Behavioral Health Billing
Revenue Cycle Management For Behavioral Health Practices
Behavioral health revenue cycle management means we check every claim before it goes out, work every denial back to its cause and post every payment against the deposit.
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Know What Changed In Your Revenue Cycle
A useful owner report explains the work behind the balance. It should separate new charges from old A/R, clearinghouse rejections from payer denials, and money received from payments that haven’t been posted or reconciled.
- Check the starting position. We look at open claims, aging by payer and provider, unposted payments, who has access to what, and which parts your current team handles.
- Agree on the recurring work. Claim submission, denial handling, follow up, posting, patient billing and reporting each get a named owner in writing, and so does the work that stays with your staff.
- Review exceptions every week. Look at rejected claims, filing deadlines, unusual adjustments, unpaid balances with no recent action, and deposits that don’t match posted payments.
- Close the loop. Every claim keeps a dated next action until it’s paid, corrected, appealed or closed with an adjustment you approved.
For a practical owner agenda, use the weekly behavioral health A/R review. It’ll help you ask better questions whether your billing’s handled in-house or by an outside team.
AdvanceAPractice provides medical billing for behavioral health practices at 7% of collections with a $300 monthly minimum for a solo provider, down to 4.5% at 26 to 50 providers. Built for telehealth, in person and hybrid practices. All of our work is done virtually, so we never come on site.
Built For Behavioral Health Practices
We bill for psychiatrists, PMHNPs, psychologists, group practices and interventional programs.
Command Suite
Know Where Collections Stand
Aging buckets, denials to work and payer friction, all in the AdvanceAPractice Command Suite, so your team isn’t guessing from a spreadsheet nobody can read.
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
What’s aging, and 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 payers keep causing the same problems, and which of those are worth raising with a provider rep.
Work With No Assigned Owner
Work that’s sitting in the EHR, the clearinghouse, the practice management system or someone’s inbox with nobody’s name on it.
Problems Before Claim Submission
Where a note that doesn’t support the code, a provider who isn’t enrolled yet or a scheduling miss is holding up 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 hand you a prioritized list covering aging, denials, queue ownership and the upstream problems slowing everything down.
Scope The Fix
We start where the drag’s worst, whether that’s billing oversight, an audit of how your outsourced biller is performing, or fixing the claim workflow directly.
Track The Work And Results
After that, ongoing support keeps denials worked and documentation holds flagged, and leadership gets a clear written status every month.
Medical Billing Priced By The Size Of Your Practice
Ongoing Billing
Claims, denials, payment posting, A/R follow-up, reconciliation and a monthly report.
7% of collections
$300 monthly minimum per provider for a solo practice. For 26 to 50 providers: 4.5% with a $175 monthly minimum per provider. No setup fee.
Start Medical Billing Online- Most questions answered within one business day, and up to two meetings a month if you need them
Rate By Practice Size
| Practice Size | Rate | Minimum Per Provider |
|---|---|---|
| 1 provider | 7% | $300 |
| 2 to 5 providers | 6.5% | $275 |
| 6 to 10 providers | 6% | $250 |
| 11 to 25 providers | 5% | $200 |
| 26 to 50 providers | 4.5% | $175 |
- Practices with more than 50 providers can ask us for a written quote.
- Prices checked October 2026.
Want The Rates In Writing First? Email Me The Order Form
We’ll email you the Ongoing Billing Order Form with every tier, minimum and term on it, so you can share it with your partners.
You’re billed on what comes in, so a slow month costs less. Your volume, payer mix, current A/R and provider count change what the work looks like, so we confirm the scope and the first month in writing before anything starts.
Monthly Billing Or Old Claims
Do You Need Ongoing Billing, Billing Cleanup Or Both?
There are two ways to buy billing help here, and they solve different problems. Ongoing Billing runs the recurring work every month. Billing Cleanup And A/R Recovery is for claims that are already old. We work the unpaid claims past 90 days, and you pay 20% of what we collect on them.
| Detail | Ongoing Billing | Billing Cleanup And A/R Recovery |
|---|---|---|
| Price | 7% down to 4.5% of collections, with a $300 monthly minimum for a solo provider | 20% of what we collect. Nothing is owed on claims we don’t collect. |
| Claims It Covers | The claims going out now, every month, under a written scope | Unpaid claims older than 90 days |
| Included Work | Claim scrubbing and submission, rejection and denial follow-up, payment posting and adjustments, A/R follow-up, reconciliation, and reporting | Working each unpaid claim older than 90 days that can still be collected. We work your oldest claims first, so nothing ages past a payer’s timely filing limit while we work the rest. Every unpaid claim gets a reason and a next step, whether that’s a correction, an appeal or billing the right party, and you see where each one stands. |
| Outside The Price | Eligibility and benefits verification and prior authorization, which need a separate written scope | Claims we don’t collect on, which cost you nothing |
Credentialing and payer enrollment aren’t in either one. They’re priced per provider and per payer in the credentialing price builder.
If the backlog’s already there, run the cleanup next to the monthly billing. The old claims get worked for 20% of what they bring in, and the monthly work goes after the causes, so the same denials don’t build a new backlog.
Send us your aging totals by payer and by age, no patient names, and we’ll email you back within one business day with what we’d work and what it costs.
How The Work Runs
What Happens Each Month Once Ongoing Billing Starts
The recurring work runs in this order, inside the EHR and clearinghouse you already use. Each step feeds the next one, so a problem caught early doesn’t turn into aged A/R.
- Onboarding. We get authorized access to your EHR, clearinghouse and payer portals, pull open claims and aging by payer and provider, and put in writing which work stays with your staff. Before we bill for a provider, we confirm the enrollment is active and linked to the practice at each payer.
- Claim scrubbing and submission. Each claim is checked before it leaves, from member ID and rendering NPI to place of service, the telehealth modifier and codes that agree with the note. Then it goes out through your clearinghouse, whether that’s Office Ally, Waystar, TriZetto or Claim.MD.
- Rejection follow-up. A clearinghouse acceptance only means the file moved. When a claim is rejected, we fix the claim or the record behind it and resubmit, so it doesn’t sit until month-end.
- Denial follow-up. Denials are sorted by payer, code, provider and reason. When a claim denies, we find the cause before we resubmit or appeal, so the same denial doesn’t keep coming back. Now and then a payer approves your credentialing before its contracting team finishes loading you, and early claims deny because of it. We know this lag well, work it directly with the payer, and get those claims reprocessed together instead of one by one. If the same reason comes back next month, it goes on the weekly review.
- Payment posting and adjustments. Remittances are posted to the right patient, date of service and line, and every adjustment carries the payer’s reason. We keep each payer’s fee schedule on file, requesting any we don’t have with your permission, and check your payments against it regularly so underpayments get caught and corrected.
- A/R follow-up. Open claims are worked in the order that moves cash and protects filing deadlines, with claim status checked in Availity or the payer’s portal. Every open claim keeps an owner, a next action and a date.
- Reconciliation. Remittances, posted payments, adjustments and bank deposits are compared before anyone relies on the totals. A deposit that doesn’t match what was posted gets traced back to the remittance.
- Reporting. You get a written report each month: what was billed, collected and denied, and what’s sitting in A/R, by provider and payer. It also shows what’s still unpaid, who’s working it and when the next action is due.
Eligibility checks before the visit stay with your front desk unless they’re in the signed scope. So does prior authorization. Keeping that line clear is how everyone knows who owns a denial when one comes back.
Before You Sign
Questions Practices Ask Before A Billing Scope
Who Does The Billing Work?
Experienced people do, and one expert owns follow-through and the monthly report. Software keeps the queues and next actions in front of us, but it doesn’t call payers, and it never decides what gets appealed.
What Do You Need From Us To Start?
Authorized access to your EHR, clearinghouse and payer portals, a few representative claims and remittances, your current billing workflow, and one owner who can approve corrections. You don’t have to switch systems. We work inside SimplePractice, TherapyNotes, Valant, Tebra (Kareo), AdvancedMD and others.
How Often Will We See Where Collections Stand?
The dashboard shows what’s billed, collected, denied and sitting in A/R, by provider and payer.
What’s The Difference Between A Rejection And A Denial?
A rejected claim never reached adjudication. The clearinghouse or the payer’s front end stopped it, for a subscriber mismatch or a provider the payer doesn’t have on file, so it gets fixed and resubmitted. A denied claim was processed and refused with a reason, which calls for a corrected claim, an appeal or a fix upstream.
How We Investigate Unpaid Claims
We compare claims, denials, payments, adjustments, and aging for the same dates and providers before telling the team where to start.
Check The Reports
We compare reports for the same dates, providers, and insurers, then investigate differences in payments, adjustments, and unpaid balances.
Group Claims By What Needs Fixing
Rejected claims, denials, claims with no response, underpayments, unposted payments, and patient balances receive different next actions.
Set The Priorities
We identify the corrections to make first, filing deadlines to protect, and claims that need an insurer's response.
Report Resolved And Unpaid Claims
The owner sees what was resolved, what remains unpaid, the next action, and the person responsible.
FAQ
Revenue Cycle Management FAQs
What Does Revenue Cycle Management Include?
It covers claim scrubbing and submission for your commercial, Medicare and Medicaid claims, rejection and denial follow-up, payment posting and adjustments, A/R follow-up, reconciliation and reporting, all inside your EHR and clearinghouse. Eligibility checks and prior authorization are added only when a separate written scope includes them. You get a written report every month.
How Do You Reduce Claim Denials?
We sort every denial by payer, code, provider and the reason the payer gave. Rejections get read, corrected and resubmitted instead of sitting until month-end. If the same reason comes back the next month, the fix didn’t hold, and it goes on the weekly review.
Can You Work Our Aged A/R Backlog?
Yes. That’s Billing Cleanup And A/R Recovery, and it’s separate from the monthly work. We take your unpaid claims older than 90 days, work the ones that can still be collected, and you pay 20% of what we collect on them. Nothing is owed on a claim we don’t collect, and we fix the upstream causes so the backlog doesn’t rebuild.
Do We Have To Switch EHRs To Work With You?
No. We work inside the EHR and clearinghouse you already have, whether that’s SimplePractice, TherapyNotes, Valant, Tebra (Kareo) or AdvancedMD, so there’s nothing to migrate. When a denial pattern traces back to how the EHR is set up, like insurance entered on an account with no effective date, we fix the setup where it lives.
What Counts As Collections?
The payer and patient payments we post for your providers from your start date. Your rate is a percentage of those payments, and the monthly minimum applies per provider. Claims already past 90 days and unpaid are a separate job, Billing Cleanup And A/R Recovery.
How Do I Move My Medical Billing To You?
You sign up online, and the first month’s minimum you pay is credited to your first invoice. You get an email invitation to the Command Suite, where you review and sign your Order Form and agreement, and your onboarding packet follows. You give us user access to your EHR, your clearinghouse and your payer portals. Billing starts once your agreements are signed and onboarding is complete, and your rate applies to the payments we post from your start date. Moving from another company? Read Switching Billing Companies.
How Do I Cancel Ongoing Billing?
Either of us can end the agreement with 30 days’ written notice. You owe the fees earned through the end date, and everything we set up in your accounts stays with your practice.
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.
What This Looks Like
Problems That Look Like Billing And Are Not
At one practice, patients were calling about large balances. The billing was fine. Insurance plans had been entered on patient accounts with no effective date, so the EHR silently never sent those claims and the unbilled amounts surfaced as patient responsibility.
Separately, two payers had each paid as primary on the same accounts and both electronic payments had posted, which is a coordination of benefits problem wearing a billing costume.
Working the denial queue harder wouldn’t have fixed either one. That’s the argument for one person holding billing, credentialing and the systems at the same time.
“AdvanceAPractice has provided a great benefit to my growing practice. They clearly explained the confusing insurance billing process and helped me create a plan to expand my business.”
See Everything Included
Every Step
- We check every claim before it goes out, then submit it.
- We bill your commercial, Medicare and Medicaid claims, whichever you bill.
- We review coding and modifiers on your claims.
- We correct and resubmit rejections.
- When a claim denies, we find the cause before we resubmit or appeal, so the same denial doesn’t keep coming back.
- Now and then a payer approves your credentialing before its contracting team finishes loading you, and early claims deny because of it. We know this lag well, work it directly with the payer, and get those claims reprocessed together instead of one by one.
- We post every payer and patient payment and adjustment for the providers we cover.
- We reconcile what was paid against what was billed, and we reconcile patient accounts.
- We keep each payer’s fee schedule on file, requesting any we don’t have with your permission, and check your payments against it regularly so underpayments get caught and corrected.
- We follow up on unpaid claims with each payer.
- You get a written report each month.
What You Provide
- Your onboarding packet.
- Access as a user in your EHR with billing turned on, your clearinghouse if you use one, and your payer portals.
Timelines
- Within two business days of confirmed payment, you get an email invitation to the AdvanceAPractice Command Suite, where you review and sign your Order Form and agreement.
- Billing starts once your agreements are signed and onboarding is complete.
- Your rate applies to the payments we post from your start date, which means the payer and patient payments we post for your providers. The first month’s minimum you pay at sign up is credited to your first invoice.
- Your rate is 7% of collections with a $300 monthly minimum per provider for one provider, down to 4.5% with a $175 monthly minimum per provider for 26 to 50 providers. There is no setup fee. Your exact rate is written on your Order Form.
What’s Not Included
- Claims older than 90 days. Billing Cleanup And A/R Recovery works those for 20% of what we collect, and nothing is owed on claims we don’t collect.
- Eligibility and benefits checks and prior authorization, unless a written scope includes them.
- Sending statements to patients. That’s its own order.
- Applied behavior analysis (ABA) agencies.
- Fixing denied Medicare or Medicaid enrollment applications.
- Credentialing, which is its own package.
- An EHR. We work inside the one you already use.
Ongoing Support
- Questions are part of working with us, during setup and for as long as you’re a client. Send them in the Command Suite or by email, and we reply within one business day, usually the same day. If a question turns into new work, like a new build or a change to something we built, we send a written quote before we start.
- Up to two meetings a month if you need them.
- Your Command Suite workspace shows what we’re working on and anything we need from you. It stays fully open during the work, read only for 30 days after, and then it’s $99 a month if you want to keep it.
- If something we delivered doesn’t work the way we said it would, tell us within 30 days of delivery and we fix it at no cost.
- Everything we set up is yours. The accounts, the documents and what we build stay with your practice.
- Either of us can end the agreement with 30 days’ written notice.
Want This By Email?
We’ll send you everything above, with the PDF, so you can read it later or share it with your partner or CPA.
See Medical Billing And A/R Options
Ongoing medical billing is priced by practice size. Billing Cleanup And A/R Recovery is based on what we collect. Compare the work, price, and next step before you choose.