Mental and Behavioral Health Providers

Mental and behavioral health providers have specific billing and reimbursement needs that can be addressed through RCM solutions.

Mental and Behavioral Health Providers

Since the onset of the COVID-19 pandemic, there has been a significant surge in demand for behavioral and mental health services. Telemedicine emerged as a vital platform for providers to deliver care to quarantined patients virtually, leading to an increased adoption of behavioral and mental health services among healthcare professionals. However, to receive reimbursement for these services, providers must undergo proper credentialing and contracting.

Behavioral and mental health providers often need to enroll with distinct networks compared to medical providers. For instance, United Behavioral Health has separated from United HealthCare for behavioral and mental health providers, a distinction that many providers may not initially recognize. TriumpHealth boasts extensive experience with these networks, having assisted numerous providers in enrolling in their desired behavioral health plans.

Upon submission of the initial credentialing application to desired payers, providers undergo a verification process. During this stage, payers examine the provider’s education, training, licensure, and professional experience to ensure compliance with accrediting organizations, insurance companies, and regulatory agencies. Credentialing is essential for mental health providers to participate in insurance networks and bill for services rendered, however it is only the first step.

Provider enrollment involves contracting the now-credentialed mental health provider into an insurance or healthcare network. Both credentialing and enrollment are critical for mental and behavioral health providers, enabling them to join insurance networks, expand their patient base, and deliver high-quality care. Patients also benefit from these processes, gaining access to mental health services from qualified providers covered by their insurance plans. Once providers’ credentials are approved and they are contracted with the payer, they can commence providing services to patients and billing insurance providers accordingly.

Additionally, TriumpHealth offers comprehensive medical billing services tailored specifically for mental and behavioral health providers. By leveraging our expertise in revenue cycle management, we can optimize reimbursement, streamline administrative processes, and ensure financial success for your practice.

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