Behavioral Health Billing
Revenue Cycle Management For Behavioral Health Practices
Core RCM is 7% of collections, with a $500 monthly minimum per provider. Included: claim review and submission, rejection and denial follow-up, payment posting and adjustments, A/R follow-up, reconciliation, and reporting. Separate unless included in writing: credentialing, eligibility and benefits verification, and prior authorization.
Ask Practice Concierge See the $6,500 Stabilization SprintWhat’s Included
What Revenue Cycle Management Includes
- Separate written scope: eligibility and benefits verification before the visit.
- Clean claim submission and scrubbing across all payers.
- Denial management worked by root cause, not one claim at a time.
- Accounts-receivable follow-up on aging and stalled claims.
- Payment and remittance posting kept current.
- Reporting that shows collections, denials, and what to work first.
Built For Behavioral Health Practices
Psychiatrists, PMHNPs, psychologists, group practices, and interventional programs. Billing runs 7% of collections, see full pricing.
Solo therapist or counselor? Skip the sales call, our self-serve path has pricing and free guides.
Command Suite
Know Where Collections Stand
Aging buckets, denials to work, and payer friction in one command center so your team stops guessing from an unreadable spreadsheet.
Ask Practice ConciergeVisibility
What Practice Owners Can See
A working revenue cycle answers these on any given Tuesday. If yours can’t, that gap is where revenue leaks.
Aging Claims, With The Reason
Not just what’s aging, but whether it’s a payer, documentation, credentialing, or unworked-queue problem.
Repeating Denials
Which denial reasons keep coming back in volume, and whether a systematic fix exists.
Payers To Escalate
Which payer relationships create consistent friction and are worth raising with a rep.
Work With No Assigned Owner
Where work sits without an owner: EHR, clearinghouse, practice management, or an inbox.
Problems Before Claim Submission
How documentation, credentialing, intake, and scheduling are slowing what you can bill.
What To Work First
A prioritized view of what moves cash flow most this week, not everything at once.
How It Works
Focus On The Problems Holding Up Payment
Review
We map how your practice submits and tracks claims, then surface aging, denials, queue ownership, and upstream drag as prioritized findings.
Scope The Fix
Work targets the highest drag first: billing oversight, an audit of outsourced performance, or direct claim-workflow fixes.
Track The Work And Results
Ongoing support keeps denials worked, documentation holds flagged, and leadership reading a clear status every week.
FAQ
How The Work Moves
What The First Operating Review Produces
We start with source reports and reconcile them before deciding which queue deserves attention first.
A Comparable Source Set
Production, payments, adjustments, denials, and payer-level aging are aligned by date range and provider so the totals can be compared.
Named Work Queues
Aging claims and denials are grouped by cause, payer, next action, and owner instead of being left as one undifferentiated backlog.
A Short Priority List
Leadership gets the controllable issues to work first, what remains dependent on a payer or vendor, and what evidence will show movement.
A Repeatable Weekly View
The same definitions carry into the weekly review so a changing total does not quietly become a changing method.
Revenue Cycle Management FAQs
What Does Revenue Cycle Management Include?
Core RCM includes claim scrubbing and submission, rejection and denial follow-up, payment posting and adjustments, A/R follow-up, reconciliation, and reporting. Eligibility and benefits verification and prior authorization require a separate written scope.
How Do You Reduce Claim Denials?
We work clearinghouse rejections quickly and run a root-cause denial workflow so recurring issues are visible. Eligibility verification and prior authorization are performed only when they are included in a separate written scope.
Can You Work Our Aged A/R Backlog?
Yes. We work aged claims to recover what is still collectible and fix the upstream causes so the backlog does not rebuild.
Do We Have To Switch EHRs To Work With You?
No. We work inside your current EHR and clearinghouse rather than requiring a migration.
For PMHNPs
Run A Psychiatric Nurse Practitioner Practice?
We keep a dedicated hub for PMHNPs, billing and coding, credentialing, and scope of practice by state. Explore the PMHNP hub or PMHNP billing and coding.
Tier 1 · Improve The Systems Your Team Already Uses
Revenue Cycle Work Queues That Show The Next Corrective Action
The responsible team can separate payer behavior from controllable workflow problems, work the next action, and see aging, repeat causes, and overdue items.
What AdvanceAPractice Changes Or Builds
- Trace representative transactions through the included eligibility, claim, remittance, posting, and follow-up stages.
- Configure supported queues, categories, assignments, deadlines, reports, and management checks.
- Document which correction belongs to staff, the biller, a system administrator, or the payer.
What Will Be In Your Hands
- Denial and payment-resolution tracker
- Defined cause and next-action categories
- Management dashboard for aging and recurring issues
- Ownership, escalation, and weekly-review instructions
Systems We Work In
- Tebra/Kareo billing and revenue cycle workflows
- Customer-authorized clearinghouse and payer portals
- Microsoft 365: Excel, SharePoint, and Power Automate
- Command Suite revenue cycle trackers and dashboards
Platforms We Can Evaluate Or Connect
- Office Ally, Availity, Change Healthcare / Optum, Waystar, TriZetto Provider Solutions, Claim.MD, Apex EDI, Inovalon, ABILITY Network, and Zelis
- Billing and report capabilities in AdvancedMD, athenahealth, Epic, Valant, TherapyNotes, SimplePractice, and ICANotes
- Google Sheets, BigQuery, and Cloud Storage for approved reporting or reconciliation designs
- Supported X12 837, 835, 270/271, 276/277, 277CA, 999, and 834 transaction paths
Supported Methods
- Native reports, work queues, remittance files, and clearinghouse exports
- Supported APIs, SFTP, webhooks, and structured export or import
- Controlled reconciliation when a supported automated path is unavailable
Access Dependencies
We need authorized access to the included EHR or PM system, clearinghouse, payer response files, current billing workflow, representative transactions, and the person who can approve corrections.