Behavioral Health & Psychiatric Billing — Remote RCM

Open to new client engagements

Billing built around IOP, PHP, TMS, and psychiatric care.

Behavioral health billing isn't general medical billing with a different diagnosis code — it runs on its own rules: per-diem and unit-based coding for IOP/PHP, recurring prior authorizations for TMS, and payers that deny more often than they should. I handle the full cycle for U.S. mental health and psychiatric practices, from eligibility check to posted payment.

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03Years in dedicated RCM

4Behavioral health modalities covered

08+EHR / EMR platforms

16+Payer & payment portals

Modalities I Bill For

Each of these has its own coding, authorization, and documentation quirks. Here's what I handle for each.

IOP — Intensive Outpatient

Per-diem/unit-based billing, authorization tracking across renewal periods, and level-of-care documentation that matches what payers require to approve continued treatment.

H0015Per-Diem

Auth confirmed → daily units billed → renewal tracked before it lapses

PHP — Partial Hospitalization

Higher-acuity level-of-care billing with its own authorization cadence and stricter medical-necessity documentation — reviewed against payer policy before submission, not after a denial.

H0035Level-of-Care

Medical necessity documented → claim billed → concurrent review tracked

TMS — Transcranial Magnetic Stimulation

Recurring prior authorizations, session-count tracking against payer limits, and appeals when session totals or documentation get questioned — the most denial-prone modality in the mix.

90867Prior Auth

Auth secured → sessions tracked → appeal filed if count is disputed

Psychiatry & Mental Health

Eligibility verification, claims, and AR follow-up for individual therapy, medication management, and general outpatient mental health visits — the baseline the other modalities build on.

9083790792

Eligibility checked → claim submitted → follow-up until resolved

Behavioral Health Denials & Appeals

Behavioral health claims see a disproportionate share of denials — auth mismatches, level-of-care disputes, timely filing. Every denial gets a root cause, an appeal, and follow-through to payment.

277Reconsiderations

Denial received → root cause found → appeal filed → tracked to payment

Prior Authorization Tracking

IOP, PHP, and TMS all run on authorization windows that lapse if nobody's watching. I track renewal dates and follow up before care — or payment — gets interrupted.

Pre-AuthRenewal Tracking

Auth window opened → renewal flagged early → resubmitted before it lapses

Why A Behavioral-Health-Specific Biller

General medical billers can submit a claim. Behavioral health billing asks more than that — it asks whether the level of care matches the documentation, whether the authorization is still active, and whether the payer's own policy on session counts or per-diem limits was actually checked before the claim went out.

That's the gap I work in. Trained specifically on IOP, PHP, TMS, and psychiatric billing rules, on top of the general RCM cycle — insurance verification, claims, denials, appeals, payment posting — so nothing about the specialty side gets treated as an afterthought.

Built around behavioral health rules

Per-diem/unit billing, level-of-care documentation, and authorization renewal cycles handled as the default, not a special case.

Denial-aware from submission

Behavioral health claims deny more often than most specialties — claims are checked against payer policy before they go out, not just appealed after.

Real U.S. time zone overlap

Structured around U.S. business hours, so authorization follow-up and payer calls happen while your practice is actually open.

Frequently Asked

Do you know how to bill IOP and PHP units correctly?

Yes — IOP and PHP billing has its own rules around per-diem and unit-based coding, prior authorization renewals, and level-of-care documentation that general medical billers often get wrong. That's my core specialty.

Have you handled TMS prior authorizations and denials?

Yes. TMS almost always requires prior authorization and frequent medical-necessity documentation, and denials are common when session counts or documentation don't line up with payer policy. I track authorizations and appeal denials as part of the normal workflow.

Do you work with behavioral health specific EHR/EMR systems?

Yes — InSync Qualifacts, Prompt EMR, Kareo/Tebra, CollaborateMD, and other systems commonly used by behavioral health and psychiatric practices.

Can you handle behavioral health specific denials and appeals?

Yes. Behavioral health claims see a disproportionate share of denials tied to authorization mismatches, level-of-care disputes, and timely filing — I review, appeal, and track each one through to resolution.

Can you handle full-time, part-time, or short-term contract work?

Yes. I've done all three, and I'm happy to start smaller and scale up as we figure out what your practice actually needs.