Top Billing Mistakes Telehealth Mental Health Practitioners Make (and How to Avoid Them)
Telehealth has revolutionized mental health care, making therapy more accessible than ever. However, navigating the complexities of billing for telehealth services can be challenging, particularly for group practices. Even small mistakes in billing can lead to denied claims, delayed payments, and unnecessary stress.
In this guide, we’ll highlight the most common telehealth billing mistakes mental health practitioners make and, more importantly, how you can avoid them to ensure your group practice thrives.
1. Misunderstanding Telehealth-Specific Billing Codes
Telehealth billing relies on unique modifiers and place-of-service codes to differentiate between in-person and virtual visits. Failing to use the correct codes can result in rejected claims or lower reimbursements.
How to Avoid It:
- Familiarize yourself with telehealth-specific CPT codes and modifiers like 95, GT, and place-of-service code 10 (telehealth provided in a patient’s home).
- Stay updated on coding changes released by CMS and private insurers.
2. Ignoring Insurance Policies for Telehealth Services
Not all insurers cover telehealth services the same way. Coverage can vary by state, insurance provider, and even plan type. Submitting claims without verifying coverage can lead to unpaid bills.
How to Avoid It:
- Verify benefits for every patient before their first session. Confirm that their plan covers telehealth mental health services and check for any specific limitations.
- Work with a billing professional who has experience with telehealth to ensure accurate claim submissions.
3. Failing to Document Sessions Properly
Inadequate or incomplete documentation can result in claims being denied during audits or reviews. Telehealth services require the same level of documentation as in-person visits, including details about the session and the technology used.
How to Avoid It:
- Use detailed session notes to document clinical relevance, patient consent for telehealth, and the platform used for the session.
- Train your team on the importance of compliance and thorough record-keeping.
4. Overlooking Credentialing Requirements for Telehealth Providers
For group practices, all therapists offering telehealth services must be credentialed with the insurance companies they bill. Neglecting this step can lead to delayed or denied payments.
How to Avoid It:
- Ensure all practitioners in your group are properly credentialed for telehealth services before they begin seeing patients.
- Partner with a credentialing expert to streamline the process.
5. Incorrectly Applying Telehealth Regulations Across State Lines
Providing telehealth services across state lines introduces additional legal and billing challenges. Each state has its own telehealth regulations and requirements for licensure and reimbursement.
How to Avoid It:
- Confirm licensure requirements for every state where your patients are located.
- Review the telehealth billing policies specific to each state and insurance provider.
6. Neglecting to Track Claim Denials and Rejections
Denied claims are a reality in medical billing, but failing to address them promptly can lead to revenue losses. Many practices overlook denials or lack the time to follow up.
How to Avoid It:
- Implement a denial management system to track and resolve rejected claims quickly.
- Regularly audit your billing processes to identify recurring issues.
7. Failing to Update Telehealth Billing Practices
Telehealth policies, codes, and regulations are constantly evolving, particularly as telehealth becomes more mainstream. Sticking to outdated practices can result in noncompliance and lost revenue.
How to Avoid It:
- Stay informed about updates from organizations like CMS, the AMA, and private insurers.
- Invest in ongoing training for your billing staff to keep up with industry changes.
8. Trying to Handle Billing Without Professional Help
Running a group telehealth practice is demanding, and managing billing on top of patient care can lead to errors and burnout. Many practices lose revenue by attempting to handle billing internally without the proper resources.
How to Avoid It:
- Partner with a billing company specializing in mental health and telehealth services.
- Delegate billing tasks to professionals so you can focus on providing quality care to your clients.
Final Thoughts
Telehealth billing is complex, but avoiding these common mistakes can save your group practice time, money, and frustration. By staying informed, using the right tools, and partnering with experts, you can ensure your billing processes run smoothly, allowing your practice to grow and thrive.
If billing feels like a burden, Anchor Point Billing Solutions is here to help. We specialize in mental health billing for telehealth group practices, handling the complexities so you can focus on your clients.