3 Ways Psychiatrists Can Improve Their Medical Billing

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Medical billing in the mental health space is often an exceedingly complicated process, as insurance coverage for these services have historically lagged behind treatments for physical ailments. With the spike in telehealth and therapy during the pandemic, rapid changes in psychiatric billing and coding standards are often difficult, if not impossible, to keep up with.

Beyond maintaining knowledge of billing procedures, there also lies the issue of executing those tasks within your medical billing software. Battling a clunky user interface and the human error that comes with repetitive data entry can cause your revenue to suffer.

Additionally, many psychiatry practices are small operations, and managing every aspect of your practice on top of providing high quality care to patients is a lot for any practitioner to handle. Here are some current psychiatric billing standards as well as what to look for in a billing software or RCM service.

The Unique Nature of Psychiatric Medical Billing

Standard medical billing can seem rather straightforward compared to psychiatric billing, because treatment for the latter is less cut and dry than, for example, a single surgical procedure at an orthopedic practice.

Psychiatrists are primarily billing for therapy, psychological testing, medications and other such interventions, and often do so based on hours of service provided compared to a single service. The way these hours are billed has also changed this last year to cover the total time of an interaction as opposed to just face-to-face time.

Partnering with insurance companies can also prove difficult. Though initial sessions usually do not require a prior authorization, many insurance providers will require them after a certain point for subsequent sessions, and they may also be required for various psychological tests or medications.

While these types of approvals exist for non-mental health treatment as well, parity laws - which require that insurance companies do not offer more restrictive coverage for mental health disorders than they do for other medical conditions - are still not fully enforced across the country and oftentimes contain loopholes. This means that mental health coverage often contains more obstacles.

Prior authorizations are a significant hurdle for nearly all specialties as 86% of physicians consider the administrative burden to be high or extremely high. However, psychiatrists face additional issues due to their frequently smaller or non-existent support staff.

Prior authorizations are also linked to negative health outcomes such as medication discontinuation by people with mental illness. Moreover, two-thirds of psychiatrists reported avoiding prescribing certain medications that would require prior authorizations.

Finally, if your practice has been conducting telepsychiatry appointments, you have likely experienced some rapid changes during COVID-19 to billing capabilities. While many providers have been able to take advantage of expanded Medicare and Medicaid coverage for telehealth during the national health emergency, these changes are not yet permanent - though the CMS has taken steps to expand telehealth coverage in the 2022 Physician Fee Schedule.

With all of these nuances to consider, it is no wonder that psychiatrists may struggle with their billing workload. However, the key is to identify critical features and solutions to automate the burden as much as possible.

How to Improve Your Psychiatric Practice’s Medical Billing Workflow

Utilize Billing Profiles & Optimize Reporting Dashboards

To make medical billing easier for your psychiatry practice, look for an intuitive, fully integrated software that works seamlessly with your EHR. This will greatly simplify your clinical workflows and likely reduce the overall amount of time spent on data entry and billing tasks.

One particularly helpful feature in a medical billing software for psychiatrists is billing profiles. These allow you to bundle codes for common diagnoses such as ADHD, anxiety, bipolar disorder or depression and have them appear in the relevant patient charts. Make sure your electronic health record and medical billing software is fully compatible with DSM-5 coding to maximize your payments.

Practitioners should also look for software vendors with bulk claims, live claims feeds and a reporting dashboard to track areas of interest for their billing. Those dashboards will allow you to make adjustments as needed to avoid recurring errors.

Hire Expert Billers & Coders

Perhaps your practice would prefer to outsource billing entirely. When faced with the complex, constantly changing landscape of medical billing for psychiatry, it is perfectly reasonable to want to hand over that work to a team of expert medical billers.

Additionally, you want to know that they can improve upon the billing process and improve your ROI. Look for companies with a proven history of boosting clean claims rates (they should have a rate of at least 96% for all claims) quickly resolving denials, and optimizing payments for practices.

Ideally, this service could also adjust medical codes in your notes if there are errors. Make sure their team has the proper CPC credentialing to handle your coding workload. Proper coding from credentialed medical coders can have a dramatic impact on your revenue. Due to the unique nature of psychiatry billing, your team’s billers and coders should have specific expertise in this specialty.

Work with an Experienced Account Manager

Proficient billers and coders are important, but you still need someone to analyze the big picture. Is your cash flow improving? How can you pivot to grow your practice? These are questions that a dedicated account manager can help with and point out areas for optimization. These regular reports and check-ins will ensure you’re on the right track.

Though medical billing for psychiatrists is complicated, there are options to simplify the process. Utilizing the best medical billing software or revenue cycle management service can help conquer the quirks of psychiatric billing.