You are going to reap a lot of benefits, if you have detailed information about the specific procedure codes, included in the mental health billing. If you make use of the autopilot code, it is recommended to opt for the similar code for different session. Hence, there are risks of under billing, or over billing, thereby leading to mental health billing errors.
Besides this, as you try to provide a new service, you should dig dipper into the service’s code descriptions, which might consume an ample amount of time. You can fix it easily by seeking information about CPT coding, and gaining its understanding, according to the processes.
Unbundling in coding
If you make use of multiple codes to increase the payment in mental health billing, it is referred to as the unbundling codes. Here, the practitioner makes the right use of different codes, as a single code is available for the specific service.
You can use it for the reflection of the process accurately. It is advisable for the mental health practitioner to avoid the unbundling codes as it will prove to be a red flag for the medical audit team. The unbundling process is interlinked with abuse and fraud. Hence, it is essential to understand what should be included within the code description during mental health billing Services. If you find that a singular code is present, it is recommended to use it.
Use of up-coding
The even up-coding helps to procure higher claims. Also, it is referred to as the red flag. You can make use of multiple codes in place of the single code to enhance the payment. Up-coding makes the right use of the singular code, which provides higher payment, for the specific service.
Up-coding triggers the investigation for the fraud. Hence, it is essential to seek information about the correct codes and monitor the therapy session accurately. Besides this, you should make sure to seek more information about the aspects, which should be included within the codes.
Up-coding happens to be a common practice, associated with healthcare billing. Mental health professionals view it with suspicion at times. Many people think that it is an attempt to take more money from the insurance company.
A perfect instance is the time which is spent with the psychotherapist. At times, the 30-minutes psychotherapy session will be passed off as the 60-minute session through the 90837 code use. There are risks to up code, likewise. You will understand the affliction’s nature, when there is prerequisite need for 60-minute session. However, it proves to be contrary, the practice will be penalized.
With proper documentation, you can make the payer understand that services are really helpful. Hence, it is essential to take the prerequisite care during documentation. Few of the crucial aspects of the documentation include the session date, session’s reason, applicable test results’ description, related history, assessment description, diagnosis and clinical impression.
Therefore, it is necessary to accompany them with the progress notes that speak detailed information about the response of the client to the treatment, and other changes in the diagnosis. The robust documentation is essential in this aspect, as it makes it faster and easier to make payments.
It is possible to remove such errors with the adoption of the definite process to billing and coding. In the beginning, it is necessary to look for the highest accuracy. The best option to eliminate the errors is the creation of the top-class quality control process. It helps reduce the complicated coding errors. It would be best to give prerequisite information to the team regarding the latest CPT changes. The best option to do so is having the dedicated team of mental health practitioner so that they can scan through different notes easily.
Through modifiers, you can offer more details to the payer. The 2-digit codes are added at the end part of CPT code. It is not possible for the practitioner to opt for the modifiers randomly. There are certain rules; you need to follow for that. If you do not follow the rules and opt for the right modifier, you can find claim rejection and denial. Owing to the modifiers misuse, the mental health billing and coding might come under scrutiny, owing to abuse and frauds. If you are not sure about the modifiers along with the rules, it is recommended to avoid them.
ERM software is regarded as the proper choice to avoid the common medical billing errors. It plays an indispensable role in decreasing the errors. If you go paperless, and digitize the process, it is recommended to be organized with the attachment of the insurance cards and the intake forms to the files of the clients. Hence, it becomes easy to add comments and session notes, claims rejections, and collect them easily for the billing process.
The ERM software offers comprehensive reports, which help track the practice health regularly. The latest software, included in the outsource mental health billing service assures the profitable and scalable practice, which help decrease the coding and billing errors. Hence, it is advisable to opt for the behavioral and mental health billing Service so that you can progress without committing the billing mistakes, and this is where a reliable company like Synergy HCLS can prove to be advantageous.