Why Outsource Your Substance Abuse Billing?

Posted by Lauren Lau on January 17th, 2021

So, you’re determined to outsource your substance abuse billing. That’s a smart move, since you’ll save time and ultimately money. After all, no one gets into the substance abuse field because they want to wade through the insurance industry bureaucracy. No, you became substance abuse specialists because you want to help people.

Nevertheless, maintaining an in-house billing structure is not only expensive, it also prompts administrative tasks and responsibilities that you simply don’t have time for. It’s never been more critical to work smarter and not harder in the substance abuse provider industry.

Your team of substance abuse professionals have a lot on their plates. By outsourcing your billing services, you can reduce your practice’s overhead costs, increase reimbursements, and decrease claim denials and rejections. This can enable a practice like yours to be more proactive, to focus more on your patients’ receiving the proper quality care, rather than spending hours on constructing and interpreting the billing reports.

However, before making the decision, be sure to know what you’re looking for in the right company. Opt for the wrong billing service and you could wind up with problems on top of already challenging issues. Medical billing on its own can be a complex process. However, substance abuse billing can bring on a whole new level of headaches for centers offering services. It comes with its own array of unique challenges. When you take into account the size and available time of office staff compared to other healthcare specialties, substance abuse practitioners are always at a disadvantage matched up to their colleagues in other fields.

That’s why you’ll want to be sure you partner with a company that provides billing services that can be tailored to your specific needs as a substance abuse provider. A firm that will guide your company through the various processes to lower your denials, improve cash flow and help you meet all your financial goals.

There are a variety of questions to pose to the billing firms you’re taking into consideration. You need to delve into each company’s history, reputation, guiding principles and methods and, more importantly, make certain you completely understand what they can and cannot do. Equipped with this knowledge, you’ll reach a more informed decision that will better meet your specific needs.

Here is a series of questions to ask of potential billing service companies and our company’s response to these questions.

What’s your experience with substance abuse billing?

Each industry has a distinct collection of established billing procedures. So be sure that the company you select has a thorough grasp of and the know-how with substance abuse billing procedures, including all addiction billing standards and laws. With our years of experience in the substance abuse treatment arena, we know a thing or two about how to maximize the billing process for substance abuse centers. Accurate and timely billing can dramatically cut the time between billing and payment. Shorter repayment cycles minus hours of extra work for you.

The team at Medwave is committed to keeping apprised of existing coding requirements. We also administer rate negotiations when offered to ensure the maximum reimbursement. Our method is straightforward – you deliver attendance data, and we do the rest.

What’s your team’s level of know-how?

How can we best describe the people who would be accountable for your day-to-day billing actions? How capable are they at their jobs? What qualifications do they possess and are they properly registered and licensed where required in accord with state laws? Inquire about any current training staff is given to stay in tune with changes in healthcare coding and reimbursement policies and procedures.

One of the many advantages in outsourcing your medical billing to us is our expertise in the substance abuse discipline and our pledge to keep you up-to-date on any current or impending regulatory changes. Our team is also well-informed and quick to identify insurance industry trends so they can readily apprise clients of any forthcoming shifts in the insurance world. We acquire documentation to make sure that substance abuse providers are in exact compliance with insurance firms and we deliver customized reports, so each and every client fully understands what’s taking place with their account.

Do you have a thorough understanding of the ICD-10 billing codes for substance abuse billing?

As a substance abuse billing company or in-house billing manager, grasping ICD-10 billing codes is a prerequisite to being successful.

ICD-10 has hundreds of billing codes concerning behavioral healthcare, including substance abuse treatment and, at times, they can be overwhelming. From Medically Supervised Outpatient Withdrawal to Chemical Dependency for Youth Outpatient Clinic, the list can seem endless at times Absent a thorough knowledge of the detailed substance abuse billing codes and procedures, a medical billing coder is, at best, ineffective and at worst, of little value. Costly errors can and will occur, all at your expense.

Here at Medwave, we appreciate the complexities of substance abuse billing codes and retain a knowledgeable team that performs hand-in-hand with both the treatment center and the insurance company. You can depend on us to grasp all the various techniques needed to accurately bill for substance abuse. We also realize the importance of billing the insurance company right the first time, every time. Billing companies familiar with working with treatment centers understand the fine points of how the everyday business is managed. With a focused knowledge of the substance abuse industry, billing providers such as Medwave can help rehab facilities provide the utmost care for patients.

Do you have a thorough understanding of the ICD-10 billing codes for substance abuse billing?

Getting patients sober is a demanding job. Coding and billing for that job is at times even more difficult. At times, it seems as though the system is intended to be mystifying. If there were only one such code for a substance abuse disorder, then it would be simple to constantly pick the correct code. But ICD-10 has thousands of billing codes concerning behavioral healthcare, including substance abuse treatment and, at times, they can be overwhelming. From Medically Supervised Outpatient Withdrawal to Chemical Dependency for Youth Outpatient Clinic, the list seems endless at times. Comprehending how the various types of codes interrelate with one another is essential to billing success.

We get it – nothing is more frustrating than fighting over unpaid claims with the insurance companies because there was a misunderstanding of the proper ICD-10 billing codes. Luckily, this is one of our areas of expertise.

Here at Medwave, we recognize that the quickest way to proper reimbursement is a clean claim. To that end, we appreciate the complexities of substance abuse billing codes and retain a knowledgeable staff that performs hand-in-hand with both your treatment center and the insurance company.

Bottom line: We understand that a grasp of ICD-10 billing codes is a prerequisite to being successful.

Do you handle substance abuse appeals?

You can transfer the task of evaluating bureaucratic denials and resolving how they can be managed – incorporating all the paperwork – to our skilled medical billing company. Our appeals handling resources follow up one hundred percent on all unpaid or underpaid claims. Conserve time and energy by employing our team of experts to spot and fix would-be mistakes in your insurance documents. We routinely deal with the shortfalls of the appeals procedure from beginning to end.


Continuous industry changes, new payer rules, declining reimbursements, tighter margins; the stakes are high, making oversight and accountability crucial. Stop looking back at the end of the month and wondering what happened to your cash flow.

Medwave provides claims and billing results for the substance abuse segment of the healthcare industry. With billing, every addiction treatment center, rehab and / or other substance abuse facilities have their own exact requirements and expectations. With our billing services, the specific and made-to-order “musts” of each and every substance abuse business can be met. Substance abuse is among the most conventional kinds of addiction. It involves a persistent support in drug rehab and a monitoring of clients to nip relapse in the bud and help them remain steadfast in their recovery.

When you partner with us, you’re given our commitment to quality work for every level of care. Our hands-on methods and customizable options make handling your substance abuse billing less hectic and far more effective. Medwave makes sure you focus on what’s of foremost importance – your clients (and their families) and your time.

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Lauren Lau

About the Author

Lauren Lau
Joined: November 22nd, 2019
Articles Posted: 29

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