10 Reasons for Third-Party Billing

10 Reasons for Third-Party Billing

Mental and behavioral healthcare today is continuing to grow in need. Because of this need, the addition of a third-party billing company is essential.  Mental health care and substance abuse treatment are all at the mercy of being completely educated and knowing the ins and outs of compliance at the federal level.

Mental health and behavioral health substance abuse practitioners are looking to gain support through joining groups versus staying in their solo practices.  Because of this shift, the Affordable Care Act is allowing for that shift through mandating mental health benefits and insurance coverage. Also available is The Mental Health Parity and Addiction Equity Act, requiring private and public insurers to cover mental health needs at the same level as medical conditions.

However, the idea of therapists, especially, moving into an interdisciplinary practice where somebody else is taking care of their billing can be frightening.

There are several reasons why using a third-party billing company is much less of a risk to one’s practice. A third-party medical billing or behavioral health and mental health billing company can provide crucial services that will provide protected financial stability and longevity for your practice.

What Are the Benefits of a Third-Party Billing Company?

Here are 10 Reasons for third-party medical billing:

  1. Federal Compliance
  2. Educational and Training Requirements
  3. Financial Liability
  4. Quality Assurance
  5. Ambiguity in Provider’s Paperwork
  6. Identifying & Reporting Credit Issues
  7. Protection From Duplicate Billings
  8. Revenue Enhancement
  9. Billing Process Organization
  10. Focus on Core Competencies

Federal Compliance

Federal law requires compliance through established policies and procedures for billing companies. Also required are Standards of Conduct which includes a commitment to compliance to requirements.  This requires an addiction treatment facility to not only hire and train internal staff on these policies but to also make sure they stay compliant.

Educational and Training Requirements

Educational and training requirements of personnel providing billing and coding procedures are essential.  Your already busy clinical team members (highly paid therapists and medical personnel) would need to continue an education that is not within their professional field. This can be expensive and costly, not to mention time-consuming, for behavioral health and substance abuse clinics.

Financial Liability

There is a lot of risk for substance abuse facilities that run their own billing cycles. Because of this, many facilities use a third-party behavioral health medical billing company. This reduces your risk areas of fraud, waste, and abuse are monitored by the third party, including a hotline for folks to report complaints.  Keeping billing in-house opens the drug treatment facility to a variety of liabilities and catastrophic losses.

Quality Assurance

The integrity of a behavioral health billing company’s information system is up to date and held accountably. The quality assurance that goes along with a successfully ran billing department requires call monitoring, compliance auditing, and overall management. The costs involved with this quality assurance can run high. Outsourcing these requirements can save behavioral health clinics money.

Ambiguity in Provider’s Paperwork

Methods to resolve ambiguity in provider’s paperwork are required. A third-party billing company has the lawyer resource to deal with a never-ending stream of appeals from insurance companies that deny every possible claim. Working on denials to be appealed takes a highly skilled professional with experience in working with claims. To clarify, a third-party billing company offers this resource.

Identifying & Reporting Credit Issues

Identifying and reporting credit issues complicates the billing process.  This is another learning curve that addiction rehabs must bear. The cost of having this employee as well as the lost opportunity cost in having an expert right from the start can lose an addiction facility money. Working with a third-party behavioral health billing company reduces this cost to your facility.

Protection From Duplicate Billings

Ensuring protection from duplicate billings involves lots of paperwork, policies, reporting, managing, and compliance.  Because this is time-consuming and costly hourly work by your staff, not having a properly trained staff can cost you money. And we all know, time is money. Working with a third-party billing company that has the experience and skills to do these processes efficiently saves you money. And, gets you to receive payments faster.

Revenue Enhancement

Efficient billing handling is carried out with software. However, upgrading and maintaining this software is costly. Behavioral health clinics can also save a lot of time and money in terms of salaries and office infrastructure through hiring a third-party billing company. With a decline in overhead costs, timely submission of claims, and increased reimbursements, third-party billing will lead you to revenue enhancement.

Billing Process Organization

A well-organized billing process is very important to gain the confidence of patients as well as making your addiction treatment practice efficient. If your behavioral health facility develops a reputation for poor billing practices, you could lose patients and clients. Avoid the problem of inconsistent billing altogether by working with third-party billing companies. The billing company provides an uninterrupted flow of professional billing services, so you can continue to focus on providing patient care.

Focus on Core Competencies

People fear change. Depending on the size and routine of your facility’s in-house billing department, some employees will want to push back against the decision to use a third-party medical billing company. Due to this challenge, we recommend keeping your staff informed of the positive parts of the change will allow you to make this transition easier for your staff. Remind your staff that they can utilize the time they gain back from chasing claims from delinquent accounts, receiving training on complex new coding requirements, or managing a virtual storage system of patient billing data for improving patient care.

Working with a Third-Party Billing Company

When we talk of a third-party medical billing company, it sounds very legalized, and for good reason. Having a dedicated, knowledgeable staff managing this part of your billing will bring you a sense of security. Above all, this billing security is essential to your facility’s financial future. As a result, you can focus on your passion for helping others get and stay healthy. This is why we are here to help you.

Let Synergy Concepts take over your behavioral health billing so that you can focus on your patients. Contact us today.

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