As the opioid epidemic continues to rise, some behavioral health and addiction treatment providers are experiencing the effects of an increased patient load, increased regulations, and technological lag. With all of these, one aspect most affected is billing.
Providers may bill and process claims in-house or through a third party biller, through software or even using a spreadsheet. But in this article we’ll illustrate how technology can serve specialized billing—specifically in an all-in-one system. We believe these three features are necessary components in billing/RCM software for behavioral healthcare and addiction treatment providers. And more than that, we believe they will make your jobs easier.
Whether you handle billing in-house or through a third party biller, you should consider an EHR/RCM solution that has these features.
1. Required Documents and Billing checklist all in one.
Human error is the number one cause of rejected claims. Having an integrated billing software that is simple to use is critical. Clean claim submission in the high 90s should be your goal. Knowing if every dollar of service provided was accurately billed and reimbursed is hard to do if you are using an outside billing company that fails to provide timely reports. Billing for “low hanging fruit” is easy. Getting paid for all services provided is a skill that may best be delivered by an in-house billing staff.
There is value in integrating clinical and medical documentation and billing into the same system. Doing so eliminates the need for providers to store documents on their computer. Documents establishing medical necessity are easily selected in the patient’s eChart, combined and faxed from one system to any payer. It’s one seamless solution.
2. Point-and-click simplicity.
Having a point and click system, that color codes green, yellow, red to guide your billers will speed clean claim submission and reimbursement. Being trained on how to bill efficiently and timely on a new system is invaluable.
A Chargemaster and Business Rules Engine take the human element out of reviewing claims, bypassing the possibility for error. The result is a faster reimbursement rate.
3. Presets and autofill.
Building your preset fee schedules and payer requirements, reducing human input and auto-filling of claims data is the benefit of an integrated solution.
Having all of the documentation that a payer may require in the same system that you bill in, saves time and money. Eliminating manual processes such as excel spreadsheets, census reports, that get faxed or emailed protects and supports better HIPAA compliance and assures that all claims are processed timely.
In behavioral healthcare, getting reimbursed quickly and efficiently is crucial. Our all-in-one solution AZZLY Rize empowers treatment centers by integrating billing and claims with the entire admissions, clinical and medical best practices to support medical necessity. If you did not document, it did not happen. Reduce the risk of a chargeback.