Medcare MSO’s Substance Abuse and Rehabilitation Billing Services

Substance abuse billing, like that for any field of medicine is complicated and time consuming, but it is vital to the success of any rehab or treatment facility. With insurers and government payers cutting down on their payments wherever they can and expenses rising, it is more important than ever to have efficient medical billing for rehab. Outsourcing billing and claims management to substance abuse billing professionals has proven to be the best solution for many treatment and rehab centers.

The Affordable Care Act’s requirement for health insurance to cover mental health and substance abuse treatment (and not exclude pre-existing conditions) has given coverage to many people who need help, but it has also resulted in high deductibles, which are often a problem for addiction treatment center billing since most patients requiring treatment or rehab have lost their incomes.

Top Reasons to Outsource to a Substance Abuse Billing Company

It is difficult for medical staff to remain focused on patient care when medical billing issues are constantly demanding attention. Rehab billing specialists are available at Medcare MSO who have the experience necessary to deal with the complex codes and difficult payers that are frequently encountered. Behavioral health billing routinely encounters several challenges that are especially common in this field. These are a few of them:

  • High ticket losses—Substance abuse treatment takes a significant amount of time, which makes it costly. Since charges are generally bundled into codes that cover the entire program, or most of it, one unpaid claim can result in a loss of up to $30,000. This makes it imperative that rehab medical billing services be handled by professionals who have a system in place to ensure that no claims fall through the cracks.
  • Payments sent to patients—In many cases, when the rehab or treatment center is out of network for the payer, the payment ends up being sent to the patient instead of the service provider. The patient is, of course, responsible for paying the center’s bill, but this often doesn’t happen. This may even be used as leverage to get providers to join payers’ networks (and accept whatever fee they offer). The substance abuse billing system must ensure that an assignment of benefits is executed and attested to prior to accepting the patient.
  • Denial of medical necessity—Insurers have to cover treatment if it is medically necessary, but may deny claims on the basis that medical necessity was not demonstrated if any of the necessary coding is not correctly included in the claim. This is another reason it is best to outsource drug rehab insurance billing to a company that is dedicated only to medical revenue cycle management (RCM).

Maximize Your Revenue with Medcare MSO’s Addiction Treatment Center Billing Services

If you want your treatment or rehab center to be sustainable, you can’t afford to leave money on the table. Medcare MSO has a large staff of certified medical coders and billers who are experienced with drug rehab insurance billing and know how to ensure that clean claims are filed, so claim rejections and denials are greatly reduced. When they do occur, our system is designed to keep track of each one and we ensure that they are swiftly addressed and resubmitted with the necessary modifications.

In addition to claims handling, we take care of all aspects of RCM, with customizable services so that you get exactly what you need and aren’t obligated to any additional services. We provide payer credentialing management, compliance reviews, annual payer adjustments and pay back, bill collection and much more.