Mental health & substance use billing at scale

Enterprise Behavioral Health Billing Services

Carve-out routing, authorization tracking, and telehealth compliance for behavioral health networks and multi-site treatment providers.

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Network-Wide
Carve-Out Routing Accuracy
48h
Auth Turnaround Target
Multi-State
Telehealth Compliance Managed

Behavioral health billing gets more complex, not less, at scale — more MBHO carve-outs to route correctly, more authorization limits to track across more patients, more telehealth compliance rules across more states. We bring the systems to manage that complexity across an entire network of providers and locations.

Common Challenges

Where behavioral health networks lose revenue

Carve-out routing errors multiply across a provider network

When a network bills the wrong MBHO entity, it's not one denied claim — it's a systemic pattern across every provider seeing that payer's members, until someone catches it network-wide.

Authorization limit tracking at volume requires automation

Manually tracking session limits across hundreds of patients and multiple payers doesn't scale. Networks need systematic tracking that flags renewals before limits are hit, across the entire patient panel.

Multi-state telehealth compliance is a moving target

Networks operating across state lines face different telehealth licensure and billing rules in each state, and those rules change frequently — compliance has to be actively managed, not assumed.

What's Included

Behavioral Health.
Done right, at scale.

Specialty-specific coding expertise backed by a dedicated implementation team and full transparency through your client portal.

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Network-wide MBHO carve-out identification and correct-entity billing
Systematic authorization limit tracking and renewal alerts across the full patient panel
Multi-state telehealth billing compliance — POS codes, modifiers, licensure coordination
Credentialing with Optum Behavioral Health, Evernorth, Magellan, and Beacon at network scale
Parity violation identification and documentation across the network
Network-level denial analysis by payer, site, and denial reason

Ready to get started?

Free revenue cycle assessment — we'll show you exactly where the gaps are and what it would take to fix them.

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