Substance Abuse & Rehab Medical billing and coding is a highly specialized and time-intensive process, yet it’s essential for the financial health of any treatment or rehabilitation facility. As insurers and government payers continue to reduce reimbursements while operational costs rise, efficient billing practices have become more critical than ever. Many centers focused on substance abuse and rehab have discovered that outsourcing billing services and claims management to experienced professionals is the most effective way to ensure accuracy, compliance, and steady revenue flow.
The Affordable Care Act’s rule that health insurance must cover mental health and substance abuse treatment, as well as pre-existing conditions, has helped many people access the care they need. However, it has also led to high deductibles, which can be a challenge for addiction treatment centers since most patients in need of rehab have lost their income.
Substance abuse treatment takes a significant amount of time, which makes it costly. Since charges are generally bundled into codes that cover the entire program, or most of it, one unpaid claim can result in a loss of up to $30,000. This makes it imperative that rehab medical billing services be handled by professionals who have a system in place to ensure that no claims fall through the cracks.
When a rehab or treatment center is out of network with the payer, payments often go to the patient instead of the provider. While the patient is responsible for paying the center’s bill, this frequently doesn’t occur. Sometimes, this is even used to pressure providers into joining payers’ networks and accepting their fees. To address this, the substance abuse billing system needs to ensure an assignment of benefits is completed and verified before admitting the patient.
Insurers are required to cover treatment if it's deemed medically necessary, but they can deny claims if the medical necessity isn't properly demonstrated due to missing or incorrect coding in the claim. This is why outsourcing insurance billing for drug rehabilitation centers to a company specializing in rehab medical billing and Revenue Cycle Management is often the best choice.
Mon – Fri
08.00 -18.00
Sat – Sun
09.00 -15.00
Rehabilitation medical billing and coding, like in any medical field, is complex and time-consuming but essential for the success of any treatment or rehab facility. With insurers and government payers reducing payments and expenses increasing, efficient medical billing for rehab has become more crucial than ever. Many treatment and rehab centers have found that outsourcing billing services and claims management to professionals is the most effective solution.
The Affordable Care Act’s rule that health insurance must cover mental health and substance abuse treatment, as well as pre-existing conditions, has helped many people access the care they need. However, it has also led to high deductibles, which can be a challenge for addiction treatment centers since most patients in need of rehab have lost their income.
Substance abuse treatment takes a significant amount of time, which makes it costly. Since charges are generally bundled into codes that cover the entire program, or most of it, one unpaid claim can result in a loss of up to $30,000. This makes it imperative that rehab medical billing services be handled by professionals who have a system in place to ensure that no claims fall through the cracks.
When a rehab or treatment center is out of network with the payer, payments often go to the patient instead of the provider. While the patient is responsible for paying the center’s bill, this frequently doesn’t occur. Sometimes, this is even used to pressure providers into joining payers’ networks and accepting their fees. To address this, the substance abuse billing system needs to ensure an assignment of benefits is completed and verified before admitting the patient.
Insurers are required to cover treatment if it's deemed medically necessary, but they can deny claims if the medical necessity isn't properly demonstrated due to missing or incorrect coding in the claim. This is why outsourcing insurance billing for drug rehabilitation centers to a company specializing in rehab medical billing and Revenue Cycle Management is often the best choice.
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Contact us : +1 862 413 4315
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