Your doctors are already documenting and creating superbills in Practice Fusion. They should also not have to follow up on the claim later. Our billers match every superbill with the signed note and keep on it until the payer pays or informs us why they will not pay.
We pick up at the superbill and stay with the claim through the payer's answer, the posting, and whatever follow-up comes after.
You don't have to move a thing. Clinicians use the same psychiatry and therapy templates they already use. Our billers will log in using an account your practice sets up, with the permissions you want, and we'll work with whatever billing system you have attached to it.
The note is coded as written. Even if someone picked 90837 out of habit, a 45 minute session billed comes out as 90834. We will not ask a doctor to change paperwork to support a higher code. If we don't understand something, we just ask.
The first thing we check is that gap. Practice Fusion pulls the ICD-10 superbill from the chart note. The claim itself is frequently constructed elsewhere in an associated system such as CollaborateMD or AdvancedMD. If the payer name or patient record doesn't match between the two, the superbill will be rejected.
Practice Fusion holds the chart and builds the superbill. Everything after that, from the coverage check to the last payer call, sits with our team.
In Practice Fusion, a visit starts on the schedule and ends up as a signed note. The superbill comes out of that note. Once someone marks it ready for biller, it heads to your billing system, and that's where the actual claim gets built.
Most of the problems we fix trace back to one of these handoffs. An appointment left open can hold up a claim. So can a note signed days late, or a payer spelled one way in Practice Fusion and another way in the billing system. Filing limits keep running the whole time, and some are only 90 days.
It's usually just one little setup error, repeated on every superbill until the denials start to pile up.
A superbill that is never designated ready for biller just sits there. You get no warning. Time codes cause trouble too. 90837 requires a minimum of 53 recorded minutes, and so many notes are a touch shy.
Even a slight difference in spelling between systems can bounce a superbill back. Many medical insurers send mental health claims to a different company with its own payer ID. And testing units expire quietly. Most practices don't know until they get the denial.
A rejected claim never made it to the payer hence it won't show up on any EOB. Post an ERA to the wrong date of service and the client balance is incorrect. Meanwhile, certain commercial contracts allow only 90 days from date of service.
None of these are hard to fix once someone is actually looking. Usually nobody is. We run the same checks on every account, so a bad payer record gets caught on the second claim instead of the fortieth.
Some practices give us the whole shebang. Others just want help with denials or outdated A/R and that is good too.
We review provider profiles, NPIs, taxonomy codes, facility settings, payer information, and superbill defaults. Then we compare them with your billing system because the two have to state the same thing.
We verify the plan's activity status, the client's per-session liability, and whether a distinct behavioural health organization manages the claims.
Explore eligibility verificationEach superbill is reviewed against the signed note. Before creating the claim we review CPT code, units, diagnosis, modifiers, rendering provider and place of service.
If CollaborateMD, AdvancedMD or any related system rejects a superbill, we identify the record that caused it and rectify it so the visit is not lost.
Evaluations (90791, 90792), psychotherapy 90832 to 90838, E/M with add-ons, family and group sessions, 90785 and testing codes 96130 to 96139.
Explore medical codingWe submit the enrolment forms to each payer and continue to follow up until we really receive ERAs.
Clean claims are submitted electronically, well in advance of the payer's filing deadline.
Explore claim submissionWe correct rejected claims at the source (typically a demographic or member ID issue) and resubmit.
All ERAs and EOBs are posted line by line, including adjustments and patient responsibility, and reconciled with your bank deposit.
Explore payment postingWe sort denials by cause, fix what we can and appeal the rest if the note allows.
Explore denial managementOpen claims worked by payer and by age. Older ones get a status check long before they come near a deadline.
Explore A/R follow-upSo we have authorisation numbers on file, allowed units and end dates, and we ask for renewals before you reach the limit.
Payer applications for new clinicians and CAQH re-attestations every 120 days. This is independent from EDI enrollment.
Mostly the first few weeks are setup. Then every visit goes through the same steps.
We acquire access, check payer and provider data and see what's waiting in A/R.
We find out which billing system your superbills go to and how payers are named on both sides.
Insurance benefits & information are verified before sessions begin.
The note and superbill are checked before anything is flagged ready for the biller.
Claims are submitted electronically, during each payer's filing time.
ERAs get posted, deposits reconciled.
Rejections are modified and resubmitted. Denials are either fixed or appealed.
We work old claims by payer and escalate claims that have stalled.
You get a clear report of what's paid and what's not.
On your side, clinicians basically sign notes on time and answer a coding question here and there. Your front desk keeps insurance cards and client details current.
Pretty much everything after the signed note. That covers benefits checks, superbill review, claims, posting, denials, and the payer calls nobody at your practice wants to make.
A doctor who prescribes controlled substances bills very differently than a counsellor seeing six clients a day, so we set things up for the work you actually do.
Add-on codes such as 90833 require separate documentation of psychotherapy time from the E/M visit.
Learn moreTesting is billed by time and many plans need prior authorisation initially.
With additional providers, each with individual credentials, payer information becomes out of sync faster.
Guardian subscriber info. Family sessions. Interactive complexity 90785. Comes up often.
90846 and 90847 hinge on whether the client was in the room for the session.
Video and audio visits follow each payer's own place of service and modifier rules.
Medication-assisted treatment visits have their own payer rules.
Here's one we get a lot. All appointments are assigned to place of service 11, including video visits. The payer wants POS 10 when the client is at home. So all the telehealth claims go out wrong and the denials come in all at once weeks later.: CMS uses POS 10 for the client's home and POS 02 for anywhere else.
For telemedicine medication management, place of service and modifier regulations vary per payer, thus we follow each payer's current policy. Your providers maintain prescribing authority. Commercial plans don't all agree on modifier 95 either, so we check before the claim goes out.
It's mostly routine. All the claims are treated equal and you can finally see where the money goes.
Looking at benefits and superbills early prevents simple mistakes before a payer even sees them.
Each open claim is assigned to someone from our staff, so nothing sits idle for months.
You'll have one system to check into to see what was invoiced and what came back.
No more nights on hold with payers, or sifting through paper EOBs.
We cannot predict what any payer will pay and you should be cautious of any billing company that guarantees a collection rate. What we can promise is diligent work and reports to show it.
We do not bill for anything except behavioural health. So we already know the time rules for psychotherapy codes, how add-ons couple with E/M and how a superbill from Practice Fusion becomes a claim. We will keep you posted. Anything we require from you, a missing signature, a question about a code, we ask for immediately and don't leave it sitting in a queue.
A Business Associate Agreement comes first. After that, we only ask for the access our billing work actually needs, and nothing more.
Mental Health Billing is an independent billing company. We aren't affiliated with, endorsed by, or partnered with Practice Fusion or Veradigm.
These are the questions that practice owners frequently ask us before we get started.
Yes. Your practice creates a user login for us and chooses what we can see. If you have a connected billing system, we work there too, so the superbill and claim stay matched.
Not usually. We collaborate with CollaborateMD, AdvancedMD and other integrations. If you're doing your billing by hand right now, we'll speak about what's sensible.
Both. We bill for individual therapists and psychiatric nurse practitioners, and for groups where multiple professionals share the same payers.
Yeah. We will verify if coverage is in place, the client's responsibility, any visit restrictions, and whether a separate behavioural health firm is handling the claim.
We read an error message. Typically it's a payer name or a patient record that doesn't match. We fix the record in the system that is faulty and then resend the superbill.
Yes. This includes E/M visits, psychotherapy add-on codes and psychiatric examinations such as 90792, all verified against the note and payer policy.
Yes, if they are still within the payer's filing or appeal time. We go over your ageing report, work what can still be collected and inform you straight whether claims are past the deadline.
It is contingent upon the payer and your location. Some payers directly credential associates. Some allow billing under a supervisor, several allow neither. We look at each payer's policy before we bill anything.
Yes. We file out-of-network claims, verify OON benefits, and produce superbills for clients to submit themselves. Review the Good Faith Estimate rules under the No Surprises Act for self-pay patients with your compliance advisor.
Request a free billing audit. We will discuss your Practice Fusion set up, interface issues, rejection patterns, open A/R and provide recommendations for the type of help that makes sense. If you want to move forward, you'll start onboarding with user access and a review of your payers and balances.
Most doctors didn't begin a practice to spend Thursday nights on hold with insurance companies. If rejected superbills or aged A/R are still taking a chunk out of your week, drop us a line. We'll go through your workflow with you and tell you honestly what we would modify.