Medcare MSO’s Psychiatric Billing Services

Our innovative approach to revenue cycle management covers everything from credentialing to daily claims management to annual reviews, protecting your income while you focus on patient care.

Because it is a very specialized field of medical care, psychiatric billing services must be extremely attentive to detail. Medcare MSO offers full revenue cycle management (RCM), including processing claims and handling rejections and denials, which greatly reduces administrative responsibilities and allows psychiatrists and medical staff to focus on patient care.

Outsourcing RCM and related administrative tasks, such as payer credentialing and compliance reviews has proven to be a winning solution for practitioners and medical institutions across the country.

Billing Medical Issues Encountered in Psychiatry

Medical billing and coding are complicated to start with, and codes change every year in addition to payers changing policies. It’s more than a busy practice can stay on top of while delivering excellent service to patients. While not unique to psychiatry, these are some of the aspects of medical billing that are especially challenging for the specialty.

  • Complex coding: Within the codes for psychiatry, there are many different codes for similar services. For example, you are required to enter different codes to indicate whether an evaluation was done by a medical or non-medical provider. This makes it difficult for inexperienced coders to properly fill out claim forms.

Add-on codes are also common, and are required, but can only be used with a primary code. Billers must know what these codes are, so they can be sure that both are present or the claim will be denied.

  • Referrals are usually required: Patients will usually have to see a general practitioner to get a referral to see a psychiatrist, so it is important to make sure the referral has been filed with the payer prior to seeing the patient. Doctors’ offices often try to keep things simple for patients by referring to specialists in the same insurer’s network so treatment will be covered, which means that psychiatrists need to be credentialed with as many insurers as possible in addition to the government payers.
  • Complicated rules for coverage: All plans offered in the Health Insurance  Marketplace are required to include mental health and substance use disorder services by the Affordable Care Act (ACA), but it does not detail what must be covered, so coverages vary greatly between plans and the same carrier may have different policies from state to state.

Medicare covers mental health care under separate parts: Part A for hospital insurance, Part B for Medical insurance and Part D for prescription drug coverage. Since patients may be enrolled in different options for each—and have supplemental insurance—billing is very complicated and requires specialized training and experience.

Medcare MSO Manages Your Revenue and Keeps Patients at the Center of Your Practice

Psychiatry serves a high-need population and can be taxing for medical staff as well as doctors. Administrative stress on top of that just doesn’t make sense when it can be avoided, and outsourcing revenue cycle management to Medcare MSO provides that relief.

Our coders and billers are certified and experienced in providing psychiatric billing services, so they know what to look for and how to handle claims issues promptly. The money we save you by eliminating lost staff time spent appealing claims, and successfully getting payment on denied and rejected claims more than covers the small percentage of collections that make up our fee.

You can outsource all or part of your RCM to Medcare MSO—our services are customized to meet your needs. We are dedicated to billing and coding so are able to keep up with the latest changes and incorporate new coding into our proprietary software to keep your billing up to date and free up your time so you can focus on taking care of patients. Get a free demo today and see how optimize your revenue management.