Add a second rendering provider and the claim math changes. We run the full revenue cycle for behavioral health groups, psychiatric practices, and multi-location clinics across the USA.
The more clinicians you bill under, the more places a claim can go wrong before it reaches a payer. We work with practices where that complexity has outgrown a single in-house biller.
A mix of LCSWs, LMFTs, and LPCs under one roof, each credentialed and reimbursed differently by payer.
Medication management alongside therapy, where E/M codes and add-on psychotherapy have to be billed together correctly.
Integrated clinics, telehealth-first groups billing across states, and hospital-affiliated behavioral health departments.
On a claim, the rendering provider in box 24J is the person who saw the patient, while the billing entity in box 33 is usually your group's Type 2 NPI. In a solo practice those are the same. In a group, they never are, and every provider must be individually credentialed and enrolled with every payer.
License level adds another layer. Some commercial plans reimburse master's-level clinicians at a percentage of the physician fee schedule. Others won't credential pre-licensed associates at all, so those sessions have to be billed under a supervising provider following that payer's rules. Get the wrong NPI, taxonomy, or supervision setup and the payer denies the claim or pays the wrong entity.
E/M codes 99213 with add-on psychotherapy 90833 — never billed standalone.
Time-based sessions 90832 90834 90837 matched to the note.
Psychological testing 96130–96139, prior auth required by most payers.
Billed under a supervising provider where the payer allows, with documentation to match.
A few issues surface again and again once a practice passes the two or three-provider mark. We build the process to catch them before they reach your aging report.
A new therapist can be fully booked before enrollment is active. Every session in that window is unbillable until the effective date lands, and some payers won't backdate.
A patient sees your psychiatrist and a therapist on the same day, and the second claim gets flagged as a duplicate. Correct coding and modifiers prove the services are distinct.
Sessions are billed by time: 16–37 min, 38–52 min, 53+ min. A note that says 45 minutes billed as the highest code invites downcodes and denials across the roster.
Testing, intensive outpatient and partial hospitalization programs, and treatments like TMS routinely require authorization. Miss it and the denial is nearly automatic.
Group psychotherapy is not family therapy, and payers price them differently. Miscoding these is a common, avoidable source of rework.
When one remittance covers fifteen clinicians, matching each payment to the right provider and patient is where in-house teams fall behind.
We treat the group as a system, not a stack of billers stapled together. The work runs the length of the revenue cycle, and every provider you add joins the same process.
We manage payer applications, keep CAQH profiles current, and track effective dates so a new clinician's claims are ready the moment enrollment activates. When retroactive billing is possible, we file it before the window closes.
Our coders work in behavioral health, so they know what an MD, a PMHNP, and an LMFT can each bill and how each payer wants it. Diagnostic evals, time-based psychotherapy, group vs family sessions, and correct modifiers.
We scrub every claim so the rendering provider, group NPI, taxonomy, place of service, and any authorization line up before it goes out. Telehealth claims get the correct place-of-service code and modifier for where the patient was.
We work denials by cause, not one at a time. If a payer keeps rejecting a provider's claims, we fix the enrollment or configuration issue so it stops, instead of reworking each failure forever.
Every payment posts against the correct provider and patient, with contractual adjustments recorded accurately. For groups that pay clinicians on collections, that number is what your payroll runs on.
We track AR by provider and by payer, so a slow carrier or one clinician's stuck claims can't hide in the group total. Aging claims get worked before timely-filing deadlines, and we chase patient balances too.
Behavioral health carries documentation demands other specialties don't. When many clinicians document in their own styles, inconsistency becomes an audit risk.
We work inside your systems rather than forcing a migration, running billing in your instance or syncing results back to it.
An in-house biller who's excellent for a two-person practice can drown at a dozen. Handing this off gives you a team that already knows behavioral health coding and doesn't leave revenue exposed when someone is out.
That focus means our coders and AR specialists recognize the patterns specific to this field, from the way a particular plan handles 90837 to the authorization quirks around testing and higher levels of care. We're not learning your specialty on your claims.
We also stay accountable to the numbers. You see how claims perform by provider and by payer, not a vague monthly summary. When something slips, we'd rather tell you and fix it than let it surface in your aging report three months later.
Some come to us with a clean setup and a growing roster. Others arrive after a stretch of denials and unposted payments to untangle. We handle both.
If your denial rate is creeping up, your credentialing is behind, or billing can't keep pace with a growing roster, send us your setup and the payers you work with. We'll show you where revenue is leaking and how we'd fix it.