There are several steps healthcare providers can take to avoid the three most common billing errors for behavioral health services, according to a CMS report.
"The risk of improper payments made to behavioral health providers is real and can pose problems for the provider," said CMS.
The three most common types of behavioral health billing errors involve documentation, the number of units billed and policy violations.
Here are four tips to avoid these common billing errors, according to CMS.
1. Documentation errors occur when claims are missing progress notes, physician orders or do not include a plan for long-term care that outlines specific services. "Specific documentation should include time sheets, encounter notes, time and place of service and evidence that a professionally led care team that included the patient and their family developed the plan," according to CMS.
2. To avoid errors involving the number of units billed, use proper codes based on the time spent on therapy. For example, if a single treatment lasted 15 minutes, do not use a 1-hour code to bill the treatment, said CMS.
3. Policy violations occur when healthcare providers fail to record progress notes in a timely manner or bill for services that Medicaid does not cover. These errors also occur when providers bill for services that require prior authorization without first receiving authorization. To avoid policy violations, it is vital providers "understand what services are covered through the state Medicaid plan, waivers and demonstration projects before providing those services to Medicaid beneficiaries," according to CMS.
4. CMS also recommends providers implement a voluntary compliance program and seek state and federal educational opportunities on proper billing practices to reduce billing errors.
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