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PSYCHIATRIC BILLING SERVICES
Complex Coding
Within the codes for psychiatry, there are many different codes for similar services. For example, you are required to enter different codes to indicate whether an evaluation was done by a medical or non-medical provider. This makes it difficult for inexperienced coders to properly fill out claim forms.
Referrals Are Usually Required
Patients will usually have to see a general practitioner to get a referral to see a psychiatrist, so it is important to make sure the referral has been filed with the payer prior to seeing the patient. Doctors’ offices often try to keep things simple for patients by referring to specialists in the same insurer’s network so treatment will be covered, which means that psychiatrists need to be credentialed with as many insurers as possible in addition to the government payers.
Complicated rules for coverage
All plans offered in the Health Insurance Marketplace are required to include mental health and substance use disorder services by the Affordable Care Act (ACA), but it does not detail what must be covered, so coverages vary greatly between plans and the same carrier may have Medicare covers mental health care under separate parts: Part A for hospital insurance, Part B for Medical insurance and Part D for prescription drug coverage. Since patients may be enrolled in different options for each—and have supplemental insurance—billing is very complicated and requires specialized training and experience. different policies from state to state.
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AFKRCM Manages Your Revenue and Keeps Patients at the Center of Your Practice
Psychiatry serves a high-need population and can be taxing for medical staff as well as doctors. Administrative stress on top of that just doesn’t make sense when it can be avoided, and outsourcing revenue cycle management to AFKRCM provides that relief.
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