Case Study: Behavioral Health Billing

Posted by Lauren Lau on February 14th, 2021

Type of Practice: Behavioral Health Group

The Challenge:

A successful behavioral health practice approached Medwave to manage their billing process. Up until now, they were performing their own billing in-house using various staff members who had had some formal training. However, they were finding that these staff members were spending an inordinate amount of time with billing, insurance regulations and collections than they were with patients. The process was ugly and it wasn’t streamlined very well.

Additionally, they wanted us to address claim-related glitches that included a lack of follow-up on claims, delays due to coding errors, issues causing claim underpayments or no payments and claims denials due to lack of prior authorizations.

The Response:

At the onset, our billing experts followed up on several of the client’s unpaid, underpaid and denied medical claims. Next, we quickly fixed the client’s problems with insurance companies. We then established a proficient medical billing team that included both medical coding and billing professionals.

The client was satisfied with the way we managed their coding and billing needs and after a month they made the decision to partner with us for full-service behavioral health billing.

The End Results:

• Our medical billing team significantly brought down the client’s average days from 35 to 21 within 6 months.
• We boosted the client’s collection percentage from 48 percent to 65 percent within 6 months.
• By improving their collection ratios, the client was able to benefit from a substantial upgrade in cash flow.
• The client was able to apportion all their time and effort to patient care. Staff were able to concentrate on their healthcare practice rather than dealing with medical coding and billing.
• We were able to maximize the client’s operating efficiency and radically reduce their administrative costs.