Are you wondering about medical billing for psychologists? Read on to learn everything you need to know.
The difference between the presentation of a business and the daily workings rarely coincide. Much like people, businesses are often more complicated than they appear. Psychologists know that the closer the facade and the substance align, the better.
The best way for a business to function is by compartmentalizing the tasks into discrete units. Again, this isn’t dissimilar to how people function. All the parts work best when they get specialized treatment and are none with purpose and distinction.
Medical billing benefits from this same mentality. Why fracture your focus when the task can be outsourced to those more capable of doing the job right.
The outsourcing industry sees dramatic growth in several sectors due to its adaptability. A medical billing company provides singular expertise to a field of shifting difficulties.
Running a psychologists practice requires a practitioner to keep the lights on and the office stable. This means charging an amount commiserate with the skill and ability of the professional(s) involved.
The problem with billing is that it doesn’t typically happen at the time of purchase. Many consumers take for granted the way that retail businesses work differently to service industries.
Mental health billing follows many of the same parameters as other health billing. We’ll outline those issues here and explain the mental health world’s specifics next.
Timeliness is the principle reason that medical billing services have started turning to out-of-house providers. It takes a lot of effort to make certain that billing is getting done even before payment difficulties enter the picture.
Dedicated staff and specific software are needed to provide proper billing. The turn around on drawing up paperwork creates troubling gaps for some patients who need to budget.
The practitioner needs to calculate for all of the resources used. Finally, a consistent timeline for reimbursement from insurance needs to be established.
Hiring a billing professional to sit in the office requires that they have space. This job is often bundled with other responsibilities for office workers or reception personnel. It is taxing and splits the skillset of the person most patients interact with.
A bill that gets lost hurts both the patient and the practice in terms of worry and stress of follow-up communication. Running medical billing through a professional outsourced site frees up time and money in-office.
Understanding the rules surrounding insurance claims isn’t easy. Questions of what is and is not covered start the list. From there you also need to know how many services can be covered. You also need to know the pitfalls that could lead to interruptions in providing services.
Medical billing and insurance interaction isn’t exactly the focus of mental health professionals. Professional organizations offer some advice on these topics. However, taking on the ever-changing regulations of insurance is a full-time gig.
Chief among the problems with insurance billing are questions concerning what can and cannot be billed. Itemization of services may create issues in which one service is cover3ed but another is not.
Part of this comes from definitions of ‘service’. The other part comes from a legitimate interest in avoiding double billing for patients.
Patients also rarely understand the behind the scenes problems that change to their own policies or providers can create. Any change can cause medical billing software to throw up red flags which delay processing. This doesn’t help the patient to receive the best care.
Specifics for Psychologists
Two major issues affect medical billing services for psychologists. These issues don’t appear in other practices. These include the tenuous concept of mental health parity laws and the stigma of mental health.
Parity in Mental Health
Mental health gets overlooked or given complicated runarounds by insurance. This, despite the prevailing notion that health insurance covers health in general. Dental insurance being separate is somehow a given.
One of the more common ways that mental health lacks parity under the law is in the existence of ‘provider networks’. These networks exist to allow healthcare companies to negotiate with insurance companies. They broker deals for their areas and patients.
In the past, mental health services have been left out of these groups. This creates defacto out of network issues for patients seeking mental health services.
Since 2008 rules have been established to address this. As you might expect, 10 years is a small time to get complicated bureaucratic systems to catch up in a way that is seamless for the consumer.
Costs of services between physical and mental health leave gaps. More often physical services are subject to itemized bills. This is where insurance concepts run into confusing difficulties.
A general services clinic may only charge a small co-pay according to insurance. They will then charge extra for medications, tests, tools, and etc. A mental health office rarely has more than one item to charge for.
Copay charges are frequently different between different types of medical offices. This happens because of minimums and maximums that can be charged. A general clinic will have a lower co-pay because they see more patients.
Mental health workers rely on established time frames. This favors quality over quantity of patients. A maximum co-pay is, therefore, more common than the minimum.
Unfortunately, mental health services still face adversity and stigma. This can make billing issues an even bigger pain for patients. Delays in the reimbursement period and complications from insurance can put undue stress on them.
A person seeking help with an issue is less likely to continue to seek whelp if getting that help becomes too difficult.
Smoothing out the billing and insurance recouping process helps provide patients with a sense of safety and security. This, in turn, helps the patient to engage more fully with treatment and be less resistant to thoughts of longer-term care.
The Bottom Line
Plenty of options exist for medical billing, this can leave you looking for more information and updates. We have a whole roster of posts about the nuances and changes going on in billing for psychologists. We also have information on other types of medical billing.
Author: Mike Cynar
Mike Cynar brings buyers and sellers together by producing reviews and creating non biased webpages allowing users to share their experiences on various products and services. He and his staff write informative articles related to the medical field, legal, and other small business industries.