%20v2_edited.jpg)
Billing 101: Common Billing Questions and Answers
- Brittany Morgan
- Nov 7
- 4 min read
By: Brittany Morgan, Billing and Credentialing Specialist at Therapeutic Billing and Credentialing
Image via Photo by Mikhail Nilov
If you’re reading this blog post, chances are you are either a provider who is interested in hearing more about common behavioral health billing questions and answers, or, you might be wondering what exactly goes into the process of billing for behavioral health and what it really means to take care of billing issues for your clientele. This blog post is going to address common billing questions, and provide you with the answers you need to be able to understand the basics of billing in the behavioral health sector.
It is important to note though, that the topics covered in this blog post are by no means exhaustive, and, these opinions are solely those of the blog’s author, and do not necessarily reflect the opinions of the company at large.
Question #1: What does it mean to outsource my practice’s billing and claims submission needs?
This is honestly most likely the biggest billing question you might have, if you’re considering outsourcing the entire billing and insurance claims submission processes to a third-party company–(such as Therapeutic Billing and Credentialing.) Here’s the breakdown: Simply put, it means that as long as you (the provider or business owner) are on top of your client list, (utilizing whichever EMR system you choose to), all of your billing and claims submissions for your clients will be handled for you–including checking with insurance payors to make sure the clients’ insurance plans are active and are able to be billed.
In layman’s terms: you can breathe a sigh of relief that you don’t have to spend hours upon hours going back and forth with insurance companies or playing phone tag with a payor about billing errors or claims that did not get paid.
Question #2: Will Denied or Rejected claims be addressed?
While I can’t speak for any other billing and credentialing third-party company, I can say with 100% certainty that here at Therapeutic Billing and Credentialing, we definitely do follow up with both the insurance payors and with you, the provider, to address reasons why some claims might be denied. (And, nine times out of ten, a denial reason is one that is a relatively easy fix.) We’d then re-submit that claim or claims to the payor, once the errors are corrected. It’s really that simple!
Question #3: Even though I am outsourcing my billing, do I still need to have extensive knowledge of CPT/HCPCS Coding?
No. Not at all! Given that, for us, Therapeutic Billing and Credentialing is a company that specializes in healthcare billing, our billing and credentialing specialists already have that knowledge of the CPT/HCPCS codes that are needed to correctly bill insurance companies. The process of hiring a third-party company like us means that you as the provider don’t have to stress or worry at all about which codes to enter into client charts, or if this code should be used instead of that code. (And, let’s not even get started on the add-on service codes!) All of this is to say, when you make the decision to hire a third-party billing company, (if this is what you choose to do), it should feel like there’s a boulder being lifted from your shoulders!
Question #4: Will I still be able to bill clients for services even if they don’t have insurance?
This is a question that is unfortunately becoming asked more frequently these days, especially with the price of insurance premiums skyrocketing. The short answer to this question is yes. You can absolutely still bill clients for your services even if they do not have any insurance plan. How can this be done? You can either choose to have the client pay you the full service fee for your sessions/services (which you will set in whatever EMR system you use), or, you can have your client pay either a reduced-fee rate (sometimes called a ‘sliding scale’ rate.) Another option, too, is having that client receive your services for a ‘Pro-Bono’ rate of $0 per session. (Of course though, every client’s billing and insurance situation is unique, and it needs to be up to you as the provider and the client working together to determine which option would suit both parties best.)
Question #5: What does it mean if I am ‘out-of-network’ for some of my clients?
Unfortunately, if you have clients who tell you that you are ‘out-of-network’ for them, it usually means that you are not fully credentialed or ‘in-network’ with their insurance payor/company. These claims can technically still be submitted, and the client can also be given a SuperBill to give to their insurance companies–but it definitely creates more of a headache for both you and your client. But, if you would like to be credentialed and ‘in-network’ with any insurance company, that is also a service that we offer here at Therapeutic Billing and Credentialing as well. Because the reality is this: billing and credentialing might seem like they’re worlds apart, but they’re really just two sides of the same coin, and when you have a company behind you that you trust with one aspect, it just makes good sense to rely on that company for both aspects.
Final Thoughts
If you’re still considering hiring a third-party company to handle all of your practice’s billing (or, maybe even credentialing) needs, feel free to schedule a consultation call with our business owner to see if Therapeutic Billing and Credentialing would be a good fit for your business. And, even if you’re not considering us, we just wanted to say thank you for taking the time to read through this blog post. We hope this information here has been helpful, and we’d love to hear from you with any questions or comments!
Comments