Monthly Billing Checklist for Therapists: 12 Things to Review
A monthly billing checklist keeps small problems from becoming lost revenue. Once a month, you look at what was billed, what was paid and what is stuck. Twelve short checks cover most of what goes wrong in a private practice. Use them yourself or hand them to the person who manages your billing.
Why a monthly billing checklist matters
Most billing losses are quiet. A rejected claim sits unseen, a secondary claim never goes out, a payer shorts a payment. A monthly billing checklist forces a regular look. It also gives you the numbers behind the behavioral health revenue cycle, so you can see where money slows down.
The 12 best checks on your monthly billing checklist
Before claims go out
1. Compare your appointments to your billed sessions so no completed visit is left unbilled. 2. Review new clients for complete insurance details, as covered in eligibility verification. 3. Confirm that notes are signed for every billed session.
After claims go out
4. Review rejected claims and fix them the same week. 5. Review denied claims and decide whether to correct, resubmit or appeal. See denied and rejected claim follow-up. 6. Look at unpaid claims by age and chase the oldest first. 7. Check that every claim with a second plan has gone to that plan. See secondary claims.
Payments and balances
8. Match deposits to remittances, as explained in electronic remittance advice. 9. Review client balances and send statements. 10. Look for underpayments against your contracted rates.
Setup and compliance
11. Check credentialing and DataSpring re-attestation dates, plus license renewals. 12. Note payer policy changes, new codes or fee schedule updates, such as the Medicare fee schedules.
Private payers vs Medicare vs Medicaid
Private payers
Keep a list of each payer’s filing limit, appeal limit and contact route. Limits come from each contract.
Medicare
Medicare publishes fee schedules and filing rules. See Medicare behavioral health billing.
Medicaid
State agencies and managed care plans set their own rules and update them on their own schedules. They vary by state. See state billing guides and Medicaid managed care.
Make your monthly billing checklist a habit
Pick a fixed day, such as the first business day of the month. Keep one sheet where you log what you found and what you fixed. If the monthly billing checklist feels like a second job, that is a signal. Read signs it is time to outsource billing and the hand-off checklist. You can also compare what a billing service includes.
Common mistakes the checklist catches
The checklist is built to catch the issues in billing mistakes therapists make before they grow. Running the monthly billing checklist every month also shows trends, such as one payer that denies the same code again and again.
Key takeaways
Review unbilled sessions, rejections, denials, aging, secondary claims, payments, balances and credentialing dates once a month. A short monthly billing checklist protects cash flow.
Frequently asked questions
How long should a monthly billing review take?
It depends on your volume. A solo practice can often do it in one focused session.
What is the most important check?
Rejected and denied claims, because they stop payment until someone acts.
Should I review billing weekly instead?
Weekly claim checks help. Use the monthly list for the full picture.
Who can run the checklist?
You, a staff member or a billing service, as long as someone owns it.
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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