Tips

What Is Medical Billing Prior Authorization & When Do You Need It?

Prior authorization plays a critical role in the process of diagnosing, treating, and accurately billing claims that meet a patient’s important medical needs. Medical insurance providers often require it for specific services and specialty treatments. With prior authorization, the patient, and the physician administering treatment are more likely to see a fast, and efficient payment of a claim. With little to no headaches. Without prior authorization, a claim for specialty diagnostics or treatment is more likely to be delayed [...]

By |February 9th, 2021|Categories: Tips|Tags: , |0 Comments

How To Maximize Mental Health Insurance Reimbursement Rates?

Most small sustainable mental health practices require the therapist to wear many hats. Often all at the same time. This includes things like being your own administrative assistant, a medical billing specialist, marketing maven, and perhaps even the office janitor. This can be a real challenge, as these other tasks can end up taking your focus off your chosen specialty which is providing your patients with the highest levels of care. Ultimately, the better you understand the business aspect [...]

By |January 1st, 2021|Categories: Tips|Tags: , , |0 Comments

What is Prompt Hierarchy In ABA Therapy?

Applied Behavior Analysis therapy offers a wide range of techniques to help teach children with autism. Prompt hierarchy may especially helpful for teaching autistic children a new task. This represents an important step in helping a child develop a greater quality of life as an adult. With this ABA treatment strategy “Prompting” refers to the level of instruction a child is given when you ask them to complete a task. It can be a physical, visual, or verbal cue [...]

By |January 1st, 2021|Categories: Tips|Tags: , |0 Comments

What is CPT Code 90791; When & How To Use It

CPT Code 90791 is one of the CPT codes most commonly used by licensed behavioral health providers. It is used as part of an integrated biopsychosocial assessment, this includes key details like the patient’s mental state, their history, and recommendations. CPT Code 90791 is typically used for diagnostic evaluations that are related to new behavioral health concerns or illnesses. It’s usually billed for the initial intake appointment and evaluation that each new patient needs to go through at the [...]

How To Maximize Initial Assessment Authorization For The Most Billable Hours

There are a lot of dynamic aspects to the initial assessment and prior authorization process that can impact both providers, and payers, as well as patients. Prior authorization is essentially a type of management practice used by health insurance providers. It requires specific tests procedures, and medication prescriptions to be first evaluated as they related to the cost of care. This important process is designed to find the least expensive, effective treatment option to keep the cost of care [...]

By |January 1st, 2021|Categories: Tips|Tags: , |0 Comments

Common ABA Therapy Billing Mistakes & Tips To Prevent Errors

Billing code errors can cause a major interruption in your practice’s revenue stream, leading to delays and potential claim denials. Making yourself aware of the common causes of billing errors will go a long way toward implementing protocols and procedures to prevent them from happening in the future. Procedural Issues That Can Cause Billing Errors The following are common procedural issues that can occur in-house, which increase your risk of experiencing claim denials and delays in your practice’s revenue [...]

By |January 1st, 2021|Categories: Tips|Tags: , , , |0 Comments

What Is A Charge Entry & Auditing For Medical Billing?

Several serious factors can interrupt the revenue stream of any practices. This includes things like persistent claim denials, a patient contesting charges, improper security protocols for HIPPA compliance, and medical coding errors. While some of these might be honest mistakes, they are often the result of an overtaxed or undertrained administrative task. The truth is most medical administrative support staff are better off handling other tasks within the practice rather than losing precious man-hours to medical coding and chasing [...]

By |December 7th, 2020|Categories: Tips|Tags: , , |0 Comments

How To Verify A Patient’s Insurance Coverage Quickly?

The cost of quality healthcare and health insurance continues to increase in the United States. This prompts some individuals to choose health insurance programs that might not necessarily meet all their needs. Worse still, they might not be aware of certain coverage gaps when they seek out necessary services from practitioners like you. This simple pattern alone can increase your chances of experiencing a denied claim or other complications that can interrupt your once consistent revenue stream. One way [...]

By |December 7th, 2020|Categories: Tips|Tags: , , |0 Comments

What Is Payment Posting In RCM For Medical Billing?

Patient responsibility costs and other out of pocket costs continue to rise throughout the United States. This can sometimes lead to delays in payment or failure to pay for services rendered. A patient who pays their co-pay, co-insurance costs, prescriptions, and other out of pocket costs in a timely manner, make it easier to close a claim cycle at payment posting. Also known as “Cash Posting” Payment posting is typically done in one of two ways. The one that [...]

By |December 7th, 2020|Categories: Tips|Tags: , , |0 Comments

How To Bill For Telemedicine & Get Reimbursed

Telemedicine seems to be part of the “New Normal” and seems like it’ll stay that way. This is thanks to an impressive success rate for helping to provide a wide range of patients with basic care and information without having to come into the clinic. Though getting reimbursed for telemedicine or telehealth visits presents a little bit more of a challenge for practitioners. Especially solo or small practices that might not have a large administrative staff to rely [...]

By |November 10th, 2020|Categories: Tips|Tags: , |0 Comments