Psychiatry Medical Billing – Overview
Billing for psychiatric services differs vastly from conventional medical billing practices. Certain variables are inherent to offering psychiatric health treatments.
Having an in-depth knowledge of medical coding is essential for psychiatry billing services.
You should also know how to check patient insurance and use the correct payer forms. The best way to go about this is to always verify benefits, keep copies of key information, take notes when speaking with payers and start the billing process as soon as possible.
Steps Followed By Psychiatry Medical Billing
These are the standard steps followed for psychiatry billing services:
1 – Know the difference between CPT and ICD-10 codes
Medical and psychiatry billing services use ICD-10 (International Classification of Diseases, 10th update) and CPT (Current Procedural Terminology) codes.
The CPT codes are more important as they denote the treatment process. Patients cannot be billed for diagnosis. However, you can still charge them for treatment services.
There are over 120,000 codes in the ICD-10 book. The CPT format has even more codes. However, psychiatry billing services usually require using the codes starting with the digit “9”. These are mostly five-digit courses.
These codes are assigned to mental health testing, assessment, psychiatric evaluation, case management, and even telehealth. Some telehealth codes may begin with a “G” instead of “9”.
Also, the length of patient treatment changes the CPT codes to be used too. It makes psychiatry medical billing easier if you use the proper codes for your services.
2 – Get to know the E/M and psychiatry evaluation codes
Most commonly used CPT codes fall into two distinct categories:
- E/M codes – These codes are helpful when evaluating a new patient. Every E/M code requires three documents. You will need to enter the code of the patient’s history, examination, and medical decisions made to treat the patient.
- Psychiatric evaluation – In case the patient is also provided with psychiatry services during psychotherapy, then these codes need to be entered individually.
3 – Check patient’s insurance cover
Once you know ICD-10, CPT, and E/M codes you can start the billing process. The first step for this is verification of benefits (VOB) for every patient before they visit. You can obtain a copy of their insurance card for this.
Next, you will need to log in to the insurance company’s portal and check if the patient’s insurance plan covers psychiatry healthcare services. You can also call the insurance company directly if they do not have an online portal.
4 – Know the billing format to use
You would become familiar with Form HCFA if you work in psychiatry medical billing services. In this, the psychiatrist will use CMS-1500 while front-office staff will use the UB-04 form.
Regardless, you will need to keep your National Provider Identifier (NPI) and Tax Identification Number (TIN) handy.
You should also familiarize yourself with the type of information required to be entered in different sections of the form.
4 Best Psychiatry Medical Billing Practices
Let’s check out some of the best psychiatry medical billing practices you can employ in your daily work life as a medical billing and coding professional:
1 – Always check the VOB
Verification of benefits (VOB) is extremely essential. Checking the patient’s insurance benefits may help save hours of work later on. This helps you to know whether the patient’s insurance plan covers the cost of psychiatry health services or not.
2 – Create and save insurance card copies
The data on the patient’s insurance card is vital for accurate psychiatry medical billing services. This information will show how to receive payments for your services.
Error in insurance card details may result in delayed receipt of bill payments from insurance companies. Hence, make sure to save multiple copies of every patient’s insurance card on your system.
3 – Collect vast information
There’s no such thing as too much information when it comes to psychiatry medical billing services. Having abundant facts and details makes billing easier and more efficient.
4 – Never delay the billing process
The billing process can often become frustrating. However, the sooner you start the billing process, the sooner you will get paid.
Psychiatry medical billing services are incredibly important. Certified professional medical billers and coders need to be well-versed with the ICD-10, CPT and E/M codes.
Always be diligent when entering any new detail or information in the billing software. This way, you can avoid calculation errors and ensure prompt receipt of psychiatry medical bills from patients.