Checking insurance coverage
We screen for active coverage, behavioral health benefits, session limits, copays and whether testing requires authorization before that patient ever walks in the door.
Psychologists face charges
Psychology Billing Services for PhD & PsyD Psychologists
Very different claims are a 55-minute therapy hour and a four-hour testing battery. We bill both, testing units, authorizations and payer rules prior to anything going out the door.”
✓ Coders certified by AAPC
✓ Therapy and testing claims
✓ Weekly denial and A/R reporting
Discuss Your Billing Needs
Behavioral health billing focus
Coders read the clinical note
A/R Follow-up and Denial
BAA prior to system access signed
Billing for Psychology
Bill how psychology really works
Psychology tells us there are details the general billing teams miss. The codes for therapy are based on time spent with the patient. A testing evaluation may consist of administration, scoring, interpretation and report writing. Each has its code, its time rule and sometimes its authorization.
We work with PhD and PsyD psychologists in solo and group practices. Payers enroll you by license, so the letters after your name don’t often change the claim. It does change who does each service and where. That’s what we build the work around.
- Solo psychologists and multi-provider groups
- Checks on every claim time Unit and rendering-provider
- Weekly Denial & A/R Reports
What we do
Services we deliver to psychology practices
Choose one or more services. We'll confirm the precise scope with you at onboarding.
Psychology charge entry
Each encounter has a note attached to it. We enter the code, minutes or units, diagnosis, modifier, place of service and the clinician who provided the service.
Medical billing for psychology
Coders compare each note to the CPT and ICD-10 selection, e.g. 90834 vs. 90837 or 96130 vs. 96136 and ask you questions when the note is lacking.
Claims of psychological testing
Hour-based evaluation codes, 30-minute administration codes, technician time, and authorization limits are all reviewed together to ensure the units match what was documented.
Psychotherapy billing
We apply session time ranges to each note, review add-on codes and check individual, family and group claims for diagnosis and provider information.
Denials and claims submission
Payer-specific edits are applied to claims before they are transmitted. Rejections are captured in the clearinghouse reports and fixed quickly rather than sitting unseen.
Posting of payment
We post each remittance, adjustment and patient balance and then match the totals to the deposit so short pays and underpayments are brought to light.
Denial Management
Each denial is read for its reason code, traced to a cause, and then corrected, resubmitted or appealed when the record supports it.
Follow up of accounts receivables
We age work buckets by payer; we log every contact; we watch filing limits to make sure older claims do not run out of time.
Billing & Statements For Patients
Plain language statements of verified patient responsibility, no more clinical detail than the account needs.
Psychology Revenue Cycle Management
One team does all of the above steps, so a pattern found in denials can change how eligibility or charges are handled next time.
Support for flexible billing
Start with denials or A/R only or turn over the whole cycle. This will depend on the mix of services you provide and on your existing staff.
Where billing gets tough for psychology
Testing claims needs a review of its own
These are the codes for evaluation. 96130 and 96131 are for interpretation and the report. 96136 and 96137 are for administration and scoring by the psychologist. 96138 and 96139 are when a tech administers the tests. The way each set measures time is different and the combinations accepted by payers are different.
- Minutes recorded for each activity and converted to the appropriate number of units
- If the test was given by a technician or the psychologist
- Prior authorization approvals and unit caps checked before testing begins
- Medical Necessity Language compatible with referral and diagnosis
Therapy claims
The session note is the code
Psychotherapy codes are based on minutes: 90832 is 16 to 37 minutes, 90834 is 38 to 52 minutes and 90837 is 53 minutes and up. 90837 is very strict for many payers so time needs to be documented in the note. When we don't, we send it back to you with a question, not a code.
- Verified billed code against start/stop times
- Individual, family and group sessions are billed separately using their own codes (90832 to 90837, 90846, 90847, 90853)
- Add-on and Crisis Codes Reviewed for Documentation including 90785 and 90839
Payment is dependent on coverage, clinician enrollment and payer policy.
Who we collaborate with
Support related to your practice
Checks are first determined by your license, payer mix, and service line.
PhD Psychologist
Therapy, diagnostic interviews and assessment work billed under clinician’s license and enrollment with payers.
Psy.D. psychologists
Also charged on license and enrollment, with the same note and code review provided to each clinician in practice.
Heavy assessment practices
Psychological and neuropsychological evaluations, with technician time, authorization limits, and multi-hour unit counts.
Group and Telepsychology Practices
Accurate rendering-provider NPIs for multiple clinicians, place of service 02 or 10, and modifier 95 or 93 where needed by a payer.
What we repair
Invoices of psychology practices that cause us problems
We trace the cause of each problem to a result. No billing team can guarantee 100% of claims will be paid.
01
Time that does not fit the code
A 50 minute note billed as 90837 results in denial and audit attention. Before we submit the note we compare the minutes in the note to the code.
02
Notes without bill detail
If a record does not have a diagnosis, time or signature, coders will query the clinician prior to building the claim.
03
Testing units exceeding limit
Plans often restrict units or require approval. By checking the limits first, you are less likely to get denials such as CARC 197 (no authorization) or 151 (units or frequency).
04
Rejections, denials
Each rejection is read for reason code and is corrected. Each denial is traced to a cause, corrected, resubmitted or appealed.
05
Payments that don't make sense
Match remittances to the account. Short pays, unexpected adjustments and recoupments are flagged for review.
06
Accusations of aging
Open claims are reviewed by age and by payer and filing limits are monitored. Medicare Part B is 12 months and some commercial plans are much less.
How the work is going
First Contact to Weekly Reports
We scope at onboarding and work within the EHR or practice management system you already use.
Practice review
We review your service mix, payer, EHR, open A/R and recent denials. The first step may offer a complimentary A/R audit.
Coverage and enrollment verification
We verify eligibility, benefits and authorizations, make sure all of our clinicians are actively enrolled with payers, and match encounters to signed notes.
Charges and coding
The clinical note is then compared to the codes, minutes, units, modifiers, and provider details.
Submission and monitoring
Run payer edits. Send out claims. Work off of clearinghouse reports for rejections.
Denials and postings
Denials are corrected, reconsidered or appealed as the record supports. Remittances are posted.
A/R revision and reporting
Claims are worked by age of outstanding Weekly report on denial reasons and A/R aging.
System access provision at onboarding. We sign a Business Associate Agreement before we even touch your systems and permissions are role-based.
Picking a Mate
Questions to ask each billing company
A good billing company can tell you who does what, how you see results, and what it costs.
- Claims of experience with psychotherapy, testing, and telepsychology
- AAPC-certified coder reviewing clinical note
- Claim edits specific to payer pre-submission
- Named account lead and weekly denials and A/R report
- Access restrictions and signed BAA before system access
- A written scope and clear terms for terminating the agreement
No billing company can guarantee payment, a specific denial rate or a time frame for payment. Get scope and fees confirmed in writing.
Thinking about the options
In-house billing or outsourcing
Nobody wins all the time. Claim volume, staffing cost and how much oversight you want all matter.
In-house billing
- Directly responsible for billing personnel
- Your practice is responsible for hiring, training and coverage for time off.
- Your team does their own payer follow up and reporting
- Claim volume may require headcount growth
3rd Party Billing
- An outside team takes on the work you agree to hand off
- Scope can be full cycle or few functions
- Works best when responsibilities and contacts are documented
- Reporting, system access and fees are agreed before commencing work
Do your own math on your own claim volume, staff costs and reporting needs before you decide.
Want to see your psychology A/R's status?
Talk to our team about your workflow and open claims and we can discuss next steps.
Frequently Asked Questions
FAQs about psychology billing services
Billing support answers for Ph.D. and Psy.D. psychologists
What does psychology billing services entail?
We do eligibility checks, charge entry, coding, claim submission, payment posting, denial work, A/R follow up and patient statements. You can take the whole cycle, or just the pieces you need.
Do you bill PhD and PsyD psychologists?
Yes. The degree type rarely matters for the claim, as payers credential clinicians based on state license and enrollment. We verify providers’ licenses, taxonomy, and payer enrollment and services on file.
Can you bill for psychological testing?
Yes. We look at the documented time, the units, the authorizations, who did the service, such as the psychologist or a technician. Whether a payer will pay for a given code is dependent on the payer’s own policy.
How does psychological testing billing differ from psychotherapy billing?
Testing is billed differently from therapy. Therapy claims are based on one code and minutes from a session. Testing often includes multiple codes combined into one encounter. Hours for interpretation and report (96130, 96131) and 30-minute units for administration and scoring (96136 through 96139).
Do you cover telepsychology claims?
Yes. We verify the clinician’s location, the patient’s location, and the place of service (02 or 10), modifiers such as 95 or 93 for each payer’s telehealth policy. Different rules apply by payer and by state.
Are you going to work on old claims and denials?
Yes. We review each denial reason, we remedy what we can remedy, and we appeal where the record supports it. The payers make the final decision, and as such we cannot guaranty a reversal.
Will outsourcing my billing ensure that I get paid?
Nope. What they are going to pay is decided by the payers. There is no billing company that can guarantee reimbursement, a specific denial rate, or how fast payments come in.
Start a conversation
Tell us about your psychology billing
If therapy claims, testing, eligibility, coding, denials or old balances are bogging you down, we can walk through your current setup and suggest which services are best for you.
Do not send patient information through the general contact form or through email.
Contact Mental Health Billing
Phone
+1 734-519-5845
+1 734-519-5845
Office
6512 N. Canton Center Rd., Bldg. B, Canton, MI 48187
6512 N. Canton Center Rd., Bldg. B, Canton, MI 48187