Nexus io offers comprehensive medical billing for mental health to meet the unique needs of behavioral health practices. Reduce billing complexity, minimize administrative workload, and improve revenue accuracy so you can focus on delivering quality patient care. Let us handle the billing while you focus on changing lives.
Your therapy notes must not only contain the required billing codes but also be properly formatted and documented for successful billing. The gap between clinical documentation and billable revenue creates constant friction in mental health practices.
As a specialized mental health billing company, Nexus io provides a connection between the clinical work performed in therapy and the financial result from that clinical work. We create claims for your therapy sessions and ensure they are accurately coded with the correct CPT codes, modifiers, and in the compliant format required by payers. Our expert medical coders know how to submit claims based on the specific time increments for submitting claims to Medicare.
Our psychiatry billing services include aggressive A/R follow-up and appeal management. We identify the patterns in payer rejections and adjust submission protocols before your cash flow starts to fluctuate. Our mental health RCM billing process includes real-time eligibility checks, clean claim submission, and proactive denial management.
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Mental health billing is quite complex. Incorrect modifier applications can confuse even experienced coders. Telehealth codes, such as GT and 95, have varying rules depending on the state and payer. Your therapists lose 10+ hours weekly to billing tasks. This is the time stolen from clinical work.
Insurance companies reimburse behavioral health services at consistently lower rates than general medical care. This creates a gap in the revenue and limits the treatment options you can provide to your patients. On top of that, add frequent authorization denials, changing payer policies, and complex split-billing requirements, and you’re managing a system designed to slow you down.
As a trusted mental health billing company, we master how to resolve the coding complexity, credentialing delays, and denial management of your mental health practice. Maintaining trained billing staff adds another layer of expense.
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Mental health providers continually have to document their sessions, code accurately, and follow the rules set by payers. CPT code selection (the procedure code) and the use of modifiers must be exact. A single error in documentation can delay reimbursement for weeks.
Your medical practice needs qualified mental health billing experts to resolve these issues. We help you navigate the complexity of mental health billing by providing an organized and thorough approach to claim reviews and structured workflows.
All claims are checked for accuracy before submitting. We verify your 90837 claims to reflect 53+ minutes of documented therapy time. We also validate that the documentation accurately reflects the diagnosis codes associated with that service.
Modifier application follows payer guidelines, not guesswork. We proactively track authorization statuses. We flag expiring authorizations before sessions occur, preventing retroactive denials. Claims go out only after eligibility verification, and our follow-up team pursues every claim until payment posts.
We handle your finances from appointment scheduling to final payment deposits. Our mental health RCM billing process quickly detects and resolves any issues that are causing delays in your reimbursements.
We compare agreed rates to actual payer reimbursements. Most practices discover they are being underpaid for certain CPT codes. Accounts receivable aging decreases by an average of 35% during the first quarter. We offer precise financial records that clearly reflect the progress of your payments via our psychiatry billing services.
Mental health billing operates under HIPAA, the Mental Health Parity Act, 42 CFR Part 2 for substance abuse records, state regulations, Medicare and Medicaid rules, and the False Claims Act. We ensure your practice stays compliant with all applicable laws.
Our audits identify issues early so that you have time to correct them before the penalties are issued. We stay updated on changes in telehealth billing and payer policies to ensure compliance with evolving rules and regulations.
Mental health practices don’t follow a 9-to-5 schedule. As a leading mental health billing company, we provide round-the-clock support to handle urgent billing questions, payer inquiries, and documentation issues whenever they arise.
When you outsource psychiatric billing services to Nexus io, you get a partner who understands the urgency of cash flow. Our experienced billing experts help you stay compliant and improve reimbursements without delays.
Mental health practices struggle with constantly shifting Medicare, Medicaid, and commercial plan requirements. Authorization protocols change. Due to the fast pace of changes, in-house billing departments often struggle to keep up with evolving requirements.
As your dedicated mental health billing company, we manage payer-specific guidelines, verify eligibility before appointments, and confirm authorization requirements. Your billing stays compliant without the administrative burden falling on your clinical staff.
Proactive denial management is accomplished by auditing all services billed against the payer-specific guidelines. This process allows us to verify that all services have been accurately coded (as required by the payers), that all documentation was completed and correctly documented, and that there are no missing authorization or diagnosis/service references. By managing these processes for our clients, we are able to prevent denials.
Prior to an appointment, we verify active insurance coverage, the specific benefits offered by the policy, the amount of copay required, and whether or not authorization is necessary from the patient’s insurance carrier. Patients gain clarity on their financial responsibility, and practices avoid surprise denials from insurance companies after service is provided.
Start improving revenue outcomes with a partner experienced in mental health billing and coding, psychiatric credentialing, and aggressive A/R recovery. We help practices navigate complex payer requirements, maintain compliance, and reduce administrative burdens that take your team away from clinical work. Submit a brief inquiry, and one of our mental health billing experts will promptly answer with a tailored assessment of your practice’s revenue potential.
How long does it take to get reimbursed for mental health services?
The average time required for an insurance company to review and pay mental health claims is 30 days from when the claim is filed or submitted to the insurance provider. When submitting a claim electronically, it usually takes 2-3 weeks to be reimbursed. If the claim was denied or had missing information, however, the reimbursement timeframe could increase to 60-90 days.
Why do mental health claims get denied more often?
The denial rate for mental health care claims is 2-3 times higher than the average denial rate for other medical specialties. Problems with time-based code selection, lack of prior medical approval, and deficiencies in the medical necessity documentation are common causes of denial. The denial rates for mental health care claims were reduced from approximately 25-40% to 5-10% after these coding errors were discovered and corrected prior to submission.
What services should the best mental health billing services include?
Psychiatry billing service includes many different components including eligibility verification, accurate CPT and ICD-10 codes, prior authorization tracking, same day claim submission, denial management, A/R follow up, credentialing, and financial reporting. Our psychiatry billing services include all these components plus a dedicated account manager and 24/7 support.
How does outsourcing mental health RCM billing improve cash flow?
Professional mental health medical billing solutions increase clean claim rates to 98%+, submit claims within 24-48 hours, and pursue aggressive A/R follow-up. Most practices see their accounts receivable aging improve by 30-40% during the first quarter after using professional mental health medical billing services. Our solutions also identify underpayment issues and allow practices to recover revenues that they did not know were missing.
What makes psychiatry billing different from general medical billing?
Billing for psychiatry differs from billing for other types of medicine in that it uses time-based CPT codes that carry strict documentation requirements. Payers impose session limits, require specific F-code diagnosis pairings, and have different authorization protocols than other forms of medicine. Each state and each payer will have different telehealth rules.
Mental health practices continue to experience revenue challenges such as claim denials, delays with authorizations, and inconsistent timelines for reimbursement, creating obstacles to cash flow and operational planning.
To optimize revenue in psychiatry, it’s necessary to establish structured workflows, detailed documentation, and clearly defined workflows for each insurance company’s specific requirements. Our mental health insurance billing services provide the structure and experience required to stabilize cash flow and decrease administrative stress.
Connect today, and let’s start improving your cash flows.
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