Substance Abuse And Rehabilitation Centers Billing Services
WeCare’s Substance Abuse Medical Billing Services
Rehabilitation medical billing and coding, like in any field of medicine, can be complex and time-consuming, yet it is essential for the success of any rehab or treatment facility. In a landscape where insurers and government payers are looking to reduce payments and expenses continue to rise, efficient medical billing for rehab has become more critical than ever. Many treatment and rehab centers have found that outsourcing rehabilitation medical billing services and claims management to professionals is the optimal solution, as it can help maximize revenue and streamline the billing process.
Rehab Centers Income Issues
The Affordable Care Act expanded coverage for mental health and substance abuse treatment but introduced high deductibles, presenting challenges for addiction treatment center billing, as many patients seeking treatment have lost their income.
High Ticket Losses
Substance abuse treatment is a time-intensive process, and the associated costs can be significant. As charges are often bundled into codes covering the entire program or most of it, a single unpaid claim can lead to a loss of up to $25,000. This underscores the importance of entrusting rehab medical billing services to professionals who have established systems to prevent any claims from slipping through the cracks, ensuring the financial stability of treatment and rehab facilities.
Payments Sent To Patients
When a rehab or treatment center is out of network for a payer, payments may end up being sent directly to the patient rather than the service provider. While the patient is responsible for paying the center’s bill, this doesn’t always happen. This situation can even be used as leverage to incentivize providers to join payers’ networks and accept the offered fees. Therefore, in the substance abuse billing system, it is crucial to ensure that an assignment of benefits is properly executed and attested to before accepting the patient, thereby helping to prevent payment complications and financial challenges for the treatment center.
Denial of Medical Necessity
Insurers are required to cover treatment if it is deemed medically necessary, but they may deny claims if the necessary coding is not correctly included in the claim, leading to a lack of demonstrated medical necessity. This underscores the importance of outsourcing drug rehabilitation centers’ insurance billing to a dedicated company that specializes in rehab medical billing Revenue Cycle Management. Such specialized expertise can help ensure that the necessary coding is accurately and comprehensively included in the claims, increasing the likelihood of successful reimbursement for medically necessary treatment.
Certified Medical Coders And Billers For Substance Abuse Billing
To ensure the sustainability of your treatment or rehab center, it's crucial not to leave money on the table. WeCare offers a dedicated team of certified medical coders and billers who have extensive experience with drug rehab insurance billing. They are adept at ensuring that clean claims are filed, significantly reducing claim rejections and denials. In the rare cases when rejections or denials do occur, our system is designed to track and swiftly address them, resubmitting claims with necessary modifications.