Aurora Mental Health Billing Service: 5 Easy Checks
An Aurora mental health billing service is an outside company that sends insurance claims, posts payments and follows up on denials for therapy and psychiatry practices in Aurora, Colorado. It helps most when a group practice carries many Health First Colorado (Colorado Medicaid) clients alongside commercial plans and Medicare. This guide gives five checks to run, plus the Colorado rules behind them.
Aurora: where a Medicaid-heavy group practice feels the strain
The U.S. Census Bureau’s QuickFacts page for Aurora lists a median household income of $88,368 for 2020 to 2024 in 2024 dollars. That number says nothing about any one client’s coverage. An Aurora mental health billing service should read each client’s card, not the zip code.
Health First Colorado and the regional organizations
Health First Colorado is the state’s Medicaid program. The Department of Health Care Policy and Financing (HCPF) runs it. Its regional organizations page says each Regional Accountable Entity (RAE) helps members with physical and behavioral health care and “contract with their own networks of behavioral health providers.”
That means a Medicaid client’s behavioral health claim may depend on which RAE the client has. The page says the member’s RAE appears on the enrollment letter and on the Medicaid ID card in the Health First Colorado app. Copy it at intake.
The same page lists Colorado Access for Adams, Arapahoe, Denver and Douglas Counties. The page does not say which county a given Aurora client lives in, so check the county on the client’s record before you assume a RAE.
Clients who speak other languages
Many Aurora practices see clients in more than one language. The language of the session does not change the claim. The claim reports the service, the code, the date and the clinician, not the language spoken.
Billing does get harder when intake notes are in two languages or names are spelled several ways. Match the name, date of birth and member ID to the card exactly. Ask the payer in writing before adding any charge tied to an interpreter. MCM South staff include some who are bilingual in Spanish.
Group practices: who is the billing provider
A group practice has a group billing identity and several treating clinicians. Each clinician needs an active record with each payer before that payer will pay for their visits. Our credentialing guide explains the process, and our insurance verification guide covers eligibility checks before the first visit.
Psychiatrists add evaluation and management (E/M) visits, often with a psychotherapy add-on code on the same visit. Read our psychiatry billing services guide for the details. If a clinician is out of network with a plan, see out-of-network billing and ask whether the service bills those claims. MCM South does.
Five checks an Aurora mental health billing service should run
Run these five checks for every new clinician and every new payer, and again when a payer changes its rules.
| Check | What to confirm |
|---|---|
| 1. Clinician enrollment | Each treating clinician’s active record and effective date with each commercial plan, in writing |
| 2. Medicaid and RAE | The client’s Health First Colorado ID and the RAE on the enrollment letter or ID card, copied at intake |
| 3. Member match | Name, date of birth, member ID and plan on the claim match the card on the date of service, whatever the session language |
| 4. Group claim setup | Billing and treating clinician names, NPIs and tax ID match each payer’s file; psychiatry add-on codes sit with the right E/M code |
| 5. Filing clocks | Medicare’s 12 months, plus each commercial contract’s and Medicaid plan’s own window, in writing |
Ask what happens to visits before an effective date. Hold or reschedule those clients until the date is confirmed in writing.
Colorado rules behind an Aurora mental health billing service
Keep private, public and state rules apart. A claim follows the rules of its payer type.
Private payers
Blue Cross and Blue Shield plans are independent licensees, so never apply another state’s plan rules to a Colorado plan. Your contract controls filing windows and appeal steps. Read it with our payer contract compliance guide, and keep payer contacts in our insurance companies contact directory.
Medicare and Medicaid
The Centers for Medicare & Medicaid Services (CMS) lists Novitas Solutions, Inc. as the A/B Medicare Administrative Contractor for Jurisdiction H, which includes Colorado along with Arkansas, Louisiana, Mississippi, New Mexico, Oklahoma and Texas. CMS shows the contract status as in progress, with a June 25, 2026 award announcement. Confirm the current contractor before you enroll or send claims.
Medicare.gov says claims must be filed no later than 12 months after the service, unless an exception applies.
For Medicaid, HCPF’s provider page lists billing manuals and provider enrollment and revalidation. Ask each RAE for its claim filing window and appeal steps in writing.
State rules
Colorado Revised Statutes section 10-16-106.5 says a carrier must pay, deny or settle a clean claim within 30 calendar days of receipt if sent electronically and 45 days if sent any other way. A carrier that misses the deadline owes interest at “ten percent annually.” That page is labeled current through Fall 2025, so confirm the official text before you rely on it.
The statute governs carriers, not Medicaid. Check the plan type to see whether it applies.
The Colorado Division of Insurance says it regulates the insurance industry in Colorado, answers questions and investigates complaints. Its site lists Behavioral Health Providers Resources under Provider Resources. The page does not say how it handles a provider claim dispute, so confirm the route with the payer or your counsel first.
How do I choose an Aurora mental health billing service for a Medicaid-heavy group practice?
Choose an Aurora mental health billing service that can show, for each clinician, which payers are active and from what date, and that bills Medicaid, Medicare and commercial claims by the rules of each.
Ask for your clean claim rate, a list of denial reasons and a sample monthly report. Ask how the service reads remittances, since each denial code points to a fix. Use our guide to CARC and RARC codes to check its answers. Get fee terms in writing, and confirm in writing that the service bills in Colorado.
What to do Monday morning
- List every clinician with each payer’s enrollment status and effective date.
- Add a plan type column to your client list: commercial, Original Medicare, Medicare Advantage or Health First Colorado.
- For each Medicaid client, record the RAE shown on the enrollment letter or ID card.
- Write each payer’s filing window next to its name, using your contract or the plan’s written answer.
- Pull your last remittance and note the top three denial reasons.
- Send the five checks to each Aurora mental health billing service you are considering.
The short version: Aurora mental health billing service
An Aurora mental health billing service earns the job by confirming enrollment before claims go out, matching Medicaid clients to the right RAE, routing Medicare claims to the right contractor and tracking every payer’s clock. Get the answers, reports and fees in writing.
How MCM South helps
MCM South Medical Billing Service, LLC bills exclusively for mental and behavioral health. We work with psychotherapists and psychiatrists in solo and medium-size practices, and we bill out-of-network claims for clients.
Colorado is one of our ten currently served states, and we work with practices there. See who we serve to learn more.
Keep going
Related reading
Ready to hand off the billing side? We can talk through your practice.
FAQ
Does a billing service need to be in Aurora?
No. Claims and reports move electronically, so a service can work with practices in Aurora and across Colorado. Colorado payer knowledge, written terms and clear reporting matter more than an address. Ask the service to confirm in writing that it bills in Colorado.
What is a RAE and why does it matter for billing?
A Regional Accountable Entity (RAE) is a regional organization that helps Health First Colorado members with physical and behavioral health care. Its page says RAEs contract with their own behavioral health provider networks. Copy the member’s RAE at intake.
Does billing change if a client speaks another language?
No. The claim reports the service, code, date and clinician. What changes is the match work: names, dates of birth and member IDs must match the card exactly. Ask the payer in writing before adding any interpreter-related charge.
How long do I have to file Medicare claims?
Medicare.gov says claims must be filed no later than 12 months after the service, unless an exception applies. CMS lists Novitas Solutions, Inc. as the A/B contractor for Jurisdiction H, which includes Colorado.
How fast must a Colorado carrier pay a clean claim?
Colorado Revised Statutes section 10-16-106.5 sets 30 calendar days for an electronic clean claim and 45 days for any other, with ten percent annual interest on late payment. Confirm the official text and the plan type first.
Where MCM South 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. We serve solo and medium-size practices that bill mental and behavioral health. Founder Michael Williams has worked with insurance payers in all 50 states. Browse the state and regional billing guides for rules that vary by state, or see our billing services.
This post is operational guidance for billing, not legal advice. Rules change, so confirm with the payer or your counsel.
