Got low reimbursement rates?

So many providers in the addiction treatment community tell us that one of the biggest struggles in the industry is battling insurance companies for reimbursement.

Despite so-called “Parity Act” laws, insurance companies remain reluctant to reimburse out-of-network providers and frequently create billing hassles to dissuade addiction treatment centers from pursuing claims to the fullest. As bad actors in the industry innovate more and more creative ways to perpetrate insurance fraud, insurance providers have become even more reluctant to pay for services rendered, often requesting a burdensome level of documentation to support claims.

Despite this dismal insurance reimbursement landscape, there are many steps your organization can take to raise your reimbursement rates and get the insurance money you deserve.

Today, let’s look at the top 4 reasons your addiction treatment center isn’t getting paid—and what you can do to fix it.

Addiction Treatment Insurance Reimbursement Problem #1: Abandoned Claims

Too often, addiction treatment centers’ billing departments run into a billing roadblock —like a medical records request or a reimbursement denial—and simply give up.

Perhaps it’s due to employee turnover, chronic understaffing of the billing department, or simple human error. Other times, the oversight is routine and it’s due to an incompetent third party billing service.

Whatever the cause for these abandoned claims, it’s important to take the time to pursue each claim until your center is reimbursed or all appeals options are exhausted.

Abandoned Claims: The BehaveHealth Difference

For users of BehaveHealth’s all-in-one cloud-based addiction treatment management system with built-in billing service, abandoned claims are a thing of the past.

Our team works to automatically correct missing or inaccurate information within your claims.

Next, we check insurance plans for coverage and limits, identify payer processing errors and gather all the documentation necessary to support and submit a successful claims appeal.

You’re kept in the loop during the process with regular updates to each claim’s status right in the billing dashboard.

Addiction Treatment Insurance Reimbursement Problem #2: Inefficient Workflows

Inefficient workflows are, unfortunately, very common in addiction treatment billing departments.

This can mean a lot of things depending on the organization, but the four most common problems we see are:

1. An over-reliance on human efforts (inviting human error)

2. Data entry errors due to clunky spreadsheet systems

3. A lack of integration between an organization’s EHR and billing department

4. Cumbersome medical records requests

These four points of inefficiency can reduce your insurance billing department to a slow crawl and reduce reimbursement rates significantly.

Workflow Inefficiencies: The BehaveHealth Difference

At BehaveHealth, we have eliminated all four of these workflow sticking points.

Our all-in-one cloud-based system eliminates human error as much as possible by linking billing activities directly to a patient’s EHR. We always bill for exactly what services were provided.

Our EHR system is simple to use and fool-proof—it won’t allow data entry errors or incomplete documentation to pass through undetected.

Finally, our medical records request is seamlessly built in to the system, making office-to-office transfer of records quick and painless.

Addiction Treatment Insurance Reimbursement Problem #3: Workflow Bottlenecks

At a lot of addiction treatment centers, the “billing department” is made up of only a handful of people—or even one person.

If there is any staffing disruption—say, a staff member goes on leave or is let go—the consequences of their absence is felt throughout the organization.

If accounts receivable is left unattended, even for a short period of time, the workflow can spiral out of control very quickly.

Workflow Bottlenecks: The BehaveHealth Difference

At BehaveHealth, we eliminate workflow bottlenecks by taking the pressure off of individuals on your staff. Our team of billing specialists is always monitoring your revenue cycle management workflow to assure that everything is running smoothly and on time.

Your organization no longer falls behind in the revenue cycle and experience cash flow issues because we complete all appeals immediately and never allow any claim to slip through the cracks.

Addiction Treatment Insurance Reimbursement Problem #4: Inadequate Follow-up for Patient Responsibility Payments

Collecting patient responsibility payments has always been tough.

That said, as insurance companies increasingly punish out-of-network providers by paying reimbursements directly to patients, the headache of collecting patient responsibility payments is becoming too much to bear for many addiction treatment billing departments.

Frequently, outreach departments are one of the first units to be eliminated in budget cuts.

With no one left to chase after patient responsibility payments, many of these bills go uncollected at addiction treatment centers across the country.  

Inadequate Follow-up for Patient Responsibility Payments: The BehaveHealth Difference

At BehaveHealth, we make sure your center gets paid, whether that’s through the insurance company or through the patient themself.

We send persistent, professional emails and letters to patients and alumni to remind them of their patient responsibility payments and create urgency around payment remittance.

We don’t stop until your center is paid.

Want to Get Serious About Raising your Insurance Reimbursement Rates?

Why not try our free trial today?

Come see why BehaveHealth users love doing insurance billing with us.