info@mentalhealthbillingservice.com
Standard medical billing rules fail in behavioral health. We secure revenue for therapy groups, psychiatrists, and substance use facilities by verifying payer-specific routing before the claim drops. Our coders match your documented clinical time to the right CPT codes, apply exact telehealth modifiers, and chase unpaid balances until the claim clears.
Mental health billing involves constant follow-ups, insurance checks, and claim corrections. We take care of those daily tasks so your team can stay focused on patients
Our team checks specific payer rules to verify active coverage and current deductible status. Behavioral health gaps never go unnoticed. We keep collections clear for your staff and routing clear for the claim.
One missing session detail can collapse the whole claim. Our certified coders review the note and CPT code together. We code around the actual telehealth rule set tied to your state and payer.
We process and submit your documented clinical sessions within one business day. Then the team scrubs every single claim for missing data and correct Place of Service (POS) codes.
Simple fixes are resubmitted within 24 hours, while appeal-worthy denials are sent with the right notes, codes, modifiers, authorization proof, or medical necessity documentation attached.
Standard billing software can clear routine procedure claims, but behavioral health billing needs a closer read. Payers constantly update their time-based coding thresholds and prior authorization limits. A single missing modifier will freeze your payments for weeks. We built Mental Health Billing Services (MHBS) to fix these exact technical failures. Our billers audit your session notes against the latest payer rules before we submit the claim.
Revenue Cycle Management & Billing Solutions
Insurance Contract Negotiations Support
Compliance and Regulatory Support Services
Provider Credentialing Services Management
Patient Insurance Verification Assistance
Electronic Claims Submission Process
Account Receivable Management Solutions
A patient hands you a primary commercial ID card, but their mental health benefits are managed by a third-party company like Carelon, Optum, or Magellan. Submitting the claim to the medical payer listed on the card triggers immediate rejection.
Our billing team checks all of it before the visit: benefits, behavioral health payer, panel status, and payer ID. That way, the claim does not bounce between payers.
Standard medical billing pays for a completed procedure. Therapy billing pays for the exact time spent with the patient. If a clinician documents a 45-minute session but bills a 90837 CPT code, the claim fails the payer's time threshold and risks an audit.
Our certified coders audit your clinical notes against CPT minute rules before submission. We match your documented start and stop times to the correct code,
Commercial and Medicaid payers have strict rules for virtual care that vary by state. Using the wrong Place of Service (POS) code or missing an audio-only modifier causes claims to fail the clearinghouse instantly.
We track telehealth parity laws and payer-specific modifier rules across all 50 states. We apply the exact POS 02 or POS 10 codes and attach the required 95, GT, or FQ modifiers so your virtual sessions clear without delay.
Many commercial plans and Medicaid MCOs only approve a specific number of therapy sessions at a time. Once a patient hits that limit, any future claims bounce back unpaid until a new authorization goes through.
Our Solution: We actively track session counts and authorization limits directly inside your EHR. We alert your clinical team before a patient exhausts their approved visits and help secure the required extensions.
We align our financial success directly with yours. Our business model eliminates the risk of outsourcing your revenue cycle. Percentage-Based Fees: We only make money when your practice gets paid. We charge a flat percentage of your collected revenue. There are no hidden software fees or setup costs.
No Long-Term Contracts: We do not lock our clients into multi-year agreements. We earn your business every month, and you have the flexibility to cancel at any time.
Dedicated Account Managers: You never have to explain your practice history to a random call center agent. You communicate directly with a single billing expert who knows your payer mix and local state rules.
Generic billing companies treat behavioral health claims like standard medical procedures. This fundamental mistake causes constant rejections. Here is exactly how we do it differently.
Payer Routing
Time-Based Coding
Denial Appeals
Telehealth Rules
Prior Authorizations
MHBS does not run therapy, psychiatry, ABA, substance abuse, and family therapy through the same billing lane. We build separate checks around the details that decide payment for each service line. As a result, more completed care, more collections instead of follow-up work.
Medication management requires precise Evaluation and Management (E&M) coding. We verify your specific E&M codes and apply the correct psychotherapy add-on codes so you get paid for your full clinical time.
Addiction treatment centers rely on strict level-of-care authorizations. We manage your specific revenue codes for inpatient, PHP, and IOP programs while maintaining compliance with federal privacy laws like 42 CFR Part 2.
We clear the technical hurdles of standard therapy billing. Our team verifies hidden third-party payer carve-outs, checks exact telehealth modifiers, and tracks your patient session limits before the appointment happens.
Physical therapy billing relies strictly on the 8-minute rule. We calculate your exact timed units, apply required KX modifiers, and track your therapy caps to prevent immediate Medicare and commercial rejections.
Psychological and neuropsychological testing claims get rejected if the base codes and add-on codes do not match the prior authorization. We verify your approved testing hours and bill your exact units to secure your payments.
Couples and family therapy often trigger medical necessity audits. We verify exactly how your local payers require you to bill conjoint therapy codes, like 90846 and 90847. Nothing like vague counseling the payer can push back on.
We work directly inside your existing platform using secure API connections and compliant remote access. You retain full control of your clinical notes and patient records while our team manages the entire revenue cycle in the background.
Local payer rules dictate how your claims get paid. A claim format that clears a clearinghouse in Texas will often trigger an automatic denial in New York. We actively track local Medicaid MCOs, regional commercial policies, and specific telehealth parity laws to ensure your claims pass local compliance checks.
We clear Texas STAR Medicaid requirements and manage strict prior authorizations for regional MCOs like Superior HealthPlan and Amerigroup.
We enforce NYS OMH compliance rules and route claims accurately through complex Empire BCBS behavioral health carve-outs.
We process mandatory Medi-Cal Treatment Authorization Requests (TARs) and route claims correctly through local Kaiser networks.
We match Florida AHCA fee schedules and secure active authorizations through managed care plans like Sunshine Health and Simply Healthcare.
We bill directly to HUSKY Health Medicaid and manage strict behavioral health session limits for ConnectiCare and Anthem BCBS.
We route claims accurately through NJ FamilyCare and track the strict therapy session limits for Horizon BCBS plans.
We ensure exact compliance with the state behavioral health manual and bill directly to Next Generation MCOs like CareSource and Buckeye Health.
We clear claims through Healthy Connections Medicaid and track precise panel requirements for BlueChoice HealthPlan and Absolute Total Care.
Transitioning to a new billing company often disrupts cash flow. We follow a strict 30-day onboarding schedule to prevent payment gaps.
DAY 1
We review your current billing setup, check your payer contracts, and spot immediate revenue leaks.
DAYS 2–3
We connect directly to your existing behavioral health software and verify your active provider NPIs.
DAYS 4–5
We pull your aging A/R to identify high-value unpaid claims before they hit the timely filing deadline.
DAYS 6–10
Our team starts scrubbing your daily clinical notes, submitting clean claims, and posting ERA payments.
Day 30
We deliver a precise financial breakdown showing your total monthly collections, denial overturn rates, and exactly what we recovered from your old A/R.
We protect patient health information at every stage of the billing cycle. Substance use treatment centers face strict federal privacy controls. We maintain full 42 CFR Part 2 compliance to secure sensitive addiction and recovery records.
Our team transmits all electronic claims through encrypted clearinghouse connections directly to the insurance payers. We also process patient deductibles and copays through secure payment gateways to keep your practice financially compliant and your patient data locked down.
Our billing team learns your specialty from the inside out. We apply the right codes, follow your payers’ specific rules, and stay on top of the reimbursement timelines that matter to your bottom line. The result? Claims that go out clean, get paid faster, and come back with far fewer denials.
Running a private practice means your time is strictly limited. We track your payer authorizations, manage your credentialing updates, and audit your 90834 and 90837 claims so you can focus entirely on your clients instead of your paperwork.
Adding new clinicians usually creates billing bottlenecks. We manage the network credentialing for your new hires, track individual provider productivity, and submit claims under the correct group NPI so your cash flow scales smoothly as your team grows.
Medication management visits require precise Evaluation and Management (E&M) coding. Our coders accurately bill your 99213 or 99214 codes and apply the correct psychotherapy add-on codes to capture the full financial value of your clinical time.
Psychological and neuropsychological testing codes confuse standard medical billers. We verify your prior authorizations for testing hours and bill your base and add-on unit codes correctly to prevent immediate clearinghouse rejections.
Facility billing requires an entirely different set of rules. We manage your specific revenue codes, track your daily or hourly attendance requirements, and verify your level-of-care authorizations to keep your facility funded.
“Working with this billing team has completely changed the way we manage our practice revenue. Their attention to detail, fast claim submissions, and follow-up on denied claims helped us improve reimbursements within the first few months. I finally have peace of mind knowing our billing is handled professionally.”
No. We work directly inside your current system. Our team actively processes claims and posts payments inside TherapyNotes, SimplePractice, athenahealth, DrChrono, and other major behavioral health platforms. You keep full control of your clinical records.
We do not just submit new claims. During onboarding, we pull your aging A/R reports to identify unpaid claims that are approaching the insurance timely filing limits. We correct the missing modifiers or coding errors and submit formal appeals to recover your old revenue before it expires.
We charge a flat percentage of your collected revenue. If you do not get paid, we do not get paid. We never charge hidden software fees, setup fees, or monthly minimums, and we never lock you into a long-term contract.
Standard medical billing relies on procedure codes. Mental health billing relies on strict, time-based codes. If a clinician bills a 90837 without documenting a minimum of 53 clinical minutes, the claim fails. Behavioral health also deals with complex third-party payer carve-outs, specific audio-only telehealth modifiers, and strict session limits that generic medical billers frequently miss.
Within the first 30 days, collections usually start to look less scattered and more predictable. We submit your clean claims within 24 hours of receiving your clinical notes. Because we verify payer routing and apply correct CPT rules before submission, your claims pass clearinghouse checks faster and pay out on the first cycle.
It is incredibly frustrating to provide great clinical care and then fight for months just to get paid for it. If your practice is dealing with mounting denials or aging A/R, we can help you find out why. We offer a free 90-day revenue audit where our team looks at your recent claim history, identifies missing payments, and finds the root cause of your rejections.
Simplifying mental health billing with accurate claims, faster reimbursements, and seamless revenue cycle management.
info@mentalhealthbillingservice.com
(860) 500-1471
403, Port Washington Road
