Medical billing is a challenge for many counselors and healthcare providers alike, as it requires an extremely specific and detailed knowledge base. Because of the difficulties providers face with medical billing, it is not uncommon for providers to recoup up to 20% less than what they are due (and only after lengthily payment delays). In addition, medical billing is doubly difficult for small group and solo-practices, as reputable medical billing services are often uninterested in serving those smaller accounts.

A mental health professional’s job is important. A counselor’s job is important. But there is a behind the scenes job that is just as important: the medical billing team. The counselor and therapist each have important responsibilities, but they need help completing their jobs.

A counselor is only as good as their medical billing.  If the medical billing is slow, the patients may become impatient, but even more, the counselor may not get paid. A counselor needs someone to make sure that claims get done properly, and correctly. Being up to date with insurance companies is extremely important – it means getting paid on time. 

Medical Billing is an administrative role that works with the insurance companies (for your payments) and with the clients (to get information and help resolve issues).

Unfortunately, collecting insurance payments is no easy task. In fact, many medical practices collect less that 80 percent of the money they’re owed from insurance companies, and it’s not uncommon for even small practices to have hundreds of thousands of dollars outstanding in their accounts receivable reports.

Medical Billing is a challenge in any medical field, whether you are a PCP (Primary Care Provider), Chiropractor, or …fill in the blank.

However, mental health professionals seems to top the list when it comes to difficulties recieving reimbursement from insurance companies. There could be many reasons for this–the type of claims that are filed, the frequent need of pre-authorizations for sessions, the fact that insurance companies often outsource their mental health benefits to other insurance companies (for examples, Blue Cross might outsource their Mental Health Benefits to Magellan).

However, one major reason that many mental health practices don’t receive the revenues their due is because the staff (both the clinicians and the administrative staff) are flat-out overworked….and medical billing is not their specialty (okay, that’s really 2 reasons).

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Dr. Anthony Centore

Anthony Centore, PhD

Anthony Centore, PhD, is Founder and Chair at Thriveworks — a counseling practice focused on premium client care, with 340+ locations across the US. Anthony is a Private Practice Consultant for the American Counseling Association, columnist for Counseling Today magazine, and author of "How to Thrive in Counseling Private Practice". He is a multistate Licensed Professional Counselor (LPC) and has been quoted in national media sources including The Boston Globe, the Chicago Tribune, and CBS Sunday Morning.

Check out “Leaving Depression Behind: An Interactive, Choose Your Path Book” written by AJ Centore and Taylor Bennett."