The US government recently reported that millions of health records are breached every year. For behavioral health organizations, each breach translates into massive fines for violations of the Health Insurance Portability and Accountability Act (HIPAA) laws.
HIPAA fines, which range from $100 to $50,000 per record, can easily bankrupt an organization.
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.
The newly enacted SUPPORT Act’s wide-ranging provisions take aim at the entire healthcare continuum, including providers, who will be on the front lines of change as the new law takes effect. The law includes amendments to Medicare and Medicaid, and changes affecting program integrity and transparency reporting of provider payments by drug and device manufacturers and the disposal of unused medication.
Accreditation is an important piece of the behavioral health industry puzzle. Treatment Centers should seek accreditation as soon as they can for many reasons. While most insurance payers don’t require Treatment Centers to be accredited, some payers have already made the shift to requiring accreditation before they will pay for the service rendered. Treatment Centers can choose accreditation at the state level through CARF. They can also opt to become accredited through JCAHO, which is accreditation at the national level.
…Last year, according to a preliminary estimate from the Centers for Disease Control and Prevention, 72,000 lives were lost to overdoses. That’s 197 people dying every day — more than enough to fill a Boeing 737 passenger jet. It’s an increase of more than 6 percent over 2016.
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.