Authorization Lifecycle Management
Extended treatment plans require initial authorization, concurrent re-authorization and discharge documentation aligned to payer medical-necessity criteria. We track every authorization from request through expiration so sessions aren't delivered without coverage.
- Initial and concurrent authorization tracking
- Medical-necessity documentation alignment
- Auto-alerts before authorization expiration
- Payer-specific clinical criteria mapping
Session-Based CPT Coding
90791, 90832, 90834, 90837, group therapy codes and add-on codes for crisis or family — each with time-component documentation requirements. Our coders validate session duration documentation before claim submission.
- Time-component documentation validation
- Add-on code application (interactive complexity, crisis)
- Group vs. individual therapy distinction
- Telehealth modifier and POS coding
Parity-Law Reimbursement Defense
Mental Health Parity Act disputes are common — payers apply restrictions to behavioral claims they wouldn't apply to medical/surgical. We file parity-law appeals when warranted and document the comparable medical/surgical treatment for defense.
Operational Challenges We Solve
- Expired authorizations blocking already-delivered care
- Session-time documentation insufficient for code billed
- Parity-law violations going unappealed
- Substance use program billing complexity (H-codes)
- Telehealth POS and modifier errors
- Out-of-network single-case agreement coordination
Discuss Your Organization's Needs
Speak with a specialist about how our RCM workflows adapt to billing services for behavioral health providers.
Contact Our Team