We’ll admit it: Medical coding and billing aren’t the most entertaining parts of addiction treatment.
But without rock solid coding, your claims—and your center—aren’t going to succeed
Your addiction treatment center is only as healthy as its revenue cycle management. At the heart of the revenue cycle is the “Net Days in Accounts Receivable” performance indicator, which—in an ideal world—should be no more than 30 days. The faster you get paid, the easier it is to support a strong cash flow and avoid racking up bad debt.
Working with the top insurance providers in the country is an important part of running an addiction treatment business. Each company handles their billing differently.
Slowly building relationships with employees at each company over time is the “gold standard” approach for managing tricky claims and other sticky billing issues with the top 10 insurance companies for addiction treatment.
About 12% of patients with Medicaid insurance have a substance abuse problem.
If your center isn’t accepting public payer plans—like Medicaid and Medicare—then you’re missing out on a massive pool of potential patients. Still, many centers decide to pass on public payer insurance and only accept private insurance and self-pay patients—and for good reason.
Getting patients sober is a challenging job. Billing for that job is sometimes even harder. Sometimes it feels like the system is designed to be confusing. There are so many codes and one simple error can completely throw off an entire revenue cycle. Understanding how the different types of codes interact with one another is critical to billing success.
“Playing nice” with insurance companies is one of your most important jobs as an addiction treatment provider. Organizations that master the art of interacting with insurance providers reap major rewards in terms of happy patients, strong revenue cycles, confident clinicians, and flawless documentation. Organizations that struggle with “insurance speak” grapple with angry patients, poor cash flow, unmet patient responsibility payments, and wary clinical staff.
Getting insurance companies to fairly reimburse for services rendered is one of the biggest struggles for many addiction treatment providers today. Between an initial verification of benefits, pre-authorizations, concurrent reviews, and even retrospective reviews, it’s easy to get lost in the insurance authorization labyrinth and spend a lot of your organization's time (and money!) fighting with insurance companies.
SOAP (Subjective, Objective, Assessment, and Plan) notes have been the cornerstone of medical documentation since Lawrence Reed introduced the “Problem Oriented Medical Record” in the 1950’s. Before the dawn of SOAP notes, medical practitioners of Reed’s time had no standardized method of record-keeping. Instead, each provider would scribble notes in their own fashion, making insurance reimbursement, coordinated care, and chart review difficult and time-consuming.
You already know your treatment center is providing excellent care, but do you have the numbers to back it up?
Anecdotal evidence is no longer enough to convince prospective clients and their families to trust your center with a life-and-death behavioral health crisis.
Thinking of opening a drug rehab center or sober living house?
Good news—your timing couldn’t be better. Now is a great time to get into this industry and start making a difference in your community!
People in the behavioral health industry are usually passionate about helping others—but they’re not usually passionate about completing paperwork.
Very rarely do we hear our clients utter the words “I love medical billing!”
But the truth is, insurance billing is the lifeline of any behavioral health organization. Do it well, and your business has a chance to succeed. Do it poorly, and you definitely set yourself up for failure.
During an overdose epidemic so large that it is cutting overall life expectancy in the US, you’d think that insurance companies and the healthcare system would be bending over backwards to get people into evidence-based treatment—especially since we have two drugs that are proven to cut the death rate by at least half. In reality, they are doing the opposite. And the barriers they place in the way of treatment are killing people.
IOP stands for Intensive Outpatient. This type of care is used most in the behavioral health industry for the treatment of substance abuse issues. It is also utilized for patients with mental health disorders. Most state licensing departments classify IOP as an outpatient service, requiring an outpatient license. IOP can be 3, 4, or 5 days per week and normally consists of at least 3 hours per day of programming.
A verification of benefits is the first vital piece of admitting a patient to your facility. If they don’t have benefits for the treatment they receive, there will be no reimbursement. There are a number of things that can be found out on a verification call; information about patient responsibility, what services are covered, etc.
To be in-network or not to be? This is a question for which many behavioral healthcare facilities struggle to find an answer. There are so many things to consider before signing any contract, but it can be difficult to know what those things are. Ultimately, it comes down to the choice of the facility decision-makers, but there are a few things to consider during the process of making a decision.