Avoiding Substance Abuse Billing Mistakes | Patient Focus


23 Jul Avoiding Substance Abuse Billing Mistakes | Patient Focus

The patient’s well-being should be the goal of a dedicated substance abuse billing staff.

An important part of providing the best substance abuse billing for the patient is to remember the patient is actually the focus, not the process. All too often, the process is mechanized and the human element is lost. Not all issues that arise during the billing process are directly related to the billing company’s responsibilities, but the company should be aware of common industry problems to stay competitive and think on its feet.

A few problems may arise by lack of focus on the patient, namely,  receiving the wrong diagnosis information and also neglecting to have the correct patient information.  Many patients have diverse treatment scenarios, such as transferring drug rehab facilities, changing insurance coverage, or switching between multiple counselors and therapists. The patient’s situation can be understood by a substance abuse and behavioral health billing specialist by focusing on these issues in order to maintain accuracy in a confusing coverage environment.

The Elevated Billing Solution

Elevated Billing Solutions stays a step ahead in substance abuse billing by only employing individuals who are passionate about relentless advocacy for patients. This is the most important responsibility for all of the team members. Over the years, Elevated has refined their process to make it simpler for their clients to get the billing done properly – such as creating a custom template for therapists or clinicians as  part of the Pre-Authorization Review.

Communication is How to Get There

The main cause of communication problems comes from not asking the right questions to the insurance company on the client’s behalf. Insurance carriers are not on the same side as the patient and the biller. These communication problems between the insurance company and the billing specialist can cause inefficiencies, slow down the billing process, and even lead to a lack of quality care for the patient.

Assuming a patient has the ability to take advantage of benefits can be a shortfall  for medical billing companies. One such issue could be the insurance company quoting the wrong network benefits, creating false boundaries to care, or payment of an inaccurate deductible. Anticipating such problems, making sure they’re handled appropriately, and following up on them, is key.

Another issue that may arise comes from a billing company that does not double check the patient’s insurance benefits. It’s important to make sure a patient’s eligibility is still current and updated, if it has been entered in the system at a previous date. Sometimes the primary and secondary insurance policies are not updated with the right information, causing the patient havoc down the road. Especially with constantly changing healthcare laws, it’s important to know what new legislation means for the patient and act accordingly. Partnering with a billing specialist that has great communication with the insurance company also prevents these mishaps.

Even medical coding errors, which are common, can happen to due communication issues. Duplicate and wrongful billing mistakes are hazards of the industry and happen mostly because of human error.  However, these errors can be minimized by making sure messages and codes are received from the therapists with accuracy.

The Elevated Billing Solution

Elevated maintains communication with insurance companies, treatment centers, and therapists by following a strict recipe for success. In the Elevated recipe, 75% of the substance abuse billing steps are communication based. That recipe serves to verify accuracy of quotes, retain proper documentation, analyze the policy, and work closely with the clinical staff of the patient. Ultimately, this allows the best possible outcome for the patients’ long-term sobriety, revenue growth for the treatment facility, and builds a sustainable billing department for long-term success.

If you have any questions about substance abuse and behavioral health billing, feel free to contact an Elevated Billing Solutions specialist.

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