How to Choose a Mental Health Billing Company: 10 Questions
To choose a mental health billing company, ask questions that expose how the work really gets done. A polished website tells you little. The answers to the ten questions below tell you a lot. Use them with every company you consider, including us.
How do you choose a mental health billing company?
Start with fit. Does the company work only in behavioral health, or is mental health one line among many? Behavioral health has its own codes, add-on rules and payer quirks. A team that works in it every day spots problems sooner. Then work through the ten questions.
10 questions to ask
- Do you work with my kind of practice? Solo, group, psychotherapist or psychiatrist. Psychiatry adds E/M and add-on codes.
- Will you sign a business associate agreement? Any company that handles patient data for you must. The HHS business associate guidance explains why, and HHS publishes sample agreement provisions. See our HIPAA for billing page.
- What exactly is included? Verification, claims, posting, denials, secondary claims, credentialing. See what a billing service for therapists includes.
- How are you paid? Ask for the structure in writing and what triggers a fee. Read how therapists pay their billing service.
- Who works my account? Ask whether you have a named contact.
- How do you handle denials? Ask for the process, not a promise. See denied claims follow-up and appeals.
- What do I see and how often? Ask for a sample report.
- Do I keep access to my data? Confirm you can see your claims and take your records if you leave.
- What does the contract say about ending it? Check notice periods and what happens to open claims.
- How do you stay compliant? The OIG published compliance guidance for third-party billing companies in 1998. It is voluntary, but it says responsibilities should be written into the contract.
Private payers vs Medicare vs Medicaid
Private payers. Ask how the company tracks each plan’s rules and changes.
Medicare. Ask how it handles Medicare enrollment and claims. See our Medicare behavioral health billing guide.
Medicaid. Ask which states it works in. State Medicaid rules differ, so a company strong in one state may not know another.
Red flags
- Guaranteed results or collection rates.
- No written agreement on responsibilities.
- Unwillingness to sign a business associate agreement.
- No way to see your own claim data.
Next steps
Compare the answers side by side. For more context, read mental health billing for private practice, part-time biller vs billing service, outsourcing therapy billing and how medical billing services get paid. See our services and who we serve.
Frequently asked questions
What should a billing company agreement include?
It should name the services, the responsibilities of each side, how fees are calculated, how to end the relationship and how data is handled. Have your attorney review it.
Do I need a business associate agreement?
If a company handles protected health information for you, HIPAA generally requires one. Ask for it before sharing any patient data.
Is a company that bills for all specialties a bad choice?
Not necessarily, but ask how deep its behavioral health experience is, since codes and payer rules differ from other specialties.
How long does it take to switch billing companies?
It depends on your open claims and the contract terms. Ask each company how it handles a transition and who pays for work on older claims.
Write your answers down. When you choose a mental health billing company, compare the written answers, not the sales pitch. Before you choose a mental health billing company, ask for a sample report and a sample agreement.
Remember that you will work with this company for a long time, so it pays to choose a mental health billing company slowly. Many practices that choose a mental health billing company in a hurry end up switching again.
Where MCM South Medical Billing Service Works
MCM South Medical Billing Service, LLC works with psychotherapists and psychiatrists in our ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.
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