May 30, 2022

Should We Outsource Behavioral Health Claims Management?

Tired woman lays her head on her arm on top of a table as she uses the calculator on her iPhone to calculate health claims

There are a lot of things to love about working in the behavioral health field. Not every job can say that they truly change people’s lives. But not everything feels as rewarding. Behavioral health claims management is not usually on the list of things a program loves doing. Perhaps it is time for your facility to consider outsourcing the billing and claims work that is tying up your program’s resources and time. Here are a few questions to see if outsourcing is right for you.

Are my staff experts in billing, utilization management and collections?

Your support staff is good at their jobs. That’s why you hired them. It’s also nearly impossible to be experts at everything. We recognize that and it’s part of how we do business. Nextus focuses solely on behavioral health programs. This allows us to stay current on changes by carriers and governments that directly impact your revenue cycle.

Are you getting reimbursed as fully as you should be?

Because our focus is on behavioral health, we can make sure your reimbursement is maximized. Our internal systems and processes were developed over time with feedback from clients like you. This has led to our clients enjoying a 99% first-pass claim acceptance rate. We continually evolve with changes in the industry so that our clients get their reimbursements in a timely manner.

For that 1% that gets rejected, we pursue it…relentlessly. Our position is that if the claim has not been paid, we are still pursuing it.

Does my staff have time to train on new changes?

If your program is like most, your staff is pretty busy. Finding time for them to train on changes from the carriers or new procedures can be very difficult. Perhaps it’s time to consider outsourcing your revenue cycle management instead of adding one more thing to an already full plate. Our team of experts can give you back time to do the things you love and are experts at doing.

How good is the utilization review at my facility?

Our Utilization Management team utilizes years of experience in all clinically based training. This allows us to conduct efficient and timely reviews, using our internal systems. We constantly implement industry best practices in behavioral health claims management to ensure that your documentation enjoys increased approvals. Our accuracy and timeliness provide your program with more efficient results. We will utilize and update your EHR/EMR system to provide real-time authorizations. Our 99% first-pass claim acceptance rate shows the efficiency and accuracy of our system.

What could I do with the extra time?

Billing, collections, utilization management and document management all take time. We help you and your staff get back that time so that you can put it to other uses. Maybe that is patient care or maybe it is self-care. Whatever you decide to do with it is your business. Our business is to get that time back for you and we do that very well. 

If you would like to discuss how Nextus Billing Solutions can help your Behavioral Health claims management, schedule a consultation with us. We would appreciate the opportunity to learn about your needs and how we can help your program thrive.