We teamed up with the law firm Nelson Hardiman to put on a webinar for professionals in the behavioral health industry to provide education and tips on how to get the most out of their collections. In this webinar, CA Billing Co-Founder Abdul Ahmed and Nelson Hardiman Partner, Zach Rothenberg talk about the importance of maintaining immaculate documentation, how to best execute appeals, how to be proactive in dealing with “special investigative units”, financial hardship, patient financial responsibility, and how to best maintain data to help you moving forward in your business. You can watch the full webinar below! Would you like to learn more about CA Billing and what we can do for you? Visit our website to learn about our services or check out our frequently asked questions page. You can also call or email us to request a free consultation.

If you work anywhere in the realm of healthcare, you’re likely very familiar with HIPAA and the compliance required within the industry. In this blog post, we wanted to cover what HIPAA is, why it is so important within the behavioral health space, and what steps are needed to ensure compliance. What is HIPAA? HIPAA stands for the Health Information Portability and Accountability Act that was passed by Congress in 1996. The HIPAA Privacy Regulations require healthcare providers and organizations, as well as their business associates to follow procedures that protect health information and ensure the confidentiality of patients. This applies to all transferring, receiving, handling, or sharing of protected health information (PHI). What is PHI? Protected Health Information is considered to be any personally identifiable information as it pertains to the past, present, or future health status of an individual. This covers any health information that is created, collected, transmitted, or maintained by a healthcare organization. Examples of protected health information can include diagnosis, prescriptions, treatment information, and medical test results. This also includes personal information of the patient including their name, social security number, date of birth, emergency contact, phone numbers, and email addresses. All of this information needs to be protected and kept secure to ensure that a healthcare organization can be HIPAA compliant. Why is HIPAA So Important for Behavioral Health? Keeping privacy protected in healthcare is always important however with behavioral health-related issues it becomes even more important. Unfortunately, there are still so many stigmas associated with mental health. Many people still believe addiction to be a moral failing and so many still don’t see the validity of mental health conditions. There are ramifications that can come with someone’s treatment being discovered including loss of job, reputation, and relationship issues. Because of these reasons, behavioral health patient information must be protected. Precautions To Ensure HIPAA Compliance During the billing process, patient information including diagnosis codes, medications, clinical notes, and other information must be shared from facility to biller, and then to the insurance provider in order for claims to be processed and paid. This means it is essential that the billing company is HIPAA Compliant. All emails, communications, and transfers of information need to be done securely and with compliance in mind. HIPAA and Telehealth In the age of COVID-19, more than ever, people still need treatment for mental health and substance abuse-related issues. This has driven many providers to make the switch from in-person treatment to telehealth. This comes with concerns as providers must take extra precautions in order to ensure that HIPAA guidelines are still being met. Luckily there are many HIPAA Compliant platforms and services available including video conference and messaging applications. CA Billing takes HIPAA compliance very seriously. Each employee, no matter what their department is certified in HIPAA compliance. We take great care to ensure the privacy and confidentiality of each patient’s claim that comes through our office. Choose a Behavioral Health Billing Agency You Can Trust Healthcare providers must ensure they are in compliance with HIPAA laws and that means they must choose their business associates carefully. When you choose us for your behavioral health billing, you can rest assured that we will not take your trust for granted and will do everything possible to protect the privacy of each and every one of your patients. Would you like to learn more about CA Billing and what we can do for you? Visit our website to learn about our services or check out our frequently asked questions page. You can also call or email us to request a free consultation.

The world of behavioral health billing can be a confusing one. There are a lot of moving parts that go into submitting claims, getting authorizations, sending the right paperwork, etc. The hope is that by doing all of this your claims will pay in a timely manner, so your business can continue operating. However, we all know that sometimes you think you’ve done everything correctly and claims still get denied. In this post, we’re talking about the top five things to consider in an effort to make sure your claims don’t get denied. Understand the relationship between Utilization Review (UR) and Billing In the billing process, getting treatment services authorized in a timely fashion by the UR team is extremely important. After authorization is obtained, it is equally important to bill correctly according to the authorization and the insurance providers’ preferences. Claims can be rejected because the billed codes don’t match what the insurance provider put on the authorization or because certain insurance providers don’t consider certain codes acceptable for a level of care (we’ll discuss this later in the article). We’ve also encountered insurance providers incorrectly inputting authorizations into their system, for example, filing it under the wrong tax ID or marking authorizations as denied when they were not Document, Document, Document Sufficient medical record documentation is key for successful behavioral health billing. Inadequate documentation can trigger all sorts of issues with insurance providers including medical necessity denials, allegations that services were not rendered as authorized or billed, as well as audits. All of which can lead to delays and denials for claims billed. Documentation training is also key so all clinicians and staff are fully aware of how to document properly. Be Familiar With Individual Insurance Providers While many insurance providers expect a lot of the same things when it comes to processing claims, there are differences and subtleties between providers. Different policies may require different documentation so it’s important to be aware of that. In addition, certain providers will only pay for certain types of facilities. Lastly, certain insurance providers are more likely to deny services for medical necessity. Because of this, it is so important to have knowledge and experience with the insurance landscape and the specific needs of each insurance provider. Keep An Eye On the Client’s Policies A simple mistake that can be made leading to a claim denial is if a patient’s policy ends or lapses during their stay at a facility. It’s key to ensure that all clients’ policies remain active throughout the duration of their treatment and that coordination of benefits is completed when needed. Ensure All Paperwork Is Signed Up Front Getting clients to sign paperwork is one of those things that can easily be breezed past, thinking you’ll just get to it later. However, the issue is that it can get missed entirely and facilities are unable to contact clients after they discharge. When the paperwork isn’t signed, reimbursement for entire stays can be lost. We advise getting all client paperwork signed upon admission — including documents assigning rights to the facility for payment. At CA Billing, we pride ourselves on extreme attention to detail so none of these key elements for proper claim processing slip through the cracks. As a business, we know how important it is that claims get paid, so you get paid — so we do everything in our power to make sure that happens. Learn more about how we can help you with behavioral health billing and avoid claim denials by contacting our office and requesting your free consultation.