reimbursement

Retroactive Reimbursement Requirements For Credentialing

In many states, the law requires carriers to pay for covered services provided to the member during the credentialing process at the in-network benefit level and under the terms of the contract. To apply, the credentialing application must ultimately be approved by the carrier. Credentialing Requirements All health plans are legally required to use a database that is created and maintained by OneHealthPort/Provider Source for credentialing purposes. This includes non-delegated credentialing, where the medical staff services department of a [...]

By |March 6th, 2022|Categories: Tips|Tags: , |0 Comments

How To Use Medical Billing CPT Modifiers Correctly

Medical billing professionals often have to use modifiers to affect the description of a diagnostic process, treatment plan, or other service performed for a client. This also includes things like prescriptions or other medical supplies that may have been provided to a patient as part of an effective treatment plan. What Are CPT Code Modifiers? A CPT code modifier is a two-digit code that is specifically linked to a CPT code that needs a further description of the [...]

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 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 [...]

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