Mental health billing with the authorization and documentation detail in view.

Eligibility and benefits come first

Confirm coverage, member identifiers, behavioral-health benefits, deductibles and visit or authorization requirements before the service. Where a plan requires a referral or prior authorization, the requirement is tracked to the scheduled visit.

• Confirm plan and behavioral-health benefit coverage
• Capture referral and authorization requirements
• Document the information used at scheduling

Authorization and visit limits

Authorization units, visit limits and effective dates vary by payer and plan. We track what was approved, what was used and what remains, and flag mismatches before the claim is submitted.

Time-based and service documentation

For services that depend on time or a specific documentation standard, the claim must match the record. We review the encounter documentation available to billing and coordinate with the practice when a detail is unclear.

• Match service and time documentation to the code billed
• Use the payer's current policy for the specific plan
• Keep clinical decisions with the treating provider

Telehealth billing considerations

Telehealth coverage and originating-site or modifier requirements change by payer and plan. We verify the current policy for the payer and service rather than applying a universal rule.

Claims, denials and A/R

Denials are reviewed by reason, corrected where supported, appealed inside the payer deadline and tracked. Recurring authorization or documentation issues are fed back to scheduling and clinical teams.

Credentialing and payer enrollment

Behavioral health providers may need separate payer enrollment, group affiliations or site-specific setup. We coordinate the enrollment details and keep the payer directory information current where that work is in scope.