Billing, utilization review, credentialing, and denial management for substance use and mental health treatment programs at every level of care. Senior staff on every account, no offshore queues, and a direct line to the people doing the work.
Senior staff on every account
A direct line to the people doing the work
Senior staff on every account
No offshore queues
A direct line to the people doing the work
No offshore queues
Your beds are full and your clinical team is doing the work. Then the payer approves three days of detox when the patient needed five. A concurrent review comes back saying the notes do not support residential level of care. A new therapist waits months on credentialing, and every session she runs goes unbilled. A denial sits for 90 days because the vendor resubmitted the same claim and moved on to the next one.
None of that shows up on a claims report until the cash is already late. And while the paperwork catches up, patients wait for care their insurance should cover.
A billing company that only files claims cannot fix any of it, because the problems start upstream. They start in authorizations, documentation, credentialing, and contracts. That is where we work.
Billing, utilization review, credentialing, and denials are one job. When separate companies run each piece, nobody owns the outcome, and every handoff is a place for revenue to go missing. We run the full cycle so the work connects.
Claim submission, payment posting, follow-up, and reporting for every level of care you deliver, from detox through outpatient.
Admissions and concurrent reviews built on documentation that meets payer medical necessity criteria, so your patients get the days they need authorized.
Documented, case-specific appeals for every denial, plus root-cause work so repeat denials stop.
We bill what was delivered, documented, and covered, and we help your program hold that standard through payer audits.
Here is what happens when a denial lands on our desk. We do not rebill it automatically, and we do not send a duplicate while the original is still pending, because payers flag both. A senior team member reads the denial reason pulls the clinical record and identifies exactly what the payer says is missing. Then we write an appeal for that payer and that case, attach the documentation that answers the objection, and track it until it resolves.
We also do not wait for denials to find us. Our team checks payer portals within three days of every claim submission and keeps checking until the claim adjudicated. When a problem is forming we see it early and work it with the payer before it turns into aging A/R.
When a denial pattern repeats, we trace it back to its source, whether that is a documentation gap, a credentialing lapse, or a contract term. Then we fix the source with your team so the same denial stops coming back.
The first conversation is about your program, not our process. We look at where your revenue actually stands: open authorizations, denial history, credentialing status, payer contracts, and the documentation your team produces today. Then we tell you plainly what will get paid, what will get denied, and what has to change.
From there, we partner together on the fix. Some of the work is ours to run, like billing, utilization review, follow-up, and appeals. Some of it belongs to your clinical and leadership team, and we work alongside them until the changes hold. When a payer audit letter arrives, you do not forward it and wait. We pull the records together, prepare the response with you, and stay in the room through the review.
You get reporting you can actually read, and you can always reach the person running your account. Susan says it simply: it takes a village. Your program succeeds when all of us do our part.
Capture RCM works only with behavioral health and substance use disorder treatment programs, across every level of care. That includes detox, residential, partial hospitalization, intensive outpatient, and outpatient services, along with dual-diagnosis programs treating co-occurring mental health and substance use disorders.
That focus matters. Behavioral health authorizations follow their own rules, and payers review them hard. A team that also bills for primary care and labs will not know those rules the way we do.
Our founder, Susan Wenner, spent three decades in healthcare billing inside large corporate operations, across every major line of service. She chose behavioral health and SUD on purpose, because that is where gaps in the revenue cycle hurt patients most.
Every person on our team brings at least ten years of experience. We do not run your account through AI bots, and we do not send your work to offshore queues. When you call, you reach someone who has already sat through the payer call, the denial pile, and the “why isn’t this authorized” meeting, and who still takes the details personally.
