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 do 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 are billed based on diagnosis and the treatment services provided, using ICD-10 and CPT codes for treatments.
The ICD-10 book contains over 120,000 codes. Psychiatry billing services usually require using codes starting with the digit “9.” These are mostly five-digit courses.
Psychiatry billing codes for telehealth and other services use a variety of prefixes, not just ‘9’ or ‘G’; the specific codes depend on the service provided.
Also, the length of patient treatment changes the CPT codes to be used. Using the proper codes for your services makes psychiatry medical billing easier.
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. E/M coding requires documentation of the complexity of medical decision-making, the extent of history, and the extent of examination, not necessarily three separate 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
You can start the billing process once you know ICD-10, CPT, and E/M codes. The first step is to verify the benefits (VOB) for every patient before they visit. You can obtain a copy of their insurance card for this.
Next, you must 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 if they do not have an online portal.
4 – Know the billing format to use
The form previously known as HCFA-1500 is now called CMS-1500 and is used for non-institutional provider billing, including psychiatry services. Psychiatrists and other non-institutional providers use the CMS-1500 form for billing, while the UB-04 form is used by institutional providers like hospitals.
Regardless, you should 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 essential. Checking the patient’s insurance benefits may help save hours of work later on. This helps you determine whether the patient’s insurance plan covers the cost of psychiatry health services.
2 – Create and save insurance card copies
The patient’s insurance card data 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, 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 regarding psychiatry medical billing services. Having abundant facts and details makes billing easier and more efficient.
4 – Never delay the billing process
Timeliness in starting the billing process is crucial for efficient revenue cycle management, but accuracy and compliance with payer policies are equally important to ensure payment.
Conclusion
Psychiatry medical billing services are incredibly important. Certified professional medical billers and coders must be well-versed in the ICD-10, CPT and E/M codes.
Always be diligent when entering any new details or information in the billing software. This will avoid calculation errors and ensure prompt receipt of psychiatry medical bills from patients.
See Also
Medical Billing and Coding Salary
How to Apply Medical Billing and Coding Schools
Medical Billing and Coding Grants
What Doctor Makes the Most Money
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