Specialties / Behavioral Health / Medical Billing & RCM

Behavioral Health · Medical Billing & RCM

Full-Cycle RCM for Behavioral Health Practices

End-to-end revenue cycle management built around MBHO carve-outs, session limits, and parity-related denial patterns.

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MBHO-Aware
Claims Routing
Full-Cycle
Eligibility to Reporting
94%
Target Clean Claim Rate

Handing over your entire revenue cycle for a behavioral health practice means more than standard coding and claims — it means a partner who already knows which MBHO to bill for which payer, tracks session authorization limits per patient without manual spreadsheets, and understands the parity-related denial patterns unique to mental health and substance use billing. We run your full cycle — eligibility, coding, submission, denial management, and reporting — with that specific expertise built in from day one.

What Matters Here

Why behavioral health needs this differently

Carve-out routing has to be right before a claim is even coded

Getting the payer entity wrong at the front end creates denials no amount of downstream RCM discipline can fix after the fact.

Session-limit tracking is a full-cycle responsibility, not a one-time check

Limits reset, renew, and vary by payer — reporting has to track this on an ongoing basis, not just at intake.

Denial management needs parity-law context

Some behavioral health denials are worth challenging on parity grounds, not just standard appeal templates.

What's Included

Medical Billing & RCM, built for behavioral health.

A dedicated implementation team and full transparency through your client portal — the same standard as everything else we run, tailored to how behavioral health practices actually operate.

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Eligibility verification with correct MBHO/carve-out identification upfront
Behavioral health-specific coding review — session-based CPT codes, add-on codes, telehealth modifiers
Claim submission and clearinghouse management across MBHOs and medical carriers
Session-limit and authorization tracking integrated into claims workflow
Denial management with parity-law awareness for MH/SUD-specific denials
Reporting broken out by payer and carve-out entity, not lumped into one view

More for Behavioral Health

Call Center Support for Behavioral Health Practices

Phone support built for the discretion and crisis-awareness behavioral health calls require — not a generic call center script.

Credentialing for Behavioral Health Providers

Enrollment across the specific MBHOs and payers behavioral health providers actually bill — Optum, Magellan, Beacon, and more.

Back-Office Support for Behavioral Health Practices

Claims processing, denial management, and administrative support built around the volume and sensitivity of behavioral health operations.

Medical Billing & RCM for Other Specialties

Primary Care

Revenue cycle management built around E/M coding accuracy and CCM/AWV capture at high claim volume.

Cardiology

Revenue cycle management built around prior authorization volume, modifier 26 compliance, and device billing.

Multi-Specialty Groups

One revenue cycle operation with the coding depth to handle every specialty under your roof correctly.

Labs & Diagnostics

Revenue cycle management built around PAMA reporting, LCD compliance, and ABN discipline — not standard physician billing.

Ready to get started?

A free revenue cycle assessment — you'll get a written breakdown of where the gaps are, whether or not you move forward with us.

Get a Free Assessment