Monthly Billing Checklist for Therapists: 12 Easy Checks
A monthly billing checklist for therapists is a fixed list of checks you run once a month to see what you billed, what was paid and what is stuck. It catches small problems before they turn into write-offs. This one has twelve checks you or a staff member can run in one sitting.
Why run a monthly billing checklist for therapists
Billing losses hide. A rejected claim sits unseen, a secondary claim never goes out, a payer underpays by a few dollars on every visit. A monthly review shows where money slows down while there is still time to fix it. Pick a fixed day, such as the first business day of the month, and use the same list every time.
Before claims go out: checks 1 to 3
These first three checks of the monthly billing checklist for therapists make sure every completed session becomes a clean claim.
- Appointments to billed sessions. Compare the calendar to the billing log so no completed visit goes unbilled.
- Insurance details. Confirm complete, current coverage for every new patient. The eligibility verification guide shows the steps.
- Signed notes. Confirm a signed note exists for every billed session.
After claims go out: checks 4 to 7
A rejection means the claim never got into the payer’s system. A denial means the payer processed it and did not approve payment as billed. Check both every month.
- Rejections. Fix and resubmit rejected claims in the same week.
- Denials. Decide for each denied claim whether to correct, resubmit or appeal. The CARC and RARC code guide explains the reason codes.
- Aging. Sort unpaid claims by age and chase the oldest first.
- Secondary claims. Confirm every claim for a patient with a second plan went to that plan.
Payments and balances: checks 8 to 10
This part of the monthly billing checklist for therapists ties the money in your bank account back to claims.
- Deposits to remittances. Match each deposit to its electronic remittance advice.
- Client balances. Review balances and send statements. Track your patient collection rate month to month.
- Underpayments. Compare what was paid against your contracted rate. See our guide to underpayments.
Setup and compliance: checks 11 and 12
The last two checks protect your ability to bill at all.
- Credentialing dates. List every payer enrollment, license renewal and profile re-attestation date. CAQH’s provider data tools hold the profile many payers read, so note its re-attestation date as shown in your own account. Our post on insurance credentialing for therapists covers the process.
- Payer changes. Note new payer policies, new codes and fee schedule updates, such as the Medicare rates on CMS’s Physician Fee Schedule page.
What does a monthly billing review look for?
A monthly billing checklist for therapists looks for claims that are missing, rejected, denied, aging, underpaid or unpaid by the patient, plus enrollment dates about to lapse. Record what you found and what you fixed on one sheet. Over several months, the sheet shows trends, such as a payer that keeps denying the same code. Watch your clean claim rate as the headline number.
Rules that change your monthly billing checklist
Your list stays the same, but the deadlines on it depend on who pays. Keep the three payer types in separate columns.
Private payers
Each commercial payer sets its own filing limit, appeal limit and contact route in your contract. Keep a one-page list of them and check the oldest unpaid claim against each limit.
Medicare and Medicaid
For Original Medicare, the provider is generally required by law to file the claim, and Medicare.gov says claims must be filed within 12 months of the date of service unless an exception applies. Medicaid is run by each state and its managed care plans, which set their own deadlines.
State rules
Filing windows, Medicaid managed care plans and appeal rights vary by state. Check your state Medicaid agency, your state insurance department and your payer manuals, and never assume another state’s rule applies.
What to do Monday morning
- Pick your monthly review day and put it on the calendar.
- Copy the twelve checks into one sheet with columns for found, fixed and date.
- Run checks 1 to 3 on last month’s sessions today.
- Name one person who owns the monthly billing checklist for therapists and one backup.
The short version: monthly billing checklist for therapists
A monthly billing checklist for therapists keeps unbilled sessions, rejections, denials, aging claims, underpayments and credentialing dates in view. Run it on a fixed day, log what you fix and keep payer rules in separate columns.
How MCM South helps
MCM South Medical Billing Service, LLC bills exclusively for mental and behavioral health, for psychotherapists and psychiatrists in solo and medium-size practices. We bill out-of-network claims for clients. If the monthly review feels like a second job, ask us what it would take to hand it off.
Keep going
Related reading
Want to hand off the monthly work? We can talk through your practice.
FAQ
How long should a monthly billing review take?
It depends on your claim volume. A solo practice can often finish in one focused session. The first month takes longest because you are setting up the sheet.
What is the most important check?
Rejected and denied claims, because they stop payment until someone acts. Fix rejections the same week and give every denial a decision.
Should I review billing weekly instead?
Weekly claim checks help. Use the monthly list for the full picture of payments, balances and credentialing dates.
Who can run the checklist?
You, a staff member or a billing service, as long as one person owns it and the results are written down.
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.
