Billing Service

Behavioral Health Billing Services

AdvantEdge helps Behavioral Health agencies improve their financial performance. As an AdvantEdge customer, you can expect:

  • Increased cash flow and no cash-flow interruptions due to staff turnover
  • Reduced administrative staff and related expenses
  • Less hassle
    • We provide the billing software and front end software for you to use
    • No need to constantly train staff on billing complexities
    • We deal with insurance companies on your behalf
  • You can focus on client care instead of billing
  • A variable cost of billing rather than a fixed (and growing) expense

Can ACOs Cross the Chasm? Download Whitepaper

The Behavioral Health Revenue Cycle Process 

Using our software, you have total flexibility in scheduling clients and providers. Scheduling can include recurring appointments and groups. Once you enter the client’s demographic information, our software alerts you to any missing information and assists in assessing eligibility and obtaining pre-auth’s or other needed approvals before the client arrives. After seeing the client, when you mark the appointment as complete, our center can begin the billing process.

Your staff has visibility into the number of authorized sessions remaining, clients where additional information is needed and outstanding client balances due.

Each potential claim is prepared and scrubbed to identify potential missing information. Our charge entry team will flag any items where additional information is needed from the provider or client. Once the claim is clean, it will be immediately filed with the appropriate payor. Payments are posted as they are received and checks deposited into your bank account where EFT payments are not possible. All EOB information is also posted for use with secondary claims, denials and in payment trends analysis.

Denial Management
The most difficult, and most important part of the billing process is working each denial. This is where the primary difference exists between typical financial performance by an in-house staff or a billing company and top performers, such as AdvantEdge.

Denial management starts by routing denials immediately to the right person. For example, if it is a medical necessity denial, then the provider must be contacted for the supporting information needed for an appeal. If the denial relates to patient information (the most common denial type) then a phone call needs to be made. Timely response is essential due to timely filing requirements. An additional element is analyzing payments that were made to identify potential underpayments or “partial denials.” This is another area differentiating top performers from the rest.

Each agency needs to see its financial results on a regular basis: in some cases, weekly or monthly; in many cases daily. At AdvantEdge, our customized workflows provide the reports and information that your agency needs, on your schedule. This includes the HIPAA-compliant online dashboards and reporting portal.

Of course, performance isn’t the only criteria that agencies use to evaluate their billing service partner: responsiveness to questions, unique requirements and personal attention are all part of AdvantEdge ClientFirst Service.

The entire revenue cycle process is highly dependent on technology to collect information, send it securely to the appropriate person(s), and receive information back. At AdvantEdge, we have been developing and using Behavioral Health technology for over 20 years: something very few Behavioral Health billing companies can match. This ability to quickly adapt to payor changes and government regulations provides AdvantEdge clients confidence that their claims are being filed compliantly and effectively.