Utilization Review in Behavioral Health: Definition, Benefits, and How to Prevent Denials
Prevent Treatment Disruptions with Utilization Review Support When someone is newly diagnosed, they need steadiness: clear next steps, consistent care, and fewer surprises. But when a program is growing fast, that steadiness can get threatened by paperwork bottlenecks—especially around authorizations and continued-stay reviews. That’s where utilization review support can quietly keep the whole plan standing. […]
Where Addiction Treatment Centers Go Wrong With Utilization Review (And How to Fix It)
You’ve got claims stacking up and UR requests bouncing back. You’re chasing peer reviews, hunting down therapists for documentation, and still getting denials for “lack of medical necessity.” If you’re a billing manager stuck trying to untangle the mess, it’s not your fault—and you’re not alone. At most addiction treatment centers, utilization review is the […]
PHP Billing Services: Compliance Pitfalls Every Treatment Center Needs to Know
Your gut says something’s off. Claims are going out, but denials creep back in like clockwork. Auditors? They’re always a few steps away. And the big question that keeps you up at night: Are we actually maximizing reimbursement—or leaving money on the table? This is exactly why treatment centers that run Partial Hospitalization Programs (PHP) […]
9 Billing Challenges for SUD and Mental Health Providers – And How to Overcome Them
Behavioral health billing stands apart from other medical specialties in both its complexity and compliance requirements. Unlike more straightforward medical procedures with clear beginning and end points, mental health and SUD treatment often involves ongoing care episodes, varying session lengths, and multiple providers, all of which create distinct billing challenges. Add to this the intricate […]
Utilization Review in Behavioral Health: How to Maximize Reimbursement
Effective utilization review (UR) is a critical determinant of financial sustainability for behavioral health organizations. As payers intensify their scrutiny of claims and medical necessity requirements evolve, behavioral health providers must optimize their UR processes to secure timely authorizations and protect revenue. Let’s examine how a well-structured utilization review program can streamline reimbursement, reduce denials, […]
Credentialing 101: Why It’s Critical for ABA Providers’ Reimbursement Success
While delivering quality patient care remains the primary focus, ensuring accurate and timely credentialing can mean the difference between quick reimbursement and costly claim denials. For ABA providers, navigating the intricate requirements of insurance panels, state regulations, and healthcare networks demands a thorough understanding of the credentialing process and its impact on revenue cycle management. […]
Avoiding Claim Denials: Best Practices for Mental Health Treatment Providers
Claim denials remain one of the most persistent challenges facing mental health treatment providers, with up to 90% of denials being preventable through improved practices. These denials often lead to delayed payments, increased administrative workload, and compromised cash flow. With complex payer requirements, evolving coding standards, and strict documentation expectations, behavioral health organizations must adopt […]
RCM for SUD Providers: Strategies to Streamline Billing, Credentialing, and Compliance While Minimizing Denials
Substance Use Disorder (SUD) treatment providers operate in an increasingly complex healthcare landscape where effective revenue cycle management (RCM) can mean the difference between thriving and merely surviving. This blog post explores proven strategies that enable providers to optimize their revenue cycle while maintaining focus on their primary mission: Helping patients achieve recovery. Why RCM […]
Optimize Your Behavioral Health Billing with Capture RCM
Are you struggling to manage the complex billing processes for your behavioral health practice? You’re not alone. Many providers find themselves overwhelmed by the intricacies of insurance claims, credentialing, and revenue cycle management. Fortunately, Capture RCM offers a comprehensive solution tailored specifically for behavioral health services. By leveraging cutting-edge technology and industry expertise, you can streamline […]
