The Key to Accurate Patient Billing and Coding with Opus RCM

The Key to Accurate Patient Billing and Coding with Opus RCM

Maximizing Reimbursements with Robust Clinical Therapy Billing Analytics: The Key to Accurate Patient Billing and Coding with Opus RCM

As the demand for behavioral health services continues to grow and face increasing pressure to maintain financial stability, it is crucial that treatment center providers have a thorough understanding of the reimbursement landscape for patient billing.

This requires access to accurate and up-to-date data insights and analytics reporting through a robust Revenue Cycle Management (RCM) platform. In this blog post, we will explore why having access to this information is so important, share some insights on services to bill, and discuss how data insights can help ensure that behavioral treatment centers receive the highest possible reimbursements.

One of the primary benefits of having robust data insights and analytics reporting through Opus RCM is that it helps treatment center providers understand the reimbursement landscape for their particular clinical therapy. This includes an in-depth analysis of the current payment structures and reimbursement rates and an understanding of the factors that can impact the reimbursement process. This information is critical in having a high level of visibility in helping directors and clinicians make informed decisions about how to optimize their billing and coding processes to maximize reimbursement.

For example, providing both Evaluation and Management E/M and psychotherapy services requires patient care to be significant and separately identifiable. E/M codes apply to visits and services that involve evaluating and managing patient health. Examples of E/M services include office visits, hospital visits, home services, and preventive medicine services.

Medicare, Medicaid, and other third-party payers accept E/M codes on claims that physicians and other qualified healthcare professionals submit to request reimbursement for their professional services. E/M service codes also may be used to bill for outpatient facility services. Facilities and practices may use E/M codes internally, as well, to assist with tracking and analyzing the services they provide.

E/M services are high-volume services. Even small E/M coding mistakes can cause major compliance and payment issues if the errors are repeated on a large number of claims. With necessary elements fulfilled and psychotherapy excluded, an E/M service can stand in as the initial interview, especially if a psychiatric diagnostic evaluation or medical services is conducted at the onset of illness or suspected illness. Such evaluations should be repeated after a 6-month break from treatment due to changes in mental status or admission into an inpatient care facility for further assessment.

If your work involves no medical activities, you can simply use the stand-alone psychotherapy codes by documenting the time spent doing psychotherapy and the number of participants, with a brief summary of addressed psychotherapy issues and the technique used.

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Having clear insights and analytics reporting can also help providers monitor their billing and coding performance over time. This can include tracking key performance metrics such as the number of denied claims, the average length of time to receive payment, and the accuracy of billing and coding practices. By monitoring these metrics, providers can make changes to their billing and coding processes to improve performance and maximize reimbursements. To ensure accurate reporting and reimbursement for these services, schedule a consultation with our experts to be able to view accurate and up-to-date data through Opus RCM analytics reporting tools and dashboard insights.

Finally, having a robust RCM service provider like Opus RCM can help behavioral treatment center providers stay up-to-date on changes to reimbursement policies and regulations. This is critical, as these changes can significantly impact the reimbursement process. By staying informed, providers can proactively make changes to their billing and coding procedures to ensure that they are in compliance with the latest regulations and policies and get the highest reimbursements for services rendered.

In conclusion, when billing clinical therapy, having access to accurate and up-to-date data insights and analytics reporting is critical to maximizing reimbursements. This information helps decision-makers and treatment providers understand the reimbursement landscape, identify billing and coding areas that may contribute to lower reimbursements, and monitor their performance over time. Additionally, by staying informed about changes to reimbursement policies and regulations, providers can proactively make changes to their billing and coding practices to ensure that they receive the highest possible reimbursements.

With Opus RCM revenue analysis, our experts can show you how easy it is to see all coding reimbursements and data through a customized dashboard with clear insights. Schedule a complimentary revenue analysis today to find out how to bill the right codes for the highest reimbursements while staying in line with patient treatment plans toward recovery!

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