rcm solutions Mental Health and Psychiatry facilities

Medical Billing And Revenue Cycle Management Solutions For Mental Health, Psychology & Psychiatry Facilities

Psychiatrists and mental health professionals perform various critical functions, such as diagnosis, treatment, and ongoing care for individuals with mental health conditions. At StafGo Health, we understand that mental health and psychiatry practices face numerous challenges in medical billing and RCM. Hence, we provide various comprehensive services of medical billing and RCM solutions made keeping in mind the sensitivity of Mental Health & Psychiatry Facilities. Our team properly understands the advances in billing for a patient population of mental health and provides services according to their special needs.

Accurate CPT Code Management With Stafgo Health

Our psychiatry coders are well trained in managing commonly used codes, including 90791 and 90792 for psychiatric diagnostic evaluations (without and with medical services, respectively), 90832, 90834, and 90837 for individual psychotherapy sessions of 30, 45, and 60 minutes,90853 and 90847 for group and family therapy sessions. When psychiatric services are combined with medication management, codes like 99212–99215 are used, particularly in follow-up visits, and at StafGo Health, we make sure that accurate usage of these codes and application of appropriate modifiers (such as GT or 95 for telehealth services) are done to meet payer-specific requirements.

Why Outsource Medical Billing And RCM To Stafgo Health For Your Mental Health & Psychiatry Practice?

Mental health and psychiatry practices have to deal with multiple challenges in billing and revenue cycle management, like time-based coding, telehealth regulations, complex documentation, and authorization requirements. At StafGo Health, we specialize in behavioral health RCM, offering solutions that align with the unique workflows of psychiatrists, psychologists, and therapists. By outsourcing your billing to StafGo Health, you will have access to experienced and skilled professionals, real-time reporting dashboards and reports, timely claims submission, and proactive denial management.

Common RCM Challenges Faced by Mental Health & Psychiatry Practices

Here are some common RCM (Revenue Cycle Management) challenges faced by Mental Health & Psychiatry practices, which impact the revenue of your practice and operational goals-

Time-Based Coding Complexity - Time duration is the main important point in psychiatric services. Hence, these services are billed based on session length (e.g., 30, 45, or 60 minutes). Errors in documentation or coding of time or duration can lead to denials or underpayments.
Frequent Policy and Compliance Changes - Payer policies are subject to frequent change; hence, mental health billing is also subject to frequent updates according to the payer, making it difficult for in-house teams to stay compliant.
Pre-Authorization and Referral Requirements - Certain procedures of mental health and Psychiatry require pre-authorization from many insurances. If prior authorization is not done properly, this can lead to non-payment.
Telehealth Reimbursement Variability - As telepsychiatry is growing nowadays, payers have various rules and regulations about what is reimbursable. Sometimes they require specific modifiers in place of service codes, which can be easily overlooked.
Multiple Service Types and Modifiers - Sometimes several procedures are involved in one session, like Psychiatrists often provide evaluation, psychotherapy, and medication management in one session. Billing these accurately requires detailed knowledge of CPT codes and appropriate use of modifiers.
High Claim Denial Rates - Due to incomplete documents or incorrect coding, mental health practices often face high rates of claim denials that delay revenue flow.
Out-of-Network Billing Challenges - Many mental health providers are out-of-network, which leads to more paperwork and fewer reimbursements

Solving Your Mental Health & Psychiatry Practice Challenges with StafGo Health

Accurate Time-Based Coding- Our billing team makes sure that time-based CPT codes such as 90832, 90834, and 90837 are used appropriately based on proper documentation, which in turn reduces chances of denials and maximizes reimbursement.

Real-Time Policy Monitoring - Our team stays updated on ever-changing payer rules, including those related to mental health parity laws, telehealth expansions, and compliance regulations, so that claims are always aligned with current standards.
Pre-Authorization Management - We have a dedicated team for handling pre-authorizations and referral verifications proactively, minimizing chances of claim rejections due to missing approvals.
Telehealth Billing Expertise - Our team of experts ensures correct use of modifiers (e.g., 95, GT) and place-of-service codes, which can help telepsychiatry services get reimbursed without any issues.
Integrated Documentation Support - Our systems manage to support documentation integration work that helps in correct coding when sessions involve both psychotherapy and medication management.
Denial Management & Appeals- Our team has a keen understanding of denials and their reasons. Our denial management experts analyze, appeal, and resolve denied claims quickly, improving your revenue turnaround and reducing write-offs.
Support for In-Network and Out-of-Network Billing- Whether you’re billing as an in-network provider or managing out-of-network claims, we streamline the process to maximize reimbursement and reduce administrative workload.